1.5/LADA what should I be asking the GP?

I'm not type 1.5 so I do t feel confident in answering most of those questions. But you're in the right place and it's good you're being proactive about things!

With the ketones, if you're clear for now then you're good in the short term. Do you have a form of testing for ketones available to you? Personally my BG meter does it but I know most people still use urine sticks. If not you need to request them. When you BG is exceptionally high, or you have a fever or just generally unwell you should check for ketones

Hi,
Testing for the level of GAD antibodies is a good way of seeing if there is an autoimmune attack. They are the most common antibodies found in adults presenting with T1 or LADA. They aren't infallible, there are other antibodies which are sometimes tested for (they actually discovered a new one only a few years ago.) There are also some people who have no evidence of antibodies yet still have a form of T1 (Type 1b)
C peptide is a marker of the amount of insulin produced. Generally people with T1 will have low levels, people with T2 normal or high levels but someone with LADA who had an early diagnosis can have low normal levels and someone who has had T2 for a long time could also have low levels .
(ie it isn't definitive all the other aspects have to be taken into account)
From what I read some GPs have little knowledge of the 2 tests.

An HbA1c of 91 means you may have had average glucose levels of 14.1 mmol/l during the time before your test. This is far higher than the levels required to diagnose diabetes on an OGTT so to me there wouldn't be any point in having one. Unfortunately you definitely have diabetic levels.

Unless your GP proves to know a lot about diabetes then I think that pushing for a specialist appointment is probably the best thing you can do.
If the doctor hasn't given you a meter and strips I think that would be really important to discuss.
(if you haven't got a meter and he won't prescribe strips then I would get one myself and test as frequently as I could afford, watching for a rise to high levels, checking for ketones if glucose rise above 14mmol/l )

Treatment depends on correct diagnosis which is why it's good that you are questioning which type you have. There are other, albeit rarer, alternatives to LADA ( a form of T1) and T2 . That's why you need a specialist and appropriate tests.

Hi Rich,

I agree with the above in that a diabetic consultant is so much more informative than the GPs usually are, my GP surgery are not the best but my consultant is great!

I'm controlling only with Metformin at the moment, it's a really good drug and it basically helps your body to use the insulin you ARE producing whilst your still producing it! I have debated in my head time and time again whether I should go onto insulin to preserve my beta cells but one of the main things stopping me (other than my fear of injecting) is the lack of evidence that it actually preserves your beta cells...there is suggestions in the medical journals that it helps for the first 18 months but after that all LADAs basically end up the same so I really think its just a personal choice with LADAs about WHEN they go onto insulin as there is no IF....

With regard to the OGTT, I had a fasting BG of over 7 mmol on two separate occasions, by Hba1c was 82 and I tested positive for GAD65 antibodies so there was no need...the only time I think the doctors think its relevant to have one of these is when youre pregnant and when you have only slightly diabetic fasting BG levels which is quite common in LADAs (apart from me as my fasting are the worst of the lot!).

All in all I think you now have a very good idea of what to ask the doctor and good luck


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

I am 47 and had diabetes one and a half year back.Initially Type 2. But a quick check this April o C levels and GAD 65 showed that this has become Type 1.5 Or LADA. I am on Insulin Humalog25 and very fast in September the doses almost doubled after the so called honeymoon period. Now even with these doses, the sugar levels remain high about 8-13.