Is it possible to have LADA/1.5 with high C peptide?

Mac Dabrowski · Dec 1, 2024

Vectian said:
I have recently had tests back, very high reading for GAD antibodies, negative for the other 2 antibodies. However, my C peptide level is high normal (1080) showing strong insulin production. I was put on insulin after the initial high A1C (97) but stopped taking it after 4 weeks, and BG better now than when on insulin, I am keeping it under control now with diet and exercise alone. Surely a strong auto-immune attack as suggested by the GAD result would result in a low or at least reduced insulin output/C peptide? I have read that it's possible to be GAD positive and have type 2, although there seems to be a lot of disagreement amongst researchers and experts.

To some extent, I have a similar situation. It is not easy to maintain my glucose level without any insuline, but if I eat really low carbs (near or full ketosis) and exercise regularly, my averaged glucose based on CGM is 6 mmol/L. I thought I was in a honeymoon phase, but it has been 3 years since diagnosis, and not much has changed. For now, I'm keeping my head down and observing. Being officially diagnosed as T1, but possibly having T2, is perhaps the best case scenario. I don't see a point in chasing doctors and nurses to find out. I try to embrace every day I can manage without insulin and yet be able to wear CGM (only available for free for T1 in the UK as far as I know).

Vectian · Dec 1, 2024

Mac Dabrowski said:
To some extent, I have a similar situation. It is not easy to maintain my glucose level without any insuline, but if I eat really low carbs (near or full ketosis) and exercise regularly, my averaged glucose based on CGM is 6 mmol/L. I thought I was in a honeymoon phase, but it has been 3 years since diagnosis, and not much has changed. For now, I'm keeping my head down and observing. Being officially diagnosed as T1, but possibly having T2, is perhaps the best case scenario. I don't see a point in chasing doctors and nurses to find out. I try to embrace every day I can manage without insulin and yet be able to wear CGM (only available for free for T1 in the UK as far as I know).

Yes this was posted quite a while ago, now 8 months since diagnosis and still not taking insulin. I had an A1C that was 36 in August, so nowhere near even prediabetic, that correlates to a CGM average of about 6.1 for me, so 6 is doing very well and perhaps better than it needs to be? I am finding that it is actually improving over time, I can eat things I couldn't a few months ago and don't need to do as much exercise.

Apparently complete remission is very rare, less than 3% of T1s. But as you say the best position for now. I have tried to read every bit of research and trials about maintaining beta function and take supplements accordingly. I know it might change one day but I want to do everything I can at least.

The only problem I am having is with fatigue, I have pretty much worked out this is due to glycogen depletion. I am not super low carb but usually around 50-70g per day. If you are not in ketosis, a certain minimum level of carbs to keep the body running seems necessary, for me anyway. Have you had that problem?

Mac Dabrowski · Dec 1, 2024

Vectian said:
Yes this was posted quite a while ago, now 8 months since diagnosis and still not taking insulin. I had an A1C that was 36 in August, so nowhere near even prediabetic, that correlates to a CGM average of about 6.1 for me, so 6 is doing very well and perhaps better than it needs to be? I am finding that it is actually improving over time, I can eat things I couldn't a few months ago and don't need to do as much exercise.

Apparently complete remission is very rare, less than 3% of T1s. But as you say the best position for now. I have tried to read every bit of research and trials about maintaining beta function and take supplements accordingly. I know it might change one day but I want to do everything I can at least.

The only problem I am having is with fatigue, I have pretty much worked out this is due to glycogen depletion. I am not super low carb but usually around 50-70g per day. If you are not in ketosis, a certain minimum level of carbs to keep the body running seems necessary, for me anyway. Have you had that problem?

Thank you for your quick reply, indeed very interesting topic, and good to hear your update (and positive news). When citing 'complete remission for T1' please note that this term usually refers to remission at limited perdiod of time, and it can extend for many years (in rare cases) but as far as I know, there is no solid proof, or available scientific data, for complete remission lasting for decades. I also heard, and observed on my personal case, that your remission (honeymoon phase) can change in a nonmonotonic way and without particular reasons. If you have a opportunity to check your C-peptide levels after 12 months, that would be useful. My case is/was very similar, I had positive GAD and normal range of C-peptide. However, most of the time I was still using insulin. Only recently (for 6 months or so) I went on low carb, and started eliminating insulin. Coming back to your original question - From what I've learned: i) It's possible to be GAD positive and have type 2; ii) it's certainly also possible to have a hybrid mode (LADA). When you think about it - it's very difficult to distinguish between the two, as both cases overlap. Regarding numbers, and how it improves over time - I found it as well, if all is going well and I stick to my routine. But when I get a cold, have lots of stress, or don't excercise for a week or two, then I start to see it getting worse. Consequences (at least for me) come often with a delay (so worth keeping it in mind). About the fatigue - yes, indeed I also often struggle and I'm stilll trying to find what's optimum. So far I was jumping between two diets - 1) trying to eat in general low carbs, and having a bit more for dinner (but then I had to often compensate with a bit of insulin) and 2) trying to go even lower carbs (didn't really count them), which were low enough to be on the edge of ketosis (e.g. around 0.3 to 0.5 mmol/L). In both cases I often had a fatigue. Currently I'm trying to go all in keto (eat more fats, and keep carbs to minimum) so that I can have above 0.5 mmol/L of ketons. So far I feel relatively good, but it has been only a few days with ketons on 1mmol/L or so. It is very likel that full keto diet will result in less fatigue because ketons will produce more glucose. I have no idea how this will show up in my glucose reading in a long term though....but my feeling is that it is going to be great. I was reluctant to start with keto, because people say it doesn't make sens for T1, but I don't think I'm typical T1 so....

Vectian · Dec 2, 2024

Mac Dabrowski said:
Thank you for your quick reply, indeed very interesting topic, and good to hear your update (and positive news). When citing 'complete remission for T1' please note that this term usually refers to remission at limited perdiod of time, and it can extend for many years (in rare cases) but as far as I know, there is no solid proof, or available scientific data, for complete remission lasting for decades. I also heard, and observed on my personal case, that your remission (honeymoon phase) can change in a nonmonotonic way and without particular reasons. If you have a opportunity to check your C-peptide levels after 12 months, that would be useful. My case is/was very similar, I had positive GAD and normal range of C-peptide. However, most of the time I was still using insulin. Only recently (for 6 months or so) I went on low carb, and started eliminating insulin. Coming back to your original question - From what I've learned: i) It's possible to be GAD positive and have type 2; ii) it's certainly also possible to have a hybrid mode (LADA). When you think about it - it's very difficult to distinguish between the two, as both cases overlap. Regarding numbers, and how it improves over time - I found it as well, if all is going well and I stick to my routine. But when I get a cold, have lots of stress, or don't excercise for a week or two, then I start to see it getting worse. Consequences (at least for me) come often with a delay (so worth keeping it in mind). About the fatigue - yes, indeed I also often struggle and I'm stilll trying to find what's optimum. So far I was jumping between two diets - 1) trying to eat in general low carbs, and having a bit more for dinner (but then I had to often compensate with a bit of insulin) and 2) trying to go even lower carbs (didn't really count them), which were low enough to be on the edge of ketosis (e.g. around 0.3 to 0.5 mmol/L). In both cases I often had a fatigue. Currently I'm trying to go all in keto (eat more fats, and keep carbs to minimum) so that I can have above 0.5 mmol/L of ketons. So far I feel relatively good, but it has been only a few days with ketons on 1mmol/L or so. It is very likel that full keto diet will result in less fatigue because ketons will produce more glucose. I have no idea how this will show up in my glucose reading in a long term though....but my feeling is that it is going to be great. I was reluctant to start with keto, because people say it doesn't make sens for T1, but I don't think I'm typical T1 so....

I asked the consultant when I finally got to see him how could it be that I have normal C Peptide, so normal insulin production, but the diabetes is caused by insufficient insulin as in T1. He couldn't answer that, or quite a few other questions! I think I may have worked it out myself though, when I had the C peptide test my A1C was 97, so fasting blood sugar of 11 or 12ish. That is higher than a non diabetic would go after eating a big carb heavy meal, so basically like a stimulated test. The stimulated C peptide values can go much higher, so 1080 as a stimulated value is not so high. I think I am probably LADA, but I acted very quickly though with fasting and weight loss and diet change, so hopefully caught it in time to preserve a decent amount of beta cell function, and trying other things to maintain it. Who knows how long it can last.

Yes unless you are doing proper keto and staying in ketosis, low carb diets seem difficult to sustain long term because your primary source of energy is still carbohydrates, but you don't eat enough to maintain glycogen stores. It's tricky because if you eat more carbs the blood sugar goes up and put more strain on the beta cells, but eat not enough carbs you can't function. I haven't got the balance exactly right yet!

Daisy_Daisy · Dec 4, 2024

Vectian said:
All the GP can do is refer me back to the diabetes centre at my hospital, where I'm already registered. So I end up with the same nurse, who says that because you are GAD positive you automatically have T1, with no discussion.

Get referred to a Diabetic clinic local to you.. ASK the Nurse to do it. if not ask th GP by econsult..

rs12 · Dec 22, 2024

Vectian said:
Yes this was posted quite a while ago, now 8 months since diagnosis and still not taking insulin. I had an A1C that was 36 in August, so nowhere near even prediabetic, that correlates to a CGM average of about 6.1 for me, so 6 is doing very well and perhaps better than it needs to be? I am finding that it is actually improving over time, I can eat things I couldn't a few months ago and don't need to do as much exercise.

Apparently complete remission is very rare, less than 3% of T1s. But as you say the best position for now. I have tried to read every bit of research and trials about maintaining beta function and take supplements accordingly. I know it might change one day but I want to do everything I can at least.

The only problem I am having is with fatigue, I have pretty much worked out this is due to glycogen depletion. I am not super low carb but usually around 50-70g per day. If you are not in ketosis, a certain minimum level of carbs to keep the body running seems necessary, for me anyway. Have you had that problem?

I am in exactly similar situation as you are. high GAD antiboides with normal cpeptide, and no other antibodies detected and normal fasting bloog glucose and A1c levels. can you help with advice on supplements other learning to preserve beta cell mass as per research?

Melgar · Dec 22, 2024

You might want to take a look at this research paper on GAD positive antibodies in none diabetic individuals. It’s enlightening. GAD antibodies show up years before in those individuals who are at risk in developing Type 1 diabetes and those with the potential to develop autoimmune thyroid issues. I too have that same risk potential.

Presence of anti-GAD in a non-diabetic population of adults; time dynamics and clinical influence: results from the HUNT study - PMC

It is well known that anti-GAD (glutamic acid decarboxylase) serves as a marker for development of autoimmune diabetes in adults. On the other hand, the clinical implications of anti-GAD positivity in persistently non-diabetic (PND) adults are ...

pmc.ncbi.nlm.nih.gov

LADA enigma · Dec 28, 2024

Mac Dabrowski said:
Thank you for your quick reply, indeed very interesting topic, and good to hear your update (and positive news). When citing 'complete remission for T1' please note that this term usually refers to remission at limited perdiod of time, and it can extend for many years (in rare cases) but as far as I know, there is no solid proof, or available scientific data, for complete remission lasting for decades. I also heard, and observed on my personal case, that your remission (honeymoon phase) can change in a nonmonotonic way and without particular reasons. If you have an opportunity to check your C-peptide levels after 12 months, that would be useful. My case is/was very similar, I had positive GAD and normal range of C-peptide. However, most of the time I was still using insulin. Only recently (for 6 months or so) I went on low carb, and started eliminating insulin. Coming back to your original question - From what I've learned: i) It's possible to be GAD positive and have type 2; ii) it's certainly also possible to have a hybrid mode (LADA). When you think about it - it's very difficult to distinguish between the two, as both cases overlap. Regarding numbers, and how it improves over time - I found it as well, if all is going well and I stick to my routine. But when I get a cold, have lots of stress, or don't excercise for a week or two, then I start to see it getting worse. Consequences (at least for me) come often with a delay (so worth keeping it in mind). About the fatigue - yes, indeed I also often struggle and I'm stilll trying to find what's optimum. So far I was jumping between two diets - 1) trying to eat in general low carbs, and having a bit more for dinner (but then I had to often compensate with a bit of insulin) and 2) trying to go even lower carbs (didn't really count them), which were low enough to be on the edge of ketosis (e.g. around 0.3 to 0.5 mmol/L). In both cases I often had a fatigue. Currently I'm trying to go all in keto (eat more fats, and keep carbs to minimum) so that I can have above 0.5 mmol/L of ketons. So far I feel relatively good, but it has been only a few days with ketons on 1mmol/L or so. It is very likel that full keto diet will result in less fatigue because ketons will produce more glucose. I have no idea how this will show up in my glucose reading in a long term though....but my feeling is that it is going to be great. I was reluctant to start with keto, because people say it doesn't make sens for T1, but I don't think I'm typical T1 so....

Extremely interesting to read and thank you for sharing.Been also very enlightening reading others posts and am grateful for this platform. I seem to be somewhat an Enigma myself with the Endocrinologist and have him scratching his head due to a normal C Peptide but glucose kept spiking and waking in the morning to high glucose levels often 11.

I have been diagnosed with LADA Type 1.5 earlier this year and have the anti bodies which confirm this. But recently things have gotten worse so just started slow acting insulin. HBA1c jumped up and glucose spiking and was tired. But the good,old C Peptide was normal (did a non fasting test).

Going to try and get back to better management of my diet especially my evening meal. I had been following a more Keto type diet but this year slipped into eating a few more carbs, but not much. I am slim build.

I went straight to slow acting insulin and this has indeed stopped the morning waking spike.

Anyway, I love all the theories and am glad I am not the only one who seems to leave the Endos scratching their heads.

Personally, I really don’t want to take fast acting insulin at the moment as well as the slow as my concern is hypos. Endo not pushing it either and being very supportive.

My theory being if I have a good day and kick out more insulin from my own pancreas and take fast acting insulin as well as my slow acting, I will no doubt have a hypo. It’s a bit of trial and error at the moment for me and I feel like I am just lucky I can be experimental as clearly still have some insulin production.

I also figure steering clear of glucose spiking foods and eating things with fibre and healthy fat, should help matters especially with my evening meal ( potatoes, even sweet potatoes seem to be an issue for me).

Shame I can’t have a permanent glucose monitor yet from the NHS so I just keep pricking my finger and making observations.

I wish there was more information out there, but I did hear from the Endo that LADA is on the increase and it makes you wonder why? Better testing maybe or perhaps another reason?

Melgar · Dec 28, 2024

For those of you with high C-Peptides and positive trace to high GAD autoimmune antibodies have you been checked for autoimmune thyroid disorders? Just a thought, because it’s something if an oxymoron to have high titres of antibodies with a pancreas that producing an abundance of insulin.
I have attached a research paper that discusses autoantibodies to thyroid and its relationship with autoantibodies to insulin.

Autoantibodies to glutamic acid decarboxylase in patients with autoimmune thyroid disease: relation to competitive insulin autoantibodies - PubMed

We evaluated the presence of autoantibodies to glutamic acid decarboxylase (GAD), competitive insulin autoantibodies (IAA) and islet cell antibodies (ICA) in sera from 288 non-diabetic patients with autoimmune thyroid disease (AITD), including 212 patients with Graves' disease and 76 with...

pubmed.ncbi.nlm.nih.gov

LADA enigma · Dec 29, 2024

Thanks Melgar for the insight and thoughts. I don’t really understand what this means, but they tested my Thyroid function- T4 and TSH, which were in normal range. I actually don’t have a clue what that means or if it is the test they use to pre determine possible autoimmune thyroid disorders.Forgive my ignorance. Is it possible those be in range but then then if they did a different test, it might through something up? Is there a specific autoimmune antibodies test ? Thank you

Melgar · Dec 29, 2024

@LADA enigma it keeps coming up in my own research about GAD positive in respect to Thyroid stuff. So I thought I would mention it. I actually have lowish C-Peptides but my blood sugars are all over the place. They keep testing me for thyroid but it comes back negative, so no clue really. I’m very interested in your outcome so keep posting.

rayq81 · Dec 30, 2024

LADA enigma said:
Extremely interesting to read and thank you for sharing.Been also very enlightening reading others posts and am grateful for this platform. I seem to be somewhat an Enigma myself with the Endocrinologist and have him scratching his head due to a normal C Peptide but glucose kept spiking and waking in the morning to high glucose levels often 11.

I have been diagnosed with LADA Type 1.5 earlier this year and have the anti bodies which confirm this. But recently things have gotten worse so just started slow acting insulin. HBA1c jumped up and glucose spiking and was tired. But the good,old C Peptide was normal (did a non fasting test).

Going to try and get back to better management of my diet especially my evening meal. I had been following a more Keto type diet but this year slipped into eating a few more carbs, but not much. I am slim build.

I went straight to slow acting insulin and this has indeed stopped the morning waking spike.

Anyway, I love all the theories and am glad I am not the only one who seems to leave the Endos scratching their heads.

Personally, I really don’t want to take fast acting insulin at the moment as well as the slow as my concern is hypos. Endo not pushing it either and being very supportive.

My theory being if I have a good day and kick out more insulin from my own pancreas and take fast acting insulin as well as my slow acting, I will no doubt have a hypo. It’s a bit of trial and error at the moment for me and I feel like I am just lucky I can be experimental as clearly still have some insulin production.

I also figure steering clear of glucose spiking foods and eating things with fibre and healthy fat, should help matters especially with my evening meal ( potatoes, even sweet potatoes seem to be an issue for me).

Shame I can’t have a permanent glucose monitor yet from the NHS so I just keep pricking my finger and making observations.

I wish there was more information out there, but I did hear from the Endo that LADA is on the increase and it makes you wonder why? Better testing maybe or perhaps another reason?

Why don't you have a glucose monitor ? If you have LADA you are most certainly allowed one on the NHS, as soon as I was diagnosed with LADA I was given libre 2 the same week.

Chris24Main · Dec 30, 2024

@LADA enigma - I would push for a CGM as well - it's the only way you'll get any insight in to what's actually going on in your own body.

On the Thyroid - the hormone itself is (not surprisingly) made in the thyroid, but the call for production comes from the Brain, via the Pituitary - that's what the T4 (hypothalamus) and TSH (Thyroid Stimulating Hormone) is looking for - is the signalling around the thyroid working properly.

Please do not take this as a diagnosis - but look at what is most likely here (and I'm being guilty of comparing to my own story) - C-Peptide is telling you that your pancreas is working - so you are producing insulin - yet you are responding to additional insulin.

My experience is that the medical system is wary about changing diagnosis, because they focus on glucose only. By prescribing insulin, you will control your blood glucose, and everything will appear to be fine (whether you are really LADA or really Type 2). However, if you are producing your own insulin, by definition, you are an insulin-resistant Type 2, and while the additional insulin is overcoming that resistance and lowering your blood glucose, it's doing nothing good for you in the long term.

This puts you in a tricky position, because the safe thing for the medical profession is to continue as is, whereas - you really need to know whether your underlying issue is a lack of insulin or too much. The only way you will understand that is with a CGM. If that sounds scary or confusing - please reach out to your endocrinologist (this is a hormone issue after all) and go through it with him.

Melgar · Dec 30, 2024

Because it really does not make sense @rayq81. I’m trying to get my head around what is going on with a pancreas that is clearly producing insulin, but not enough to suppress your blood sugars. Is it a damaged pancreas, but what’s with the GAD antibodies? That’s why I wondered about the Thyroid. An autoimmune attack on your Thyroid would also produce GAD antibodies - GAD65. It’s a marker for , as we know, t1 but also Graves’ disease, Hashimoto thyroiditis, pernicious anemia, epilepsy and Addison’s disease. I’m not for a moment suggesting these are in play, but that GAD antibodies are produced from a T cell attack on other areas of the body too.

I’m sure you have looked into all this. My understanding, and please anyone correct me if I’m wrong, but an attack on the pancreatic islet cells would kill them off. So there would be a deficit in C-Peptides. In other words your beta cell mass would be severely compromised, and with the loss of these insulin producing islet cells they would be unable to replenish. Are you in a honeymoon phase, alongside insulin resistance? Maybe the medical establishment does not yet understand fully the mechanisms by which late onset T1 progresses. So just a few thought on this.

I’ve incorporated the second link as it lists other autoimmune disorders that produce the GAD65 marker.

https://www.sciencedirect.com/science/article/abs/pii/B9780444563781000460

https://www.mayocliniclabs.com/api/sitecore/TestCatalog/DownloadTestCatalog?testId=81596

LADA enigma · Dec 30, 2024

rayq81 said:
Why don't you have a glucose monitor ? If you have LADA you are most certainly allowed one on the NHS, as soon as I was diagnosed with LADA I was given libre 2 the same week.

Hi Ray- I was told my my Endo as I am currently only on the slow release insulin (one dose at night) , I don’t qualify. When I am prescribed the fast acting insulin and therefore need 2 jabs of insulin, I am told I then qualify. I wish I had a Libre as it would make monitoring what makes me spike and being able to easily check I am above 5 and can drive, would be very useful. Of course the DVLA have strict rules on this and I appreciate why.

LADA enigma · Dec 30, 2024

Chris24Main said:
@LADA enigma - I would push for a CGM as well - it's the only way you'll get any insight in to what's actually going on in your own body.

On the Thyroid - the hormone itself is (not surprisingly) made in the thyroid, but the call for production comes from the Brain, via the Pituitary - that's what the T4 (hypothalamus) and TSH (Thyroid Stimulating Hormone) is looking for - is the signalling around the thyroid working properly.

Please do not take this as a diagnosis - but look at what is most likely here (and I'm being guilty of comparing to my own story) - C-Peptide is telling you that your pancreas is working - so you are producing insulin - yet you are responding to additional insulin.

My experience is that the medical system is wary about changing diagnosis, because they focus on glucose only. By prescribing insulin, you will control your blood glucose, and everything will appear to be fine (whether you are really LADA or really Type 2). However, if you are producing your own insulin, by definition, you are an insulin-resistant Type 2, and while the additional insulin is overcoming that resistance and lowering your blood glucose, it's doing nothing good for you in the long term.

This puts you in a tricky position, because the safe thing for the medical profession is to continue as is, whereas - you really need to know whether your underlying issue is a lack of insulin or too much. The only way you will understand that is with a CGM. If that sounds scary or confusing - please reach out to your endocrinologist (this is a hormone issue after all) and go through it with him.

Hi Chris- I shall push for a CGM- makes sense to me. I really don’t like being told they can’t work out why I can produce normal amounts of insulin myself and yet need long lasting insulin to stop my spikes. I find it very hard to keep an eye on my glucose with my job and can’t stop my work easily to test. It’s a very demanding role.

Like you say, be it LADA or type 2, we need a better picture. I am very aware of carbs and really am careful of what I eat, even the order I eat it and if anything am underweight. If I cut out carbs pretty much all together, weight just falls off me and I don’t want to get that skinny again (when I first had a raising HbA1c, the GP told me I was pre diabetic and to loose a stone and I was a healthy weight at that point). I did what he said though. The only way I found I could keep my HbA1c from climbing for a while was to hardly eat carbs, but then I couldn’t stop loosing weight, and I didn’t like it, I looked ill. Some I had to re introduce healthy carbs and then since then the HbA1c got to about 43/44 and stayed there a few months. Then about 3 months ago I felt so tired and my next HbA1c test showed it had jumped up to 52 and then they started the slow insulin.

I am so grateful for this input, as I am so new to all this.

LADA enigma · Dec 30, 2024

Melgar said:
Because it really does not make sense @rayq81. I’m trying to get my head around what is going on with a pancreas that is clearly producing insulin, but not enough to suppress your blood sugars. Is it a damaged pancreas, but what’s with the GAD antibodies? That’s why I wondered about the Thyroid. An autoimmune attack on your Thyroid would also produce GAD antibodies - GAD65. It’s a marker for , as we know, t1 but also Graves’ disease, Hashimoto thyroiditis, pernicious anemia, epilepsy and Addison’s disease. I’m not for a moment suggesting these are in play, but that GAD antibodies are produced from a T cell attack on other areas of the body too.

I’m sure you have looked into all this. My understanding, and please anyone correct me if I’m wrong, but an attack on the pancreatic islet cells would kill them off. So there would be a deficit in C-Peptides. In other words your beta cell mass would be severely compromised, and with the loss of these insulin producing islet cells they would be unable to replenish. Are you in a honeymoon phase, alongside insulin resistance? Maybe the medical establishment does not yet understand fully the mechanisms by which late onset T1 progresses. So just a few thought on this.

I’ve incorporated the second link as it lists other autoimmune disorders that produce the GAD65 marker.

Thanks again and like you I have been googling and researching like mad. I really appreciate these links you have shared, it is so very much appreciated. I like answers and to be told by not only the Endo but the diabetic nurses, that I have the consultant Endo scratching his head and he can’t understand why my CPeptide is normal (high end of normal range ) is more than a little disconcerting.

I have other things going on. Of interest, I have rheumatoid arthritis and have for a good few years. Really aggressive so I have to inject with a low dose of chemo once a week.

I have other things too. But, perhaps of interest, as a child I actually couldn’t digest sugar and it would literally sting on the way out. I had to take potassium citrate. Was like this until maybe 14 years old. Not diabetic. No diabetes in the family either.

I really can’t help wondering if they have missed something - so push for more answers I shall.

Melgar · Dec 30, 2024

@LADA enigma I cannot do the very low carb, high fat diet, as I am unable to tolerate fats. I may have a messed up gall bladder/ pancreas. Like you I am thin. My weight just drops off if I stop carbs, literally. When I could tolerate fats better, a couple of years back, I did the very low carb diet, my goodness my weight loss was a concern. To be honest I looked like I was about to leave this earth.

Now I do do around 70 miles a week walking, some of it on the mountains here, so peak heart rate exercise. I also do resistance training. All in all I burn a significant amount of carbs off. In the summer I will be kayaking as well, so lots of upper bidy work. It beggars belief I am still dealing with raised blood sugars, with short periods of blood sugars well into the high teens mmol/l wise

It’s strange you don’t qualify for the Libre system. My brother is on a Novamix and he qualifies as a T1.

Ed spelling

LADA enigma · Dec 30, 2024

Melgar said:
@LADA enigma I cannot do the very low carb, high fat diet, as I am unable to tolerate fats. I may have a messed up gall bladder/ pancreas. Like you I am thin. My weight just drops off if I stop carbs, literally. When I could tolerate fats better, a couple of years back, I did the very low carb diet, my goodness my weight loss was a concern. To be honest I looked like I was about to leave this earth.

Now I do do around 70 miles a week walking, some of it on the mountains here, so peak heart rate exercise. I also do resistance training. All in all I burn a significant amount of carbs off. In the summer I will be kayaking as well, so lots of upper bidy work. It beggars belief I am still dealing with raised blood sugars, with short periods of blood sugars well into the high teens mmol/l wise

It’s strange you don’t qualify for the Libre system. My brother is on a Novamix and he qualifies as a T1.

Ed spelling

Reply- bless you, sounds like you have a lot going on yourself. Shame about your intolerance to fats, what an nightmare.

On the plus side sounds amazing that you have mountains to walk on. You do a lot more cardio exercise than me at the moment. though today I took delivery of an exercise bike

I looked into Graves’ disease and I must say I can see your thinking.

I shall be putting a call in to speak to the Endo and let’s see if I can get a CGM and more tests (fingers crossed).

Happy 2025 to you and all on the forum

Antje77 · Dec 30, 2024

Melgar said:
I cannot do the very low carb, high fat diet, as I am unable to tolerate fats. I may have a messed up gall bladder/ pancreas.

I'm not sure if I asked this before, but with your unclear type of diabetes which may or may not be T3C, and your intolerance to fats, have you ever had tests for EPI? It may be you need creon with your food to properly digest.

Is it possible to have LADA/1.5 with high C peptide?

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