Confused about my Type 2 diagnosis

[Skys]

Hi there, brand new member here, I'm a Brit living in Costa Rica, 41 years old.

Last December I admitted myself to the hospital because I had lost several kilos and had the classic diabetes symptoms (frequent urination, constant thirst etc) The doctor ran some blood tests on me and told me my hA1c was 10.6 with a blood glucouse of 340 mg/dL, he instantly told me I was a type 2 diabetic. I asked him if it was normal for a type 2 to lose weight, and he explained that it can happen sometimes with type 2. At the time I was slightly overweight with a bmi of 28. He sent me home with a packet of SGLT2 inhibitors (Dapagliflozin) and within three days my glucouse levels had droped to the 80 - 150 mg/dL range, so I assumed he was correct about the diagnosis.

Fast forward six months, my glucose levels were stable but I was still losing weight (another three kilos), I had a second appointment with the same doctor and I mentioned the weight loss but he didn't seem to be bothered by it which surprised me, he was just happy to see my glucose levels were stable and kept me on the same medication.

Feeling a bit frustrated, I decided to do my own research on the internet. I came across some info about LADA diabetes and watched many videos on youtube and felt that this made more sense in my case. So I went to a private lab here in C.R and did my own GAD65 antibody test and C-Peptide with fasting insulin (three tests that the doctor never game me)

The results were:

GAD-65 15 UI/mL
C-Peptide 0.5 ng/mL
Fasting Insulin 3.3 μU/mL

According to the ranges, the GAD-65 test is postive for antibodies, however I see it's low compared to other cases I've seen which makes me wonder if they are high enough to be considered LADA. Since I never got tested for these antibodies when I was admitted to hospital I don't know if they were higher or lower during my hyperglycemia. Does this sound like a classic LADA case to you? I haven't been able to find a lab that tests for the other two antibodies common with Type 1/1.5.

I'm disappointed that my doctors here in Costa Rica have never even heard of LADA diabetes. I'm hoping that someone here can help me figure out what's going on

 

[CatsFive]

"my hA1c was 10.6"

I guess that is percent. 10.6% translates to around 90 in mmol/mol, which is what the UK and many other countries use. Plenty of T2 here have been diagnosed with a higher value, and in the UK it's the mainstay of diagnosis. And plenty of those T2 folks have got their HbA1c down to pre-diabetic or normal levels purely with a low carb diet.

Has he considered your continued weight loss might indicate you have another condition alongside the T2? I

 

[Antje77]

Does this sound like a classic LADA case to you?

Well done for doing your own research!

We can't diagnose on the forum. But I would get back to the hospital with your positive antibody results and lowish C-peptide, and see if you can find an endocrinologist.
LADA is T1, it only comes on slower than 'classic' T1 in children, and it's treated like T1 as soon as you need insulin. So if they don't really call it LADA in Costa Rica, just say you think you may have T1 instead of T2, no need to use the term LADA.

He sent me home with a packet of SGLT2 inhibitors (Dapagliflozin) and within three days my glucouse levels had droped to the 80 - 150 mg/dL range, so I assumed he was correct about the diagnosis.

Can you test for ketones?
Flozins hold a risk of DKA without having high blood glucose, especially in misdiagnosed T1s. Because of the normal BG levels, it's easy to overlook the possibility of DKA when a patient feels ill because this usually only occurs with very high BG levels.

Reminder: Flozins and the risks of diabetic ketoacidosis and Fournier’s

www.medsafe.govt.nz