Do They Always Test For Lada?

I get the impression from comments on this forum that things are changing: there are a number of threads starting "I was diagnosed today but don't know yet which type."
However, this does not appear to be common enough for it to be the norm.

When I was diagnosed, there was no such test done.
My diagnosis was based on "you're too thin to be type 2"!
In my case the diagnosis was correct but I'm not sure it was for the right reasons.

coconutjob said:

Hi, does the test for diabetes routinely test for LADA?

When I went to the doctor & said I thought I was diabetic he took my symptoms & said if I am it’ll be type 2 then I did the blood tests.

I was very slightly overweight (I lost a bit on lchf so now I’m thin) & it’s a lot in my family.

I’m wondering if LADA was ruled out. I’d prefer to be type 2 but I’d also like to know what I’m up against if it turns out to be more progressive.

I will ask at my next hba1c but I know I’ll be fobbed off & told it can’t be because of my age etc (they’re not very knowledgeable here & I watched my father get worse for years & die)

So is it standard to test for LADA?

Thanks

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Hi, I was diagnosed with type 1 LADA about 2 months ago. My symptoms were quite prominent, I lost 4 and a half stone in 9 months. While the weight loss was a bonus the thirst and increased trips to the bathroom weren't .

In terms of being tested for me I had a hba1c done and with in a week they had me in the GP office again with a result of 131. They said to me that i was definitely diabetic. But due to my symptoms gradually coming on over 12-9 months that I was more likely a type 2. They took more bloods to check for antibodies which they said will be to determine my type. In my case it was type 1. I can't say it's not been a rollercoaster of emotions but in a short time I've got a good understanding of what I need and what I'm doing.

That was my journey anyway. I don't know how different areas go about testing. Most will have different experiences to me.

I was diagnosed 4 years ago, long before the media started all the rubbish about obesity being a cause of T2.
I knew nothing about diabetes.
I asked my nurse how she knew I was T2. She said because my HbA1c wasn't very high, my FBG test was only 7, no glucose in my urine, and I was feeling very well. She said had I been T1 I would have had higher levels and been very poorly.

No, it's not standard to test for T1 (LADA) upon diagnosis with diabetes, unless you land in hospital with ketoacidosis.

Bluetit1802 said:

I asked my nurse how she knew I was T2. She said because my HbA1c wasn't very high, my FBG test was only 7, no glucose in my urine, and I was feeling very well.

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Which is exactly what LADA looks like if caught early.

Bluetit1802 said:

I was diagnosed 4 years ago, long before the media started all the rubbish about obesity being a cause of T2.
I knew nothing about diabetes.
I asked my nurse how she knew I was T2. She said because my HbA1c wasn't very high, my FBG test was only 7, no glucose in my urine, and I was feeling very well. She said had I been T1 I would have had higher levels and been very poorly.

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LADA fits that list just as well, but I don't see the point of doing the antibody unless someone can't control with diet and the normal type2 drugs. But i do think everone with type2 should be testing thier own BG at least once a weak, to cover the risk.

They don't test routinely. My GP sent me to the hospital for further tests because my onset was quite quick, because of my strong family history, because my blood glucose was regularly in the 20s despite 3 months on a low carb but not keto diet, because I was already thin and had lost more weight. I think if you're concerned that your diagnosis is wrong, then do pester your GP for antibody and c peptide testing. In my area this has to be done by a consultant.

One issue is that it can take some time until the antibody are at a high level in LADA and people without type1 can have low levels that the are not detectable on the next test. But if low carb plus metformin is not working then the test would be very senible.

They dont test routinely. My GP was convinced I was type one (I was 43 on diagnosis) but the practice nurse told him I couldn't be because I was too old. My hba1c was 147 and I was barely 8 stone.

Luckily when they put me on gliclazide they also gave me a monitor and for the next week the number of glic tablets went up, but the lowest the meter for to was 26!

So I ended up in A&E. At some point they took bloods for antibodies and I had high results on two.

Circuspony said:

They dont test routinely. My GP was convinced I was type one (I was 43 on diagnosis) but the practice nurse told him I couldn't be because I was too old. My hba1c was 147 and I was barely 8 stone.

Luckily when they put me on gliclazide they also gave me a monitor and for the next week the number of glic tablets went up, but the lowest the meter for to was 26!

So I ended up in A&E. At some point they took bloods for antibodies and I had high results on two.

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It's like what I said everyone's journey to their diagnosis is different. My bloods at first we're in the high 20's and low 30's. 2 months in my average is about 6. I don't know much about type 2 in terms of control and meds. But different types have different things you can take as positives. That's one of the key things that has helped me. Yes I'm a type1(LADA) and multiple daily injections look grim... But I can eat more or less what I want. And after sinking a pack of 3 krispy kreme donuts the future isn't looking too bleak with a little bit of understanding.

Circuspony said:

They dont test routinely. My GP was convinced I was type one (I was 43 on diagnosis) but the practice nurse told him I couldn't be because I was too old. My hba1c was 147 and I was barely 8 stone.

Luckily when they put me on gliclazide they also gave me a monitor and for the next week the number of glic tablets went up, but the lowest the meter for to was 26!

So I ended up in A&E. At some point they took bloods for antibodies and I had high results on two.

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With levels like that they should have started you on inslin while waiting for the test results. Stockport has a "phone a consultant" service GPs can use to get advice to try to prevent this type of error. I was told by a consultant that a GP is unlikey to see more then 1 or 2 adult type1 new cases in their life.

ringi said:

With levels like that they should have started you on inslin while waiting for the test results. Stockport has a "phone a consultant" service GPs can use to get advice to try to prevent this type of error. I was told by a consultant that a GP is unlikey to see more then 1 or 2 adult type1 new cases in their life.

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I only live 15 mins from the hospital and the diabetes team were furious the GP hadn't phoned them when he got my blood results. The consultant later said that GPs should send anyone with high sugars and ketones to A&E.

Circuspony said:

I only live 15 mins from the hospital and the diabetes team were furious the GP hadn't phoned them when he got my blood results. The consultant later said that GPs should send anyone with high sugars and ketones to A&E.

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My GP sent me straight to A&E. Phoned for the ambulance while I was sitting in front of her.

I think I had been diabetic for over a year before I mentioned it to my doc though. BG was over 30, ketones off the scale of the strips, but I felt fine. Until they started treating me, then I got worse and worse. I did not get on with the consultant, so when I went home I binned all the drugs and insulin. At my 3 month check with the dsn he freaked out and told me if I was t1 I wouldn't be alive.

Definitely a slow-start type lada, but he ordered c-pep and gad tests to be sure. It makes sense to me to let a dsn order the tests, so when you do see a consultant you're not wasting time.

coconutjob said:

Thanks for this, mine was 57 but I was feeling terrible all the time with headaches, nausea & fatigue, I still feel sick a lot. I’m doing the low carb diet and at first got my blood down to 5.5 & I was feeling good, now I’m struggling to get my blood down, it’s now in the 8s & 9s all the time & I’m really tired so I feel like it’s progressing. I don’t want to go on meds so I’ve been trying really hard.

Was not told to test (as is the norm it wasn’t mentioned at all) so lucky I’ve got so many diabetic relatives.

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Why wouldn't you want to go on meds if diet can't do the job? You might feel better with better blood sugars and you might reduce the risk of diabetic complications.

The antibody testing is not done until after you have been diagnosed as diabetic. Even then, it is not always done. There are some sites that say the differential diagnosis is just a matter of intellectual curiosity. They say to treat you as T2 until you need insulin and then you are T1. Personally I disagree.

If you are LADA, you are insulin sensitive with erratic and diminishing insulin production, not insulin resistant with excessive levels.
T2 drugs to stimulate insulin production are not necessarily in your best interest. They may burn out what beta cells you still have producing insulin.
Drugs to increase your insulin sensitivity may not work. My labs show I am extremely insulin sensitive. Trying to increase my sensitivity would be pointless.
When you need insulin as a LADA, they may play around with drugs that won’t work because they would like to try everything else before putting a T2 on insulin. LADA is not T2. That playing around could land you in the hospital on an insulin drip.

If you think you may be LADA insist on getting the diabetes antibodies panel and the c-peptide test which indicates how much insulin your body makes and is not distorted by insulin antibodies if you have them.

ringi said:

I was told by a consultant that a GP is unlikey to see more then 1 or 2 adult type1 new cases in their life.

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Wow! I guess I really am a Special Snowflake .

coconutjob said:

If I have to I will, but I’d much prefer diet control. I think meds solve one problem but create others that they end up throwing more meds at.

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I fully agree as long as diet control does the job. You wrote:

coconutjob said:

I still feel sick a lot. I’m doing the low carb diet and at first got my blood down to 5.5 & I was feeling good, now I’m struggling to get my blood down, it’s now in the 8s & 9s all the time & I’m really tired so I feel like it’s progressing.

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So you already feel sick and tired with high bg. Meds might create other problems, but they might also make you feel much better and reduce your risk of diabetic complications.
Good luck and I hope you'll feel better soon, with or without meds!

Kailee56 said:

If you are LADA, you are insulin sensitive with erratic and diminishing insulin production, not insulin resistant with excessive levels.

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Lot of people with LADA are inslin resistance, there is nothing stopping someone having type2 and LADA at the same time. Hence if the NHS was to do more tests as standard, I think the most useful would be fasting inslin, so that someone's inslin restiance can be tracked.