Type 1.5 Lada Question.....

Hi,

You mention diet controlled? What diet are you on?
As i understand it, some ND diets can produce low levels of ketones in urine as a matter of course?

How elevated is your recent BGs?

I'll tag in @Antje77

I hope you get some answers soon!

I would say that it is possible to be LADA and have small levels of ketones.......

I think every body has different thresholds to which ketones are produced......the same for glucose spilling in to urine.....

Only the tests will confirm.....ultimately the sooner you get a diagnosis, the quicker a treatment regime can begin and you can get on with your life....

KatieLou said:

whether it’s possible to have LADA and have low levels of keytones?

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yes! Urine dip test for ketones isn't too specific anyway.

how high is your BGs?

i Think as mentioned in your first posting back then people were surprised at the T2 diagnosis............!

So you've stopped taking both metformin and Glicazide? (The metformin doesn't do that much but the glicazide probably does - so if thats the case I can see why your BG levels have gone up)

KatieLou said:

My specialist seems so confident that i can’t be anything other than type 2

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And have tests been done to prove this?

And have you stopped taking the glicazide?

Hi @KatieLou ,

If you've been omitting your prescribed diabetes meds recently? This will most likely be the cause of the higher BG readings...

KatieLou said:

My specialist said i was controlling my levels well so she took me off meds. I’ve been off them for 3 months and seemed to be stable. The levels have only started increasing in the last couple of weeks with no particular changes to diet/lifestyle.

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Ah, OK. I see. my apologies. Just needed clarification. It's time to see your specialist pronto!

Agree with Jaylee - just needed clarification and time to go back to them, or see what tests your Doc has asked for/results, hopefully a c-pep and gad test have been ordered.

KatieLou said:

Yep those are the 2 i’m having. Fingers crossed I’ll have more clarity next week

. There doesn’t seem to be a lot of info about LADA out there which is frustrating.

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Can’t really help much either other than treated as T1 but has potential slower onset - usually an extended honeymoon period where pancreas does produce ‘some’ insulin for a bit or partly recovers (for a bit) when ‘rested’ while using injected insulin - but of course diabetes being as it is there are no real hard and fast set rules!

Hi. Various points. If you are slim or have lost weight unexpectedly recently then LADA becomes possible. LADA often has long honeymoon period - mine lasted 5 years or so! A low-carb diet can result in ketones due to ketosis (fat burning) but that will happen even with a normal person so the ketone level is only relevant if high and is dangerous if you also have high BS. At the early stage of a LADA honeymoon when these are still some beta cells, Gliclazide can help a lot. I was on it for many years. The dose was gradually increased to the max of 320mg/day and no longer had any effect so insulin was needed. The C-peptide and GAD tests will not prove T2 but MAY help prove T1. A low C-peptide can imply low insulin and hence LADA. A negative GAD proves nothing. A positive GAD does indicate T1. In my opinion both Cholesterol and BP are not related to T2/diabetes so in that respect ignore them. Even as an amateur I might challenge your specialist. He is assuming that LADA always has a rapid onset with high ketones leading to DKA - it did with my Nephew whereas mine was very slow. I'm still officially diagnosed as T2 as the GPs couldn't accept otherwise despite always being slim and having little insulin output. The problem with all of this is the lack of suitable and low-cost tests together with inadequate GP training.

KatieLou said:

Is it possible to be diagnosed with LADA if there are only traces of keytones in your urine?

I just wanted to know whether it’s possible to have LADA and have low levels of keytones? I will know one way or another after i’m tested next week, but there doesn’t seem to be a lot of info online about LADA? Any ideas?

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Hi,

I managed just over four years as a diet controlled (assumed) T2. I then had two months feeling, as you say, "quite ill ... exhausted and ... generally unwell." I also lost a stone in weight.
Having spent over four years well controlled, I'd stopped testing my BS, so can't comment on my levels, but my GP soon alerted me to high BS, and resumed testing revealed figures in the 20's. A few weeks later a first appointment at the Diabetes Clinic only revealed ketones of 0.8. I was assumed LADA and put straight on an insulin regime. The dual meter (BS/ketones) I was given never showed higher ketones, but my pancreas had clearly given up on producing insulin.

I'm thankful that my body kept me alive without going into DKA (Diabetic Ketoacidosis), so before LADA diagnosis I soldiered on without the need for hospitalisation. Just feeling cr*p.

I guess the answer to your question is : yes !
Geoff

Thanks for the tag @Jaylee . I'm a bit late in reacting here, so it looks like you've got a lot of useful answers already. I agree with the above, LADA comes on pretty slow, so I'd think it's very well possible to still produce enough insulin to ward off high ketones. As far as I understand even 'classic' type1's don't develop DKA at the same bg levels.

I'm not speaking from experience though, as no-one ever thought to check my ketones, and when I asked the practice nurse if it would be wise to test for LADA I had to explain to her wat c-peptide and anti GAD tests were. I haven't bothered trying to get those tests again, as I'm well managed on a typical type1 regime, so I'm a type2 on my records.

Hope things will clear up for you shortly!

The 2 months before my LADA T1 diagnosis was when I really started showing symptoms, but given how high my hba1c was on diagnosis and how much weight I'd lost I the specialists said they thought I'd been running high for up to a year. The nurse at the local GP practice was still convinced I was T2 though given my age (43) despite my skeletal look and ketones of around 4 and rising.

Hospital said a child would have been unconscious with my results but adult bodies deal with the onset of T1 a lot more slowly. With you they may have caught it early and if they have that's great. They are likely to start you on low dose insulin to help your remaining beta cells.

I think my son is LADA 1.5 ATM....
He was diagnosed type 1 but after 8 days came off insulin 10units at bed, but made him to low in the mornings fasting bs 2.5
so hospital nurse said to come off insulin ....5 months on he is still off insulin with normal readings
He's on LCHF diet, excercises 4/5days a week inc biking 10miles on a Saturday
Doctor says type 1 in honeymoon stage, but honeymoon stage still has bs lows and highs doesn't it unless helped with insulin to control