LADA / Gestational link?

Hi Jaxx, my journey started with an impaired glucose tolerance in my 1st pregnancy 20 years ago, then gestational diabetes 13 years ago. I was tested for GAD antibodies then, but at that time it came back negative. I was told that I was likely to get type 2 and had yearly blood tests. When my Hb1Ac started to climb, I was put in the type 2 box.
I have now been diagnosed as type 1 (at 53!) after a positive GAD test.
When we are tested during pregnancy, what is measured is HOW we deal with a glucose load, not usually what mechanism is causing us to have high blood glucose. The reason for having high blood glucose is either not making enough insulin (ie tending type 1) or insulin resistance (type 2). I would have thought that it would be useful to test everyone with high blood glucose for insulin sensitivity to distinguish between type 1 and 2, but it doesn't seem to happen.

Hi
I was diagnosed with type 1 during pregnancy (I'd say I'm probably LADA but it has always been referred to as type 1). I think most doctors would have said it was gestational then at a later date changed the diagnosis to type 1 or 2.
My consultant told me it was type 1 the first time he saw me - I was about 28 weeks pregnant and still in size 8-10 clothes. He did a GAD antibody test to confirm. He said I would have developed diabetes anyway but pregnancy may have speeding up the onset.

Right now I am diagnosed as type 2 but I have my suspicions that I may be LADA. If so, I also had gestational diabetes twice.

Hi,

I was also diagnosed with GD in my first pregnancy in 2012. I was very slim (always been a size 6-8), very athletic, 29 years old and hadn't gained any excess weight while expecting. I controlled it with diet BUT only because I learned to eat very very low carb. If I ate even half a piece of toast, my sugars would go up to 9+.

My GD didn't go away. Frustratingly, because I have been able to control my sugars so well with diet, I am constantly brushed under the carpet as a type 2 and nobody will test me for GAD antibodies. I'm convinced I'm type 1.5/LADA and my diet control has been keeping its progression slow. I am quickly losing the ability to control my sugars as well as I was with a no carb diet and my fasting sugars are consistently high now (only just above the recommended level, but I can see this is a steady worsening). I have to constantly balance my sugars by snacking on small things because if I go too long without eating, my sugars go up (even between meal times) and again, I can't even eat a meal with 10g carbs without going over 9mmol. Surely this isn't normal for type 2 diabetes at age 32 (in someone with zero risk factors)?!

I feel the only way to be taken seriously is to binge on carbs and have constantly very high readings, but I don't want to undo all the hard work I've been doing for the past 3.5 years!

ktm83 said:

Hi,

I was also diagnosed with GD in my first pregnancy in 2012. I was very slim (always been a size 6-8), very athletic, 29 years old and hadn't gained any excess weight while expecting. I controlled it with diet BUT only because I learned to eat very very low carb. If I ate even half a piece of toast, my sugars would go up to 9+.

My GD didn't go away. Frustratingly, because I have been able to control my sugars so well with diet, I am constantly brushed under the carpet as a type 2 and nobody will test me for GAD antibodies. I'm convinced I'm type 1.5/LADA and my diet control has been keeping its progression slow. I am quickly losing the ability to control my sugars as well as I was with a no carb diet and my fasting sugars are consistently high now (only just above the recommended level, but I can see this is a steady worsening). I have to constantly balance my sugars by snacking on small things because if I go too long without eating, my sugars go up (even between meal times) and again, I can't even eat a meal with 10g carbs without going over 9mmol. Surely this isn't normal for type 2 diabetes at age 32 (in someone with zero risk factors)?!

I feel the only way to be taken seriously is to binge on carbs and have constantly very high readings, but I don't want to undo all the hard work I've been doing for the past 3.5 years!

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Goodness. That sounds like LADA to a tee. I agree - beg, borrow or steal to get the test privately? Treatment is *different* and if you're LADA this is not helping.

Another lada here was diagnosed as type two after gestational....last three months I've felt awful so had emergency appointment with dsn she's now put me on insulatard and to stay on the metformin but off of the gliclazide. Test four times a day and dsn will ring me on Friday afternoon I feel like I'm in limbo

Hang in there Louba84. You ARE in limbo and its horrible. Everything seems to move so slowly and its frustrating waiting. Like the others here have said, trust your instincts and be assertive.
In pregnancy (as I understand it) our insulin resistance increases to allow glucose to remain in the bloodstream for the baby to access. If we are tending LADA, then we won't be able to make the extra insulin needed to keep our sugars normal. However, the medical profession seem to automatically assume that all increased blood glucose in pregnancy is due to tending type 2, so we all get put in the same box.
Good luck, hopefully you will soon get the correct treatment for your condition.

yup - **** sure I had GD with pregnancy 2. I had the extreme weight gain and fatigue during pregnancy and a big baby. Weight went very slowly back to normal-ish, then stress upped the ante.

I was warned about becoming prediabetic. I was diagnosed with GD during pregnancy 3. Insulin helped but it was a runaway train keeping up with bub pushing my sugars up and insulin increases to keep them down. I returned to normal weight reasonably well for a short while after delivery and then gained. A visit to my GP got me a type2 diagnosis.

About 6 months later, my endo gave me a GAD test which returned positive.

I have, what the diabetes expert I eventually saw referred to as a "strong autoimmune footprint". I have significant numbers of GAD auto antibodies attacking my pancrease, but the ICA test couldn't be read because there were too many ANA autoantibodies covering the slide. Therefore he decided to ignore the autoimmune aspect and since I am 57 he has given me no medication of any sort, told me to stop the lchf diet and eat what I like and although I'm not obese and I don't have high blood pressure he says that he can class me as type 2. He mentioned there being a financial aspect to the diagnosis, but refused to expand on the topic. He says that he will consider medication, but probably not insulin, when my blood sugars have remained at 11 (fasting) for 4 consecutive days. My husband came with me to the interview and was very impressed and keeps offering me ice cream and chocolate. My blood sugars are normally around 7 or 8, but 10s are not unusual. Is there something I'm missing?

Did your doctor ever bother to do a c-peptide test? That would be a good measurement of how much insulin your pancreas still produces. Make sure you do not fast before the test as it can your end false low results.

Honestly, I have the same question you do: what are we missing here? It's almost as if your doctor doesn't know what type of diabetes you have so he's just classifying it as type 2.... As I've mentioned on this forum before, that's really what "Type 2" is. It's not a specific type of diabetes, but rather the group of unclassified diabetes.

Personally, I would NOT accept the recommended treatment you were given or even the answers you received. Type 1.5/LADA if misdiagnosed as type 2 can be very dangerous as the chances of you needing artificial insulin are all but inevitable, but the chances of you getting it prescribed are slim.

By some standards, I may have type 1.5/LADA as I'm still producing some natural insulin more than 14 months after the first signs I had diabetes. Fortunately, my doctors have never once even brought up the T1.5 term and always classified me as type 1.

Of note: I live in the US so there was never a possible "conflict of interest" for a doctor to try to save costs and avoid prescribing insulin.

Within 3 weeks of my diagnosis, I was on Levemir, Novolog/Novorapid, a Dexcom G5 CGM, and an Accu-Chek Aviva Expert.

My point is, if you're not comfortable with the answers you're receiving keep pursuing this. I know I would if I were in your shoes (and I was last year).

It took 4 months to get any extra blood tests done after the initial information that I have diabetes, which came from a routine blood test. The routine blood test was because I have hypothyroidism because I had Grave's disease as a child in junior (grade) school that culminated in a subtotal thyroidectomy just after my 14 th Birthday and turned into hypothyroidism by my 15th Birthday. This and the fact that my only sibling has type 1 diabetes placed me in the position of being able to ask my go for the other tests. A c-peptide was carried out as well and wasn't high enough to confirm type 2 nor low enough for type 1 so that was also dismissed by the expert. The diabetician said that he thought blood tests generally are a waiste of time. He believes that "diabetes care is an art not a science". He asked me how big a baby my only child was and when I told him that she had weighed 8 pounds he concluded that 8 pounds must have been massive in 1981 and that I must have had undiagnosed gestational diabetes and therefore must be type 2. I looked it up when I got home and 8 pounds was very normal even in those far off days and it seems unlikely that I had GD let alone that it proves a type 2 diagnosis. I had really hoped that the finding of the GAD antibodies in large enough numbers even for this country would be enough to place me in a position to get the treatment I suspect I will need. I find it frustrating that the "expert"appears determined to write me off what ever the evidence.

So you've now been dx T 2? Or not dx at all? Don't understand, sorry.

I really don't understand why a diagnosis of GD is automatically assumed to be type 2. All they test for is how high blood glucose goes after a carbohydrate load. They have no idea whether it is because of insulin resistance or lack of insulin production. Type 1 and type 2 are separate diseases, OK I accept that the general population might not get that but it's shocking and extremely disappointing that the medical profession seem to have trouble understanding it!

I don,t know eirher. I,ve been into the gp's surgery a couple of times and asked whether the letter from the specialist has come through, but as of last week (3 weeks post appointment) they've heard nothing. I'm assuming he'll tell them. He warned me that he can only classify people as type 1 if the pancrease has stopped producing any insulin and that the only other classification he can give is type 2 so I did ask if he was able to leave things vague. He didn't respond. Perhaps that's why there hasn't been a letter?

I had gestational diabetes 6 years ago and the last year have been treated with various tablets for type 2 then yesterday my consultant informed me I was more LADA and started me on insulin. I think I'm still in total shock and to be honest don't really know how I feel. My BM's are always in the late teens.

JuliePerks said:

I don,t know eirher. I,ve been into the gp's surgery a couple of times and asked whether the letter from the specialist has come through, but as of last week (3 weeks post appointment) they've heard nothing. I'm assuming he'll tell them. He warned me that he can only classify people as type 1 if the pancrease has stopped producing any insulin and that the only other classification he can give is type 2 so I did ask if he was able to leave things vague. He didn't respond. Perhaps that's why there hasn't been a letter?

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I had gd. Got all clear after delivery but told to have annual checks. Then diagnosed type 1 five years later.