New HbAc1 figures up on low carb for last year?

Chris24Main

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As I recall - there are 5 antibodies that are created on account of auto-immune attack on the pancreas, and only 4 of them can be tested for. A positive test on one antibody does not 100% mean T1 (you would expect positive on most if not all 4) - and I think for me, if this is 2 year old information, it's highly unlikely that you have an autoimmune condition that is both a problem and at the same time not a problem in 2 years.

That's the way I would put it - but I would put it to your doc - on no account take this as a diagnosis of anything.

It really is confusing - and because the diagnosis revolves around blood glucose, they appear all to be much the same - but you need to be firm in the idea that T1 - no insulin and T2 - too much insulin that isn't working properly.

C-Peptide is a way of measuring insulin (it's a byproduct of insulin production in the pancreas, and so is a good way of determining whether you can produce insulin even if you are taking it in injections too - but partly this is because insulin itself is more difficult to measure).

So - it tells you different things - Honestly, if you have been 2 years with no meds (and you are feeling well, and your blood glucose hasn't shot up) then it's unlikely that there is any need to panic in any case - You have clearly had some success with lowering carbs - but I think that many get lost between lowering carbs and lowering calories - you need a little more time to understand your own body
 

Antje77

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A positive test on one antibody does not 100% mean T1 (you would expect positive on most if not all 4)
Most T1's are not positive for most/all antibodies, and a percentage (forgot how many, or even if there is a clear number on this) are negative for all, and still T1.
To make it more confusing, antibodies apparently can come and go as well.
 
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Caz141

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Thanks @antjee
So I’m gathering it really is muddy waters of diagnosis for which type of diabetes and unless I’m going dangerously high or low then it comes down to an older body just not doing what it used to do as a spring younger chicken self.
There is a science to all this stuff I’m sure but an awful lot of guess work along the way.
 
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Chris24Main

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Most T1's are not positive for most/all antibodies, and a percentage (forgot how many, or even if there is a clear number on this) are negative for all, and still T1.
To make it more confusing, antibodies apparently can come and go as well.
Yes - I'm really just trying to relay the conversation I had with my HCP 18 months ago now, but I believe that's also true - I kind of had the impression "why would you have me take this test and then spend even longer explaining all the ways that it might not tell me anything ?"

@Caz141
It isn't necessarily just getting older.

Some simple figures - of all diabetes sufferers, 90% or so are T2. The rates of both T1 and T2 are increasing, but the rate of something "other" than classic T1 or T2 is about 2% - so anything other than "the norm" is quite rare.

The median age of onset of T1 is surprisingly 29 - later than I would have thought, and I have no data, but I would have thought it unlikely that over a two year period, from having been diagnosed with high blood glucose - that this could be getting better while your pancreas is getting worse.. (just laying out what I would expect a doctor to be thinking).

So - you can see from that that the system will see you as very likely T2. With a C-Peptide test, you can say for sure that your pancreas is capable of production of insulin; so you can feel much more confident in that (you are a statistic to the system, but everyone is unique to themselves).
 

Angela64

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@ Antje77, thank you for the reply.
When i was first diagnosed i had a test done called insulin antibodies that came back with the results of 5.2.
Is this anything to do with what my body is making on the insulin scale? Or do i need the test for the C PEPTIDE? Or the glucose test which few people seem to get unless going private.
From what i gather this is supposed to be
I remember having to fight with the receptionist and doctor just to get an HbA1c test because i heard those same words, i just was not the right figures to fit the category of diabetes. I think they were shocked when it came back at 10.4% (90mmol). Again Type 1 was mentioned but i went into over drive and drove the figures down with LCHF and walking until now that they are slowly creeping.

I was thinking if I’m making no or little insulin then this would go into TYPE 1 or the other ones out there of LADA/ MODY but then i would then be having either extreme hypos or hypers? My figures rarely go low and keeping the carbs low they may go into higher figures once a week. These are the times I’m experimenting with something new or to see though wishful thinking if i can add some foods back in (i so haven’t become any more insulin sensitive over the year).
It’s just the morning figures that are still in the 6,7 or 8’s. There is no pattern or consistency to this figure. After a year of this way of eating i thought they would be better.

As to the fat i was eating more fat than i do now but my weight was slowly gaining so i then cut back on it over the last month or so and my weight is either stable or moves down by 2 pound. That is what made me think that there was too much fat in my menu with the gradual weight gain?

Then there is the whole thought process that because I’ve got my body to the low carb regime that when i do slightly higher those carbs then my system don’t know what to do with them and goes into the 8’s on the finger prick testing? But it seems it’s not till the next day that this shows up?
And yes i do think my eating is healthy but also un healthy in the same breath but if I’m eating to my metre then that is somewhere around here. Could be really wrong though.
I can relate to your experience, I was diagnosed T2D in July2021. Was strict low carb. Still low carb but not as strict, I haven’t cut out every carb. Life is difficult enough and I’ve other wretched health problems as well Not due to the T2D, a complex mixed bag
Yes lots and lots of different things affect the numbers and impossible to work out what’s causing the rising BG’s Last time I saw DN she Was for putting me on injecting in the evening, I refused and she looked at my graphs from the Libre 2 and was ‘ok’ with that. Will be having a check up in January and I’m not holding my breath for a good HbA1C ‍♀️
A consultant endocrinologist I saw 6/7 months after diagnosis said ‘You've got to live’! I think of this when I’m down and frustrated either way all my ails
I’m a really good cook and lost my mojo to bother as, I shouldn’t eat what I can cook.
I go in fits n starts with adjusting the recipes so I can eat some of what I like without too higher carb spike.
Sometimes I can be really naughty and my levels are as high as I’d thought ‍♀️
 
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Caz141

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I can relate to your experience, I was diagnosed T2D in July2021. Was strict low carb. Still low carb but not as strict, I haven’t cut out every carb. Life is difficult enough and I’ve other wretched health problems as well Not due to the T2D, a complex mixed bag
Yes lots and lots of different things affect the numbers and impossible to work out what’s causing the rising BG’s Last time I saw DN she Was for putting me on injecting in the evening, I refused and she looked at my graphs from the Libre 2 and was ‘ok’ with that. Will be having a check up in January and I’m not holding my breath for a good HbA1C ‍
A consultant endocrinologist I saw 6/7 months after diagnosis said ‘You've got to live’! I think of this when I’m down and frustrated either way all my ails
I’m a really good cook and lost my mojo to bother as, I shouldn’t eat what I can cook.
I go in fits n starts with adjusting the recipes so I can eat some of what I like without too higher carb spike.
Sometimes I can be really naughty and my levels are as high as I’d thought ‍

I can relate to your experience, I was diagnosed T2D in July2021. Was strict low carb. Still low carb but not as strict, I haven’t cut out every carb. Life is difficult enough and I’ve other wretched health problems as well Not due to the T2D, a complex mixed bag
Yes lots and lots of different things affect the numbers and impossible to work out what’s causing the rising BG’s Last time I saw DN she Was for putting me on injecting in the evening, I refused and she looked at my graphs from the Libre 2 and was ‘ok’ with that. Will be having a check up in January and I’m not holding my breath for a good HbA1C ‍
A consultant endocrinologist I saw 6/7 months after diagnosis said ‘You've got to live’! I think of this when I’m down and frustrated either way all my ails
I’m a really good cook and lost my mojo to bother as, I shouldn’t eat what I can cook.
I go in fits n starts with adjusting the recipes so I can eat some of what I like without too higher carb spike.
Sometimes I can be really naughty and my levels are as high as I’d thought ‍

It is frustrating because you get hyped up on the low carb diet because lots have a good success rate with it. I’ve no doubt though if I’d of continued without it I wouldn’t be in the same position I’m in today. Even if right now I’m a little deflated with the diet.
I think about those times like you that I have something a little more carby and see the numbers rise but from reading of late your body knows even less what to with carbs on a low carb diet. I thought I’d become more sensitive to carbs but I didn’t .
I think it works a similar way to the tablets that are needed more and more over time but on the food side the carbs become less and less to try and control the sugar levels. Yes then the brain/inner critic kinda kicks in sluggishly to cheer me on” but you’ve got to live! “.

I love this forum because it makes you feel you’re not walking this silent frustrating path alone but with others. Thank you for telling me your story

I hope your health check up in jan shocks you in a good way. Hba1c amazing
Good luck.
 

Melgar

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@Caz141 , I did the very low carb diet in early 2023. I was consuming less that 35 carbs a day, working on rebuilding a coastal cottage of mine so lots of physical work, but my blood sugars dropped only a tiny bit. I lost too much weight, weight I could I’ll afford to lose. My conclusion from that is my raised blood sugars are not down to too much carby food. As I have coeliac disease and my brother is a T1 diabetic (both have the same genetic root) I am susceptible to T1 diabetes, but having a susceptibility does not mean it’s inevitable. I don’t produce enough insulin. Now It could be early LADA or I could have a damaged pancreas, the point is I don’t produce enough insulin no matter what I eat. I exercise, which works well for me. I do around 10-12 miles a day.

T2 means your pancreas is forced to produce too much insulin in an attempt to keep your blood sugars in range because in classic T2 your body’s cells are resistant to the insulin. So upon taking a C-Peptide test to see how much insulin your pancreas is producing anything above 1000 pmol/ls ( fasting )is likely T2. I’ve seen members here with very high blood sugars (10% Ac1 - 180 mgdl) producing less than 300 pmol/ls of C-Peptides. They were diagnosed T1. Their pancreas’ cannot produce enough insulin regardless of how high their blood sugars go.

In T2 your pancreas can produce a lot of insulin, because it remains undamaged. The beta cells are intact . That said, not all pancreas’ are made equal, some people‘s pancreas’ are capable of producing more insulin than others hence the rise in Blood sugars, but they still produce a lot of insulin and are still T2.

In T1 their pancreas’ simply are not capable of producing enough insulin regardless of what they eat, hence the very low C-Peptides, or their pancreas’ produce no insulin at all.

As for autoimmune antibodies, they can be transient. If It’s a low result it can be deemed a false positive. I will attached a research paper for you. It is concerned with GAD autoantibodies in none diabetics but it maybe of interest as it discusses their transient nature when they are at lows titres.

 

Caz141

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Messages
56
Type of diabetes
Treatment type
Diet only
@Caz141 , I did the very low carb diet in early 2023. I was consuming less that 35 carbs a day, working on rebuilding a coastal cottage of mine so lots of physical work, but my blood sugars dropped only a tiny bit. I lost too much weight, weight I could I’ll afford to lose. My conclusion from that is my raised blood sugars are not down to too much carby food. As I have coeliac disease and my brother is a T1 diabetic (both have the same genetic root) I am susceptible to T1 diabetes, but having a susceptibility does not mean it’s inevitable. I don’t produce enough insulin. Now It could be early LADA or I could have a damaged pancreas, the point is I don’t produce enough insulin no matter what I eat. I exercise, which works well for me. I do around 10-12 miles a day.

T2 means your pancreas is forced to produce too much insulin in an attempt to keep your blood sugars in range because in classic T2 your body’s cells are resistant to the insulin. So upon taking a C-Peptide test to see how much insulin your pancreas is producing anything above 1000 pmol/ls ( fasting )is likely T2. I’ve seen members here with very high blood sugars (10% Ac1 - 180 mgdl) producing less than 300 pmol/ls of C-Peptides. They were diagnosed T1. Their pancreas’ cannot produce enough insulin regardless of how high their blood sugars go.

In T2 your pancreas can produce a lot of insulin, because it remains undamaged. The beta cells are intact . That said, not all pancreas’ are made equal, some people‘s pancreas’ are capable of producing more insulin than others hence the rise in Blood sugars, but they still produce a lot of insulin and are still T2.

In T1 their pancreas’ simply are not capable of producing enough insulin regardless of what they eat, hence the very low C-Peptides, or their pancreas’ produce no insulin at all.

As for autoimmune antibodies, they can be transient. If It’s a low result it can be deemed a false positive. I will attached a research paper for you. It is concerned with GAD autoantibodies in none diabetics but it maybe of interest as it discusses their transient nature when they are at lows titres.


Thanks melgar for the info, i will take a look at the paper