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Lada Diabetes, low HbA1C but have complications

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nikki_kent

Member
Messages
6
Type of diabetes
LADA
I am new to this forum so thank you for letting me join.
I was diagnosed with LADA diabetes a couple of years ago when I had a positive result for GAD antibodies. GP surgery is brilliant and I have all the diabetic checks that are available. I have an HbA1C done every 6 months and the results are always excellent so I am not on any medication for my diabetes at all. However I have developed diabetic retinopathy (one bleed point in one eye) and have excrutiatingly painful neuropathy for which I have just started Gabapentin (current dose 600mgs three times a day). GP puts this down to LADA diabetes being rather a nasty type of diabetes that can give complications even though BG levels are normal.
Is there anyone else in this situation?
I also have pernicious anaemia and have B12 injections every two weeks to keep me upright and functioning.
Best wishes to all - Nikki
 
I'm tagging @LucySW , @Daibell and @phoenix to see if they have any further info on this one. I'm not aware of LADA making you more likely to suffer complications with a good Hba1C, unless you were unaware that you had it for a long time and were eating a high carb diet that had pushed your average blood glucose levels up a fair amount.

Maybe the others will have more information.
 
Hi and welcome,

It may be that the excruciating neuropathy is caused by the Vit B12 deficiency, rather than bad blood glucose.
Have you had a look at the symptoms of B12 deficiency? There are some great You Tube documentaries on the subject. From what I can remember, sometimes the symptoms are reversible, and sometimes, sadly they are not. But definitely worth finding out.

I would also, in your circumstances, be pushing for HbA1c tests every 3 months, not 6. A heck of a lot of things can change in half a year, in your situation.

Do you have a test meter, and (forgive me for asking) do you use it?
 
I have been diagnosed by dn with Lada n take no medication at present I have been diabetic since April I have also got pain in my feet n not yet had retinothopy test eye sight is poor i have been eating a lchf diet n my blood sugars normalish now dr reluctant to give me any medication for my feet


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I'm curious as to who told you LADA can give nasty complications without high BF levels ? Can I ask what your A1C levels are?
 
Thank you everyone for answering.
Pernicious Anaemia can cause the problems but I have B12 fortnightly as a result but foot pain worse instead of better. HbA1C equates to a blood sugar reading of below 5. It was the diabetic GP specialist in my surgery that said LADA can be nasty as complications can build up before the BG levels get high enough for a diagnosis of diabetes.
I don't do a daily BS as the surgery have said BG levels are well controlled at present and just manage with diet. When I have the B12 jabs I sometimes get the practice nurse to do some random BG levels and these are always good as well.
I've just read the recommended article on anaemia and blood sugar levels but pernicious anaemia is an autoimmune disease that is lacking in B12 (although essential for health blood cell formation). I'm not anaemic - in fact Hb is 17 which is too high.
 
Hi @nikki_kent

Sorry you're having problems. I have Type 1 and I'm not a medical person in any way, but if it was me I'd be testing my blood sugar at home, particularly after meals, to see if there were hidden highs.

I've not heard of LADA or any diabetes causing complications without high sugars : / When I was first diagnosed as Type 1, my consultant said that my insulin response was still there but was 'too much, too late'. This meant I could eat a carby breakfast and have a blood sugar in the 3s before lunch (without insulin) BUT my two hour reading could be 13 or 14. I wouldn't have known that without home testing and I'd have gone along thinking all was fine when actually I was having highs throughout the day.

I don't know if that's relevant to you at all, but I thought I'd mention it in case it helps at all.
 
Hi @nikki_kent , sorry for the irrelevant link! There are other asymptomatic blood issues that can adversely impact on the accuracy of the hba1c & that might be something to look into.

The reason I question whether a hba1c of in the region of 28 is accurate is because your microvascular complications would usually be associated with much higher levels. However, you might just be unfortunate enough to be genetically prone to the complications without having to run particularly high.

In any event, a hba1c only shows an average - it is possible that you are spiking & dropping to maintain a normal average but with damaging peaks - as @azure mentions.

Bearing in mind that if it is caused by running higher, obtaining tighter control can alleviate complications, so I would want to be sure that my hba1c was correct & I wasn't missing high blood sugar levels of a very variable glucose profile by relying on the hba1c - the only way to do that would be to regularly test blood sugar levels (or to invest in a CGM/libre).
 
Also, was just thinking (it can take me a while) as you are GAD positive, you are type 1, no matter how slow the onset - LADA is just slow onset type 1. NICE guidelines provide that type 1s should be supported to test at least 4 times a day. So even though you are managing with diet alone, you should be getting a prescription for a monitor and test strips on prescription.

See NICE guideline 17 https://www.nice.org.uk/guidance/ng17/chapter/1-Recommendations#blood-glucose-management-2
 
Thank you everyone and Catapillar I will talk to my GP about testing. I think he might have been talking about the genetical issues as I seem to be collecting auto immune diseases! I appreciated you posting the article - it was a very interesting read. I used to be a nurse and what is frightening is frightening (and I've learned this on the Pernicious Anaemia forums) is that patients know much more about their conditions than the medical teams.
 
Can i just ask Nikki - were you diagnosed as LADA just based on having gad antibodies but normal blood sugars? And were you tested for gad antibodies because you have other autoimmune diseases?
 
Lesleywo said:
Can i just ask Nikki - were you diagnosed as LADA just based on having gad antibodies but normal blood sugars? And were you tested for gad antibodies because you have other autoimmune diseases?
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Lesleywo I was diagnosed by a neurology consultant following a referral for trying to improve balance etc with the Pernicious Anaemia. He did the GAD antibody test and also went against NICE guidelines to let me have B12 fortnightly.
 
So they told you you had diabetes just on being gad positive with normal blood sugars? Did you get a c peptide test done to see how much insulin your body is producing? I ask because i have hashimotos and addisons and am gad positive with ok blood sugars but i have not been diagnosed with diabetes
 
I think there are other antibody tests that can assist in determining the likelihood of developing type 1 - http://www.healthcentral.com/diabetes/c/651280/142381/development-1/ - I'm not sure I really understand the information in the link to be honest! But if you are that way inclined you should be able to find more information from the trial net study on the risk of developing type 1 with one or more antibody positive test.
 
I also failed the glucose tolerance test big time lol - went from 6 before to 17 afterwards!
 
I was diagnosed with LADA 2 years ago. I take metaformin and my hb1ac was 5.6 last time. my specialist says my control is excellent but I do have bad neuropathy in my feet and hands.
 
nikki_kent said:
I also failed the glucose tolerance test big time lol - went from 6 before to 17 afterwards!
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Were you given any advice then? That's a big jump and 17 is pretty high. Have you adjusted your diet at all if your not on meds?
 
nikki_kent said:
Diet controlled Azure and seems to be under control
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OK As you can read in my earlier post, I had normal sugars every day but hidden highs (usually after eating). I don't know if you're testing at home now, but - and this is just my opinion and what I'd do in similar circumstances - I'd test to make sure all my sugars were in range as any highs do build up and can potentially cause damage over time. Did you decide to test yourself?

For me, my own blood test results gave far more information than my HbA1C. 'Luckily', I becamd quite ill and was admitted to hospital and put on insulin, but I could have gone on with high sugars for ages and been none the wiser.

I'm not a medical person, but I've not heard of getting diabetic complications with normal sugars - hence my concern (although I appreciate you have other health issues ).
 
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