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Is LADA hereditary?

3ndlessdreamz

Newbie
Messages
2
Type of diabetes
Other
Treatment type
I do not have diabetes
Hi all Newbie here, don't know if this question's been asked before.
I'm curious as my dad was diagnosed with Type 1 in 2008/2009 when he was about 52, so I'm pretty sure he's got LADA.
So is LADA hereditary?
I've seen some articles suggesting that LADA has properties of Type 1 and 2, so maybe the heritability from type 1 is possible?
Also, LADA is an autoimmune disease, so technically, it can just be as hereditary as other autoimmune disease? or not?
Some articles I've read also suggest that most common LADA occurs in the 35+ age group, so if it's hereditary then I won't need to worry about it until I'm 35+?

I did have a blood test for Type 1 when my dad was diagnosed, but the test came out -ve. So I'm also wondering how much the GPs know about LADA?

Thanks guys
 
My diabetic consultant says my children now have a 20% higher chance of getting T1 diabetes than normal (because I am T1 / LADA). He does not officially recognise LADA, he says I am a T1 in the honeymoon period, accepts that some call this LADA. He also says there was nothing I could have done to have prevented it. I think that is rubbish. I know that had I been on my diet a few years earlier (low carb) I would not be a T1 now.... Maybe later, but not now.

You probably have a 20% higher chance of getting T1 diabetes. In my opinion you can lower this risk by simply being careful with carbohydrates. Eg being careful with potatoes, bread, pasta, rice, cakes etc.
 
Ian, can you point to any evidence that reducing carbs will reduce the risk of T1/LADA. T2 yes, but T1 is due to islet cell death and I've not seen anything to suggest reduced carbs will prevent or delay that?
 
Daibell said:
Ian, can you point to any evidence that reducing carbs will reduce the risk of T1/LADA. T2 yes, but T1 is due to islet cell death and I've not seen anything to suggest reduced carbs will prevent or delay that?
Click to expand...
The only evidence I can give is my own experience, coupled with the belief that high BG levels kills islet cell / insulin making beta cell death.

I was diagnosed over two years ago. Over the last 15 months I have kept my fasting BG levels at an average of 4.5, and see virtually no indication of further beta cell death. This make me believe that had my BG levels say three years ago been within the same range as they are now, I would not be T1. Three years ago I had no idea what my BG levels were, never ever checked, but I had terrible bleeding gums that my dentist was concerned about and was constantly needing the bathroom. Now no gum problems and no barroom problems, which indicates to me I had high BG levels 3 years ago, and without doubt I must have had more beta cells alive then than now, so if I had gone on a low carb diet and kept my BG levels low, I would most certainly have more beta cells alive now.

I could take the beginning of my dental and bathroom problems back to maybe 6 or 7 years. Which points to a gradual onset, not sudden.
 
Daibell, There's evidence that as the beta cells are working hard producing insulin, they become more visible to the rogue T-cells because of substances they are producing along with the insulin. So avoiding spikes might screen off the auto-immune attack.

@tim2000s has links on this. But it's bona fide.
 
Last edited by a moderator:
Hello,
I am Josephine and 2 years ago, I was diagnosed with Diabetes Type 1.
Since, I am on a prolonged honeymoon period using only basal insulin and metformin.

If my understanding is correct, my case is called LADA or 1.5.

My doctor has explained to me that ‘LADA” is, in fact, semantics and in practical terms "LADA" Diabetics are Type 1 Diabetics in a prolonged honeymoon period which means that our pancreas is still producing some insulin . Eventually, our pancreas will seize production and we will become Type 1 on a basal/bolus scheme. In a simplified way, we are caught in the middle of Type 1 and Type 2 (being insulin dependant and insulin resistant) on a journey towards Type 1.

I hope that my explanation is correct.
Warm Regards
Josephine.
 
How old are you out of curiosity Josephine? Im 25 and i believe my type 1 is indeed lada too.
 
Hi James,
I am 38 years old and I was diagnosed when I was 35.
Initially, I wasn’t taking any medication at all and was controlling diabetes with strict low carbohydrate diet. (Honeymoon period.)
After about 6 months, my doctor introduced 2 metformin pills per day.
Gradually, I started needing the help of some basal insulin, starting with 12 units a day (and metformin.)

I am currently trying to control my condition with 18 units of basal insulin, metformin and a low carbohydrate diet. I would like to introduce exercise as well in my effort to control (I used to be very active in the past) but, I am rather afraid just yet.

Warm Regards
Josephine.
 
Hi Josephine, as long as you have access to plenty of test strips, I'd certainly get back into exercise.

I was misdiagnosed type 2 over a year ago,and at that time while I ate a low carb/low GI diet, exercise was the only effective way I could get my blood sugars down. 15 to 20 minutes on a stationary bike about an hour after eating would bring my levels down 3-4. A brisk 30 minute walk also worked.

There are 2 ways that glucose is removed from the blood- 1 is via insulin, the other way is when muscles contract and take glucose out of the bloodstream. As diabetics we need to balance our glucose/carb intake, our insulin AND exercise. Obviously you need to talk to your doctor, but I'd suggest testing BG levels, doing 10-15 min exercise and then re-testing BG levels. The benefits of exercise are so important, we all need to be active. And as I'm sure you know being fit also reduces insulin resistance.
For inspiration, check out the cycling team http://www.teamnovonordisk.com , these guys manage top level cycling and type 1 diabetes.
 

Hello Viv, thank you for your suggestions.
Exercise is a little tricky for me. Here is what happens:

Theoretically, during the hours of exercise my blood sugar levels should drop/soften. In my case however, they rise.
When I exercise, even at a low impact pace (for example, quick walking) my blood glucose (from a relatively safe level for exercise, well below 10) can reach up to 14 or 15 (has reached 17 as well.)

It is only after 5 to 7 hours after the exercise, usually during my sleep, that my blood sugar levels drop (to the point of hypoglycemia during my sleep).

Strenuous walking (trekking of 4 hours) did not lower my blood glucose at all during the exercise (on the contracy) but, triggered a hypoglycemia later on as well as lower readings during the next 2 days…

Likewise, a 1 hour walking at 14:00 in the afternoon caused a hypoglycemia at 01:00 am on the same day. However, during the time of the exercise my blood sugar was rising.

This situation confuses me a bit. I do not know if this is something which happens at the moment and if it will get sorted later on.
I am wondering if it is something that can happen as each case of diabetes is different for every person.
I am also wondering if it is an insulin issue (if, for example, I need more basal insulin…)

Thank you
Josephine.
 
LADA is considered much more hereditary than T1.
 
misswhiplash said:
LADA is considered much more hereditary than T1.
Click to expand...
Heritability is a minefield, although it is known that T2 is very heritable and lots of research has been done into the genetics of it, the heritability estimates vary widely from 20-80% heritability

It's even more the case for LADA where there has been almost no research.
The risk for T1 is thought to be the result of certain predisposing genes yet the heritability isn't nearly as high as for T2.( further increased risk if you have a sibling with T1 though )
For LADA the info I could find seems to suggest that people with a family history of any sort of diabetes have an increased risk that is higher than that for T1 and slightly less than for T2 (though the prevalence of LADA is low so when you are thinking about increased risk that is a very important factor to be taken into account, the prevalence of T2 is much higher)

Interestingly, people with LADA who have higher levels of antibodies are less likely to have a family history of diabetes. Those with lower levels of antibodies are more likely to have a family history of diabetes.
" A tentative explanation could be that less autoimmune activity is required to cause LADA in individuals with genetic susceptibility to diabetes (i.e., genetic susceptibility of a kind that is unrelated to autoimmunity)" http://care.diabetesjournals.org/content/30/12/3040.full.pdf
 

Hi Josephine, that sounds awfully complicated, poor you.

I do know that sometimes my liver releases glucose if I'm low (under 6) before I start exercise, I found that out before I had started on insulin, my BG would go up a couple of points. Nowdays I test before starting out and eat something if I'm under 6. Since starting on insulin in August I haven't done any high intensity exercise for longer than 30 minutes at a time and I test after it. Yet to go back to all day hiking, but hoping to do so fairly soon, with lots of testing and snacks

I guess I'm one of the lucky ones where my sugars react fairly quickly to exercise & food, as you say each case of diabetes is different, yours looks pretty challenging- wishing you good luck in sorting it the best you can.
 

It may sound strange, but there is another way sugar/glucose is burnt up and can lead you to hoping Hypo, that is using your Brain. This is proved and a medical fact but many Diabetic a Clinics and consultants never mention this. I do about 8 hours a day of computer work, reconstructing hard drives to get back lost information for Companies and Police cases, also when writing programs or looking for faulty code, this can burn up to 5.0 off my blood meter test and as my aim is 6.5 you can see how hypos can happen, as some days I don't do any a Computer work, just doing a normal day out and about I have to use a different pattern on my Insulin pump, altering both the background Insulin, Basal and alter my Bolus intake with food. It's the only way to keep within my permitted targets and prevent hypos which I use to get a lot more of each day. I've been on Insulin for over 50 years, and back then the brain wasn't considered as burning up energy, but it does, and can cause Hypos without people knowing why, if you do sport or any activity you know you will burn up more, when you are ill or have infections your blood sugar goes up, so why it was t realised that the brain working hard solving problems etc will obviously make a difference. I don't think or know if you use up calories, but it certainly affects blood sugars if used more than for light everyday things. One reason (not proved) I think that the stress of taking exams at school and Uni are sometimes responsible for diabetics needing to take some carbohydrate to keep their sugars up. My Consultant now says this has all been proved and can be shown on ward as a day patient if you burn higher than normal. I presume in layman terms you run,you burn up energy, so what feeds the brain? Just the same evidently. This is not of course the medical description but written, I hope, to be understandable. In my pump I only use quick acting Insulin, I was surprised as were people at the clinic with a pump user using long acting insulins such as Insultard as mentioned among others earlier, the whole idea of a pump is to prevent hypos and keep controlled generally for more problem or serious hypo people, long acting insulin couldn't work, as your Bolus is to match the food consumed, and Basal to keep your background level if you didn't bother to eat. How would you make long acting work properly pumping it in hourly?
 
Hi again Josephine, I'm fairly new to type 1 & insulin, so this might be out of order (maybe some more knowledgeable types could comment?), but isn't 18 units basal a lot & why no mealtime/ bolus insulin?

I was started on 6 units basal, when that wasn't enough my DN introduced 2-3 units bolus at lunch and dinner. That helped, but wasn't quite enough, so the basal went up to 9. At that level, I have to eat a mid morning snack (10-15g carb) to avoid going hypo before lunch- I don't have bolus insulin at breakfast, the basal alone will send me hypo (at work, no exercise), god knows what 18 units basal would do, I expect I'd need an ambulance. Of course we are all different, but maybe someone experienced might know more about this.

Hey Johnski, that's really interesting. That would suggest that glucose can move into the brain without insulin. Time for me to give the grey matter a work out and find out more .
 

Hello Viv and thank you for your reply.

Actually, when I was initially diagnosed, 2 metformin pills were enough to keep my blood sugar levels balanced. At some point, metformin alone could not do the job so, we had to incorporate basal insulin, I was taking only 2 units and this was enough. Gradually, the 2 units became 6, but, in time, I started to demonstrate higher blood glucose readings. After 3 months, for the same reason, I had to raise my basal insulin intake to 8 units and, in 3 months time to 10 units.

10 units of basal insulin served me well for 6 months but, suddenly I started having higher blood sugar so, 10 units became 13. After 6 months, 13 units became 15 and, throughout the years, since my initial diagnosis, I am now at 18 units.

What I mean by this is that, the ability that my pancreas has to produce insulin is fading with the passing of time. I guess the same must apply for other diabetics as well. I didn’t start with 18 units of basal insulin and, likewise, I may need more in the future.

In fact, my endo has told me that 18 units is still a low number…

As for your bolus question, as you know the pancreas is producing insulin in 2 rates: The first is the basal insulin which is distributed throughout the 24 hours. The second is the bolus insulin to cover meals. When the pancreas begin to lose its ability to produce insulin, usually in the beginning it loses the ability to produce the background insulin (but can still cover from its own production low carbohydrate meals.) Hence, the injected basal insulin corresponds to the amount that the pancreas cannot produce on its own anymore (but, can still produce some bolus on its own to cover for the meals.)

Regards
Josephine.
 


Hello Johnski,
You are ever so right and actually, my endo has warned me about this (because I work in a mentally strenuous field.)

Mentally active people or people who are, in generally, occupied in mentally active fields are more prone to lower blood sugar levels. Although the brain is an organ per se, in the field of neuroscience it is considered a muscle because it is basically tissue — like muscle — that can be called to action for any purpose. (it is for this reason that I.Q. is not strictly fixed but, can be raised through Brain fitness programs – fascinating, isn’t it!)

The brain continuously slurps up huge amounts of energy for an organ of its size.

Energy travels to the brain via blood vessels in the form of glucose, which is transported across the blood-brain barrier. When there is strenuous mental exercise, the local capillaries dilate to deliver more blood than usual, along with extra glucose and oxygen.

It is exactly like any other muscle exercise and, should probably be considered and treated as such.
A treadmill workout for the brain.

Regards
Josephine.
 
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