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LADA and type 2 drugs...waiting for diagnosis

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GoAliGo

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I'm taking lantus and byetta while I wait for confirmation of my LADA diagnosis...My question is, does Byetta do anything to help type 1.5??? Or am I wasting my time and money trying to manage post meal blood sugar with it?

My diabetes team seems pretty convinced I've got LADA not type 2, as first assumed. I was diagnosed 11 months ago when my doctors were monitoring blood work because i had something called DRESS syndrome (an allergy that can trigger organ damage) and they were watching for stuff like this to happen. I also have had Hashimoto's for 10 years. I am (and have always been) normal weight and have normal blood pressure and normal triglycerides. I'm also very physically active and always have been.

Anyway i'm taking Byetta now, because metformin wasn't helping at all. First we added Lantus and now we have switched the metformin for Byetta. But nothing is working for mealtimes at all. I'm hovering around the 10 mmol/l mark long after the two hours mark. On 9 units of lantus, my fasting BS is a lovely 5-6 mmol/l all day.
 
Hi. I'm surprised you are on Byetta which is normally used to help T2s lose weight? It's a completely different drug from Metformin and I can't imagine how it would help LADA. Something like Gliclazide is often prescribed following Metformin as it stimulates the pancreas to produce more insulin. There may be special circumstances which is why Byetta has been prescribed for you? Have you been given the two tests for LADA i.e. GAD and C-Peptide?
 
He prescribed it because I used it as part of a drug trial last year, and had good results. But that was before my pancreas seemed to pack it in last November and my mealtime numbers have been creeping up since then. I have to be below 15 g carbs per meal if I want to stay under 10 mmol/l after 2 hours. Another over that and I hover around 12-14 for 3 plus hours. I was referred to and endo because my diabetes nurse and dietician do not believe I am type 2. I have to wait to get the tests until my appointment with the endocrinologist. I am normal weight (BMI - 21.5) normal blood pressure (100/70) and excellent cholesterol profile (and have pre-existing autoimmune diseases (hashimotos and vitiligo) and a family history of type 1. SO the tl;dr of all that is, my gp is ignorant and doing his best with what he knows. Thought Byetta might help, but it hasn't. Won't prescribe bolus insulin until i see the endo. Don't see the endo till March 16.
 

Dr google suggests that byetta is OK for LADA ?

Latent Autoimmune Diabetes in Adults - How to diagnose and treat LADA (ontrackdiabetes.com)

while sulponyruras such as gliclazide are bad. (or at least, that one article does.)

But if you've been prescribed it and your team think you are LADA then presumably they are bearing this in mind. Sounds like you'll get put on bolus insulin soon enough, glad the basal works so well for you.

GoAliGo said:
Or am I wasting my time and money trying to manage post meal blood sugar with it?
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Hmm, take it you're in a country where you are paying for your medication? While 10mmol/L isn't great, it's not that bad in the global scheme of things, so though you could try stopping the byetta you might find that that makes it much worse.

When are you seeing your team again?

ps Welcome to the forums.
 
Interesting. Yes, Gliclazide may help for a while but I agree it could cause more beta cell damage although I've read conflicting accounts. I was on it for several years at full, 320mg, dose not knowing it was possibly contra-indicated. I suspect that was not a good idea and perhaps I should sue the GP. Yes, Byetta won't do any harm but moving to a Bolus insulin to go with the Basal would make the Byetta redundant.
 
Daibell said:
Yes, Gliclazide may help for a while but I agree it could cause more beta cell damage although I've read conflicting accounts.
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Sometimes I wonder if there's any point in trying to reduce beta cell damage when you're going to end up on zero insulin anyway. Prolonging the honeymoon period doesn't necessarily seem so helpful to me, but then I probably never had one. (Diagnosed as a child pre glucometers). But I suppose it's good if you can stay off insulin longer???
 
GoAliGo said:
I have to be below 15 g carbs per meal if I want to stay under 10 mmol/l after 2 hours.
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Could you bear to try Dr Bernstein's 6-12-12 carb diet? In his classic book "Diabetes Solution" he says: "Many diabetics can be treated with diet alone, and if your disease is relatively mild, you could easily fall into this category. Some patients who have been using insulin or oral agents find that once on our diet they no longer need blood sugar–lowering medication. Even if you require insulin or other agents, diet will still constitute the most essential part of your treatment." You can read much more online for free, though the book is well worth buying.
http://www.diabetes-book.com/restricted-carbohydrate-diet/
 
I've been doing a keto/very low carb diet for the past year, since I was diagnosed in Feb last year. It's been declining in how well it's working over the year, to the point now that every meal has my bs over 12 mmol/l for at least 3 hours. I don't think i can do a lower carb diet than I'm currently doing, at least not long term. I did try going med-free for 5 weeks, but my insulin production is decreasing so quickly that I was unable to maintain reasonable levels without meds within 5 weeks despite exercising 90 mins every day and eating virtually nothing!
 

Hi Ellie, I was told that yes, there is a benefit to doing so in that your body releases/uses many different hormones (of which insulin is one, obviously) and they work very tightly in tandem with each other. If you still have some working capacity to process insulin naturally (via what's left of any beta cells) this enables the rest of your inner workings to sing in harmony thus keeping you (overall) healthier for longer and with a less stressed body. My Consultant said even a tiny bit of your own insulin can work towards this and so beta cells should be preserved (if possible) at all costs hence he felt even using small amounts of injected insulin to top up your own was beneficial. My opinion is that there is nothing 'good' about staying off insulin for longer per se, unless your body is fully able to process the insulin you are producing and can do so without undue stress. There are probably other views as well mind and as we all know it can be very complicated. x
 

Hi Alexandra, just wanted to add (just in case people misinterpret your quote from Bernstein) is that he is on about type 2 diabetics (and possibly LADA in the early stages) NOT type 1, who in his own words 'disappear in a puddle of sugar water without insulin)!!! Lovely.
 
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