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LADA after being initially diagnosed as T2

I don't think a C-peptide test would be very useful at this point. you're clearly producing enough insulin at the moment to make you hypo, and you are producing enough to not go crazy high (like 20's high). My prediction would be that your C-peptide would be in the normal range because of your normalish BG.
With the antibodies plus erratic but not diabetic BG, I would take the possibility of developing T1(LADA) in the future seriously.
Chris24Main said:
Timing - who knows ... @Antje77 was very much 2 years and done.
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Uh, no, I begged for insulin after a month of orals (gliclazide), low carb, and testing, and I was on a full blown T1 type basal and bolus insulin regime within two months, which worked (and works) very well for me.
Rediagnosis after two years was mostly paperwork, it didn't change my treatment.
 
Aurelie said:
Would it rule out type 2/IR or would a fasting level not reflect that?
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Seeing as you do not have diabetes at the moment (despite having pretty wildly fluctuating blood glucose) it wouldn't rule out/in any type of diabetes because you're currently not diabetic.

Even a diagnosis of IR wouldn't rule out a future diagnosis of T1, and having T1 doesn't rule out IR either.
Your numbers prove you are producing insulin. A C-peptide test could show an overproduction (IR), like it could in any non diabetic. But with the positive antibodies you'd likely be diagnosed with T1 if you ever develop diabetes. But you haven't.

A lowish C-peptide may rule out IR, but not necessarily if you've been eating low carb. Fewer carbs means less insulin needed and less insulin produced. Interpreting a C-peptide result is not a straightforward thing: it measures how much insulin was produced in a very short period of time, which is dependant on what happened metobolically during this time. So the interpretation has to be done alongside a current BG, it's about comparing multiple factors agains eachother.
Easy if the C-peptide is very high with normal BG (T2/IR), easy if the C-peptide is very low with high BG (full blown T1), not so easy on the various middle grounds.
 
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Totally agree with @Antje77 on this.
The primary purpose of a C Peptide test is that for someone who is injecting insulin, you can also tell if the pancreas is independently making more. You already know you are producing insulin.

I'm not sure whether it's a comfort or not, but statically IR is very common. 27% of the entire population in the UK, and the majority of the US.
 
As of today, I've just been diagnosed as LADA and will be starting insulin. Was diagnosed as type 2 three years ago. I'm quite daunted, but really glad to have some answers. I had to battle convince the NHS to refer me to an endocrinologist, but I eventually won that battle and struck gold with a great consultant.
 
@Melgar, this happened to me too. Was misdiagnosed in 2013 as T2. Struggled for 2 years with bg getting higher and higher. Had GAD and C-Peptide test which both came back as abnormal, was told by nurse that it is T1 but my medical notes still said T2. But today after 10 years of trying to sort this out my new GP finally decided to check back and said yes you're definitely T1 and I will change this today. It's only taken 10 years to sort out. So yes because I was 66 when first diagnosed with T2, and of course "older people" don't get T1 you are right. It's a case of let's go by the medical books and not what's happening in front of your eyes.
 
Seaside34 said:
What tests do you need for LADA, my HBA1C is 107, currently waiting for Endo referral which says it has an average waiting time of 17 weeks. Meanwhile the GP is doing nothing and I feel terrible. Low cortisol aswell.
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@Seaside34 think you need to ask for a GAD antibody test and also a C-Peptide test. A GAD test is a blood test which measures whether the body is producing a type of antibody which destroys its own GAD cells. Presence of these autoantibodies suggests type 1 diabetes. A C-peptide test measures the amount of C-peptide in the blood or urine. The pancreas releases C-peptide when it makes insulin. The test can help determine the type of diabetes you have or how well diabetes treatments are working. If the results come back as abnormal then it's likely you are T1.
 
Are you on insulin now? Thanks.
 
Elmas said:
Are you on insulin now? Thanks.
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Hi Elmas

I am indeed - I currently take 13 units of Semglee (basal) per day and Trurapi (bolas) with meals - I try to keep my bolas insulin intake lower if possible, for example if I am at home I use exercise in the mix too. I find judging it for exercise and alcohol is probably the trickiest part. So far managing (mostly) to keep things under control, but have put a fair amount of weight on since despite maintaining a relatively low carb diet and exercise regime which gets me down a bit. They did say I might put a little on once on insulin, but have gained 10kg ( still down 20kg from my heaviest ).
 
Well done for winning the battle with the NHS - I hope you are getting on okay with your insulin Martha. I struggle to understand why the NHS make the assumption about type 2 when a simple test can pretty accurately diagnose LADA.

The natural assumption would be the cost of the test being prohibitive, but given people are effectively being given the wrong treatment - possibly for years - therefore risking long-term symptoms which then would cost the NHS a lot in the long-term treatment I think it really needs a re-think.

I wonder if perhaps the more LADA they find, the more long-term insulin and related treatment costs they have to pay out for, so they perhaps don't want to diagnose tooo many LADA patients - is that too cynical? I am just trying to understand a rational reason for so many people going misdiagnosed when tests actually exist...and I am not someone who hates on the NHS, far from it.
 
Small update - had my first HbA1c result since being on insulin late last year - came back as 43.6 which they seem happy with 'for a diabetic'. They have put a request in with my GP to change my basal from Semglee to Lantus - so will be trying that soon. It was quite unprompted, but I did feel I wasn't getting the 'full 24 hours' out of Semglee - I will post an update once I have been on it a while.
 
DiabeticBear said:
They have put a request in with my GP to change my basal from Semglee to Lantus
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Semglee and Lantus are both insulin glargine, Semglee is a biosimilar of Lantus, and I wouldn't expect much of a difference in action time.
An alternative is Tresiba, which has a longer action time. And many people find they are more stable on a split dose of Lantus taken morning and night, something you might want to keep in mind if you find you're going higher in the last hours of your basal insulin.

Your hba1c isn't something 'to be happy with for a diabetic', it's ******* amazing, well done!
 
I had a similar experience. I was initially diagnosed as Type 2, (refused metformin), for 2 years I tried to get blood glucose levels down via food and exercise, then, suddenly blood glucose flew up to 120. Particularly in the mornings I started dragging my feet in an odd way.............. I had taken a urine sample to the doctor's appointment (my initiative, it was not asked for), the GP detected there were a high number of Ketones, & I was therefore rushed into hospital literally from the GP's room, with DKA, I was in for 5 days on drips, & came out with a diagnosis of Type 1. And I also had to request at a later date a c- peptide test, (in the end I had to persistent about that to get it done!), as I believed I was still producing insulin for a couple of years or so after the diagnosis, and wanted that information....but obviously I was not producing enough. Eventually, of course----as of now----I have no insulin of my own at all.
 
So glad I found this forum.. I'm not alone!!.. I have had a mirrored experience to DiabeticBear (mid-2022, type2 diagnosis even though very low BMI, initially emergency hospitalised, Insulin for some months before recovering then stopping treatment altogether, then 2years as T2 on Metformin only, then when that stopped working, GAD/C-pep tests and voila.. LADA!.. now I'm on 'hybrid' treatment with Metformin + basal insulin (Tresiba) & CGM, it's soooo much easier being a T1 than being a T2 on restricted diet.. although I still need to be careful.
 
I agree! When I was diagnosed, they were not sure whether I was T1 or T2... until they got the results from my blood test (after the second test, because they did not test what they were supposed to be looking for!!)

In the end I was T1 (LADA), which was a relief, T1's in the UK are treated a little better than T2's!

I didn't have a problem injecting insulin! I would not be too concerned if your blood glucose goes a bit high every now and then, most diabetics struggle for a good time in range! And it is a best case scenario which is different for everybody!

My control is rubbish, but when I get it a little better, we go on holiday and then all bets are off! But at least I am trying...

And at least now you have the correct diagnosis!
 
Sounds almost identical to my experience!
 
@LionChild "Particularly in the mornings I started dragging my feet in an odd way."..... wait what? Before I was first diagnosed (initially T2, mcuh later LADA) I had the same problem. I have a couple of herniated disks in my back and occassionally need physio/ostio/pilates to manage but no real drama, but I had exactly the problem you described. Dr said it was trapped nerve and I had a couple of weeks of physio but during this time it was really difficult to walk...it was a bit later that I noticed weight loss and asked for the blood test which highlighted diabetes... I had not made the connection before you mentoned it... perhaps it could have been DKA?
 
I was also classified as type 2 at the age of 57. At the time my doctor was confused as I did not seem to fit into either type 1 or type 2. For the next 10 years I tried everything, diet and exercise etc. It was only when I was on every possible med and was struggling to keep within range and was down to 8st and had lost a lot of muscle that I was referred for tests. It showed up antibodies and I was given a new diagnosis of type 1. Apparently the fact I had had Graves disease in my 30s may have been a factor. I stopped all medication and started on insulin straight away. All I can say is I have never looked back and would reassure you that you will feel much better once you get used to the insulin regime. Diet and exercise is still useful, but you don't have to be do severe. Good luck on your journey.
 

Thanks for sharing your experience
 
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