Fed Up - LADA or not?

[Lesleywo]

A couple of weeks ago I had an HbA1c and my result was 5.7% and was marked as High, being one point over the top of the range (4.0-5.6). My fresh out of med school GP didn't say anything really about it and I didn't realise until I got home that the range had changed as the lab has changed the way they do the testing.

I had another appointment today and I asked her about it and told her my history of being GAD positive (even took copies of the 3 gad tests to show her); she is aware of my other autoimmune endocrine diseases (adrenal and thyroid). I asked her if I was LADA in the honeymoon period and her response was "you aren't diabetic. Your fasting numbers are good (4.5); if you were diabetic it would be 7". She said my numbers aren't diabetic .. well obviously they aren't but my point was, my HbA1c is now in the pre-diabetic range (only just but still up 3 points since last test 2 years ago and following low carb diet) so what am I? "Pre" what? She didn't really answer the question, just brushed me off but said I'm not LADA.

Seriously .. I felt like banging my head on her desk (or better yet, her head). Seeing my endo in two weeks.

 

[Indy51]

If you got a definitive diagnosis, what exactly in your life would change? It seems that you're already doing everything short of medication to keep things under control and your doctor is unlikely to prescribe anything. So it doesn't seem that "knowing" would change anything?

 

[Lesleywo]

If you got a definitive diagnosis, what exactly in your life would change? It seems that you're already doing everything short of medication to keep things under control and your doctor is unlikely to prescribe anything. So it doesn't seem that "knowing" would change anything?

Ah Indy ... knowing could change nothing ... or everything! Positive diagnosis would mean i didnt stray from my diet so often ...negative diagnosis would mean i could eat lots of nice fruit and bread and other carby treats.

I am the kind of person that doesnt like to be in limbo .. if i dont have lada why would i follow a low carb diet? I only do it because i think im delaying the inevitable. .. but if i dont have lada .... i feel there's a healthier way of eating and imagine all those yummy carbs i could have eaten ... and it was all for nothing!

 

[Diakat]

Well, you could eat the carbs, get the numbers up, go on insulin and then manage the cabs? Just saying...

 

[Lesleywo]

Well, you could eat the carbs, get the numbers up, go on insulin and then manage the cabs? Just saying...

So you are making the assumption i am LADA then?

 

[Daibell]

Hi. You may well become LADA one day as you have positive GAD but currently you show no signs of diabetes based on your BS so I would just test every few weeks or so with the meter to check you are stable and go back to the GP if you have a few 2-hour post-meal readings above 8.5mmol

 

[Geri0463]

A couple of weeks ago I had an HbA1c and my result was 5.7% and was marked as High, being one point over the top of the range (4.0-5.6). My fresh out of med school GP didn't say anything really about it and I didn't realise until I got home that the range had changed as the lab has changed the way they do the testing.

I had another appointment today and I asked her about it and told her my history of being GAD positive (even took copies of the 3 gad tests to show her); she is aware of my other autoimmune endocrine diseases (adrenal and thyroid). I asked her if I was LADA in the honeymoon period and her response was "you aren't diabetic. Your fasting numbers are good (4.5); if you were diabetic it would be 7". She said my numbers aren't diabetic .. well obviously they aren't but my point was, my HbA1c is now in the pre-diabetic range (only just but still up 3 points since last test 2 years ago and following low carb diet) so what am I? "Pre" what? She didn't really answer the question, just brushed me off but said I'm not LADA.

Seriously .. I felt like banging my head on her desk (or better yet, her head). Seeing my endo in two weeks.

Hi, what is LADA??

 

[Diakat]

So you are making the assumption i am LADA then?

I can't diagnose you.
I was playing devils advocate.

 

[azure]

Hi, what is LADA??

Late onset Type 1.

 

[librarising]

Hi, what is LADA??

Latent
Autoimmune
Diabetes in
Adults

Geoff

 

[DaftThoughts]

Ah Indy ... knowing could change nothing ... or everything! Positive diagnosis would mean i didnt stray from my diet so often ...negative diagnosis would mean i could eat lots of nice fruit and bread and other carby treats.

I am the kind of person that doesnt like to be in limbo .. if i dont have lada why would i follow a low carb diet? I only do it because i think im delaying the inevitable. .. but if i dont have lada .... i feel there's a healthier way of eating and imagine all those yummy carbs i could have eaten ... and it was all for nothing!

I know exactly how you're feeling. I don't like 'not knowing' things like this either, it drives me insane. I may not end up doing anything significant with the information, but if I know, I know!

I'm not a doctor giving you a diagnosis, but if I were in your shoes, I would interpret the results you received from the specialists as this: you are GAD positive based on the specific tests to determine this. That means your body is having the auto-immune response that all other LADA diabetics have too. Your values appear to be good, but slightly increased, because you are managing and delaying the development of the condition by removing stress from the pancreas with a LCHF diet. Your fasting values are great because of this, not because you aren't LADA. Your HbA1c is creeping up because LADA is a progressive condition that can't be stopped. Having great values is testimony to your great self-management, not so much a lack of your condition.

GPs are also not specialized in diabetes and often don't know anything other than the simple 'you're only diabetic if your numbers are 7 or higher' mantra. We all know it's not as simple as that, diabetes gets a crapton more complex than this, but a GP isn't a DSN or endo. (Mine refuses to answer diabetes related questions and refers me to my DSN and endo at all times because of this.)

Trust yourself in this situation. Do you interpret your results as you being LADA? Do you believe your self-management is giving you great numbers and buying you extra years before you progress to prescribed medication? You have all the facts on paper and you know your diet and exercise regime better than anyone else.

 

[Lesleywo]

Thank you @DaftThoughts for your insightful response to my dilemna. Finally somebody truly understands how i feel. I believe knowledge is power but sometimes ignorance is bliss and i sometimes wish i didnt know i was Gad +. But i do and i feel lucky because most folk dont know they are lada til they have full blown diabetes whereas i have the chance to delay the progression of the disease with diet well before things start to go awry.

I totally agree with your opinion on what is happening with my blood sugars. And i think it's pretty reasonable to want a diagnosis. Even if its not what i want to hear i will know, can take control and move forward, doing what i can to keep my blood sugar as low as possible.

I enjoy low carbing but, having studied nutrition, i dont believe it's the best diet for optimum health, though i do believe it's the best diet for diabetics, providing it includes plenty of vegetables and fibre.

Will be interesting to see what my endo has to say on the matter.

 

[Kristin251]

I believe I postponed my progression to LADA for many years eating low carb. But then things srarted to change. Meals got smaller, carbs got less, exercise raised me rather than lowered me. Everything I ate raised me you know your LADA, and you know you still have pancreatic function. As things start declining despite all your efforts you will notice and know what's going on and can get the meds you need. Most people aren't so lucky and don't find out until they've dropped shed loads of weight and feel miserable. At least now you know what to watch for.

 

[Daibell]

My route was similar to Kristin's. I ended-up on full Metformin, 320 mg Gliclazide and full Sitagliptin and still sugars sometimes in the 20s. It was obvious the Gliclazide was doing nothing and hence my pancreas had gone so low that there was little left to stimulate. It took around 10 years along this route. My stupid diabetes GP refused me insulin until a year later when, having a higher HBa1C, she said I'm afraid you will have to go on insulin and having forgotten who I was, and was surprised when I said 'great'!

 

[Lesleywo]

I believe I postponed my progression to LADA for many years eating low carb. But then things srarted to change. Meals got smaller, carbs got less, exercise raised me rather than lowered me. Everything I ate raised me you know your LADA, and you know you still have pancreatic function. As things start declining despite all your efforts you will notice and know what's going on and can get the meds you need. Most people aren't so lucky and don't find out until they've dropped shed loads of weight and feel miserable. At least now you know what to watch for.

Hi @Kristin251,

Yes I do consider myself lucky. I was also lucky catching the Addisons Disease early in the process too because I was already under an endo for Hashimoto's. Whilst I did have symptoms, I was still functioning. Most Addisonians end up in hospital in a crisis near death before they are diagnosed.

I agree with what you are saying ... getting to know how your body responds to certain foods via blood testing and as you say, noticing when things go downhill; keeping your eye on the ball so to speak. Basically taking control of your own health by being proactive with regard to educating yourself and managing your condition accordingly.

 

[Nidge247]

I believe I postponed my progression to LADA for many years eating low carb. But then things srarted to change. Meals got smaller, carbs got less, exercise raised me rather than lowered me. Everything I ate raised me you know your LADA, and you know you still have pancreatic function. As things start declining despite all your efforts you will notice and know what's going on and can get the meds you need. Most people aren't so lucky and don't find out until they've dropped shed loads of weight and feel miserable. At least now you know what to watch for.

Hi @Kristin251

Over how many years was your postponement through eating low carb, and what level of carbs was that? I'm interested as I'm in a similar position but much earlier on.
I have 30-50g carbs daily, and an abundance of energy I haven't seen for 40+ years!