Finding Out If T1, T2, Lada, 1.5,3 Or?? Plus Maintaining Weight And Energy Levels.

[Geoffno6]

My DN reckons I’m T2, my GP reckons I’m T1, they’ve suspected this since June. My appointment with an Endocrinologist isn’t until November. So I splashed out £240 on a consultation with a diabetes specialist on Friday 14th. He has me in tomorrow for a blood test, so hopefully I might find out soon.

The low ish carb diet, some days under 20g rarely over 40g has me down from 18s in June at diagnosis to mainly 6s to 9s and Hba1c is down from 126 to 67.

My question is weight and energy related I’ve always been a strong and fit 14 stone 6 footer, now I’m struggling to stay above 12 stone and maintain energy levels. Has anybody had a similar experience? I do between 1 and 3 hours exercise per day so try and eat plenty to fuel that. I know my BG levels are helped by eating less but that makes me lose weight. Any comments/advice will be gratefully received.

 

[Guzzler]

It surprised me greatly just how much healthy fat I had to add to my diet to maintain weight. I added in extra protein, too and fingers crossed, have stalled the weight loss and have good energy levels. The extra protein had no negative affect on my bg levels.

Edited to add.

If it turns out that you have T1 or T1.5 then protein may become more of an issue wrt bg levels. Good luck.

 

[Geoffno6]

It surprised me greatly just how much healthy fat I had to add to my diet to maintain weight. I added in extra protein, too and fingers crossed, have stalled the weight loss and have good energy levels. The extra protein had no negative affect on my bg levels.

Edited to add.

If it turns out that you have T1 or T1.5 then protein may become more of an issue wrt bg levels. Good luck.

Mmm, when I eat a pile of egg and meat it does push up my BG. As my BP and cholesterol are fine I’ve been a bit blasé with fat. I’ll take your advice and hunt down more healthy fat foods.

 

[Canvaspic]

Hi, a fasting c-peptide may give you and your docs some more info regarding insulin production. Numbers above .88 usually mean insulin resistant, below .35 may lean towards low insulin production.
There is also a post meal c-peptide test, with different cutoffs.

 

[Geoffno6]

Hi, a fasting c-peptide may give you and your docs some more info regarding insulin production. Numbers above .88 usually mean insulin resistant, below .35 may lean towards low insulin production.
There is also a post meal c-peptide test, with different cutoffs.

Thanks for that @Canvaspic

 

[Diakat]

Has anyone done a GAD test?

 

[DCUKMod]

My DN reckons I’m T2, my GP reckons I’m T1, they’ve suspected this since June. My appointment with an Endocrinologist isn’t until November. So I splashed out £240 on a consultation with a diabetes specialist on Friday 14th. He has me in tomorrow for a blood test, so hopefully I might find out soon.

The low ish carb diet, some days under 20g rarely over 40g has me down from 18s in June at diagnosis to mainly 6s to 9s and Hba1c is down from 126 to 67.

My question is weight and energy related I’ve always been a strong and fit 14 stone 6 footer, now I’m struggling to stay above 12 stone and maintain energy levels. Has anybody had a similar experience? I do between 1 and 3 hours exercise per day so try and eat plenty to fuel that. I know my BG levels are helped by eating less but that makes me lose weight. Any comments/advice will be gratefully received.

I'd agree that if you are otherwise well on your LC diet, then you likely need to adopt the approach I call "balancing fats". That's what I do to maintain weight (from dropping further). Reading the low levels of carb you eat, you may be surprised just how much fat you will need.

To be clear, I'm not suggesting every coffee should be Bulletproof, or that you should be melting blocks of butter to smother your veggies necessarily (although if that floats your boat.....), but fattier meats, such as belly pork, slow roasted to create fabulous crackling (and snaffling more than your fair share of that deliciousness), a bit more lamb perhaps, and also the fattier fish all help.

I don't know whether you pay any heed to calories at the moment, but if you do, I suggest you forget that for now and concentrate on balancing your intake to maintain a static weight (+/- a natural day-to-day variance).

I'm quite a small person - 160cm, and weigh 48kg (+/- 1.5kg), and when I have looked at caloric intake it varies from 2000-2500 calories a day. I have maintained at that for almost 4 years, although it took some time of incremental changes to reach that point.

When I last saw an Endo (for a non-diabetic issue), his throw away comment to me was, "watch out for that LADA. It's a sneaker beggar".

I've stored the comment away, but hope it was made in the light of having seen very few people who have apparently reversed their T2 status, and maintained it for some time. Obviously, if my situation changes, I will bring his thoughts to the forefront of my mind, and deal with it best I can.

I do hope you get the answers you're seeking, but sadly, many cases of diabetes are not that cut and dried; particularly when diagnosed in middle age.

Edited to correct my calorie intake. 200 calories? Never in my healthy lifetime!!

 

[Geoffno6]

Hi, a fasting c-peptide may give you and your docs some more info regarding insulin production. Numbers above .88 usually mean insulin resistant, below .35 may lean towards low insulin production.
There is also a post meal c-peptide test, with different cutoffs.

My fasting c-peptide was 1.66 so it looks like I’m producing insulin. @Diakat my GAD was 0.70.

 

[Canvaspic]

My fasting c-peptide was 1.66 so it looks like I’m producing insulin. @Diakat my GAD was 0.70.

I should have said the units in my first post were 3.5nmol/l and .88nmol/l.
nmol/l = ng/ml / 3.

 

[KK123]

My fasting c-peptide was 1.66 so it looks like I’m producing insulin. @Diakat my GAD was 0.70.

Hi Geoff, glad you came back to us. What conclusion did the specialist come to? I ask because my C peptide & gad were pretty much like your figures.

 

[Diakat]

If you have had antibodies then T1 looks like the answer. So possibly slow developing LADA but overall T1.

 

[Geoffno6]

If you have had antibodies then T1 looks like the answer. So possibly slow developing LADA but overall T1.

Hi @Diakat, my result of les than 1 (0.70 U/ml) and suggests to me negative to T1 but do correct me if you think I’m wrong. The NHS guide said below 1 is negative, while low positive 5 to 30 is LADA but don’t quote me on the 5-30 being LADA.

 

[Geoffno6]

Hi Geoff, glad you came back to us. What conclusion did the specialist come to? I ask because my C peptide & gad were pretty much like your figures.

Im seeing the specialist on 28th Sept, so I’ll report back then but if I had to conclude now I’d say I’m Type 2.

 

[Geoffno6]

Here’s the document, I should’ve posted this earlierView attachment 28617

 

[Geoffno6]

 

[KK123]

Thanks for posting Geoff, I see your GAD was 0.70 (I misread), mine was 75.

 

[Diakat]

I was told antibody positive is T1. No values though.

 

[Geoffno6]

I was told antibody positive is T1. No values though.

Less than 1 is classed as negative and people who are positive generally have numbers in the 100s. But don’t trust me I haven’t researched it in depth and have no training in this v confusing subject.

 

[SOPHIE2006]

My DN reckons I’m T2, my GP reckons I’m T1, they’ve suspected this since June. My appointment with an Endocrinologist isn’t until November. So I splashed out £240 on a consultation with a diabetes specialist on Friday 14th. He has me in tomorrow for a blood test, so hopefully I might find out soon.

The low ish carb diet, some days under 20g rarely over 40g has me down from 18s in June at diagnosis to mainly 6s to 9s and Hba1c is down from 126 to 67.

My question is weight and energy related I’ve always been a strong and fit 14 stone 6 footer, now I’m struggling to stay above 12 stone and maintain energy levels. Has anybody had a similar experience? I do between 1 and 3 hours exercise per day so try and eat plenty to fuel that. I know my BG levels are helped by eating less but that makes me lose weight. Any comments/advice will be gratefully received.

Im in a similar situation to you. I was diagnosed in July this year. I presented with type 2 symptoms but when i was admitted to hospital they said it was more likely type 1. They mentioned something about an antibody test. Seeing my consultant in a few weeks and hopefully more answers

 

[EllsKBells]

@Geoffno6 @Diakat yes, below 1 is negative - the way antibody production in the human body works is that even the healthiest of healthy might have one or 2 floating around. In healthy individuals, most of them get nuked in the thymus, but a few slip through the net. For whatever reason, the nuking of these particular ones stops in T1s. You're also IAA2 negative according to those results, which are the two most commonly associated antibodies with T1. They can also test for ZnT8, but my understanding is that it isn't routinely done. Antibody production is a very confusing and messy subject, principally because there hasn't been much research done until fairly recently, and it's tricky to research - one of the reasons we hear about all these amazing studies in mice that don't then transfer to humans is that the mouse immune system is more different to that of humans than you might think.

Your c-peptide value suggests that you are making plenty of insulin - the c-peptide is a bit of protein that is produced when insulin is cleaved from its pre-cursor molecule pro-insulin, and secreted in equal amounts with insulin, so it tells you roughly how much insulin you are making, there or thereabouts.

Obviously I am in no way shape or form a medical doctor, but I would be inclined to agree with you that those results would seem to suggest T2.