Newly diagnosed and a bit confused

[Amine83]

Hello everyone,

So happy to be in this forum where I found plenty of information. I'm going to describe the story of my diagnosis and hope to find advice from you.
I'm 37 years old, BMI of 23 (weight 78kg, height 184cm) with family history of diabetes (both parents and aunts are type 2 diabetics). 6 months ago, I went to the doctor for palpitations, stress and anxiety and I discovered that I had 190 mg/dl FBG and HbA1c of 8.8% with no symptoms (no thirst, no frequent urination, no weight loss), and also, found hyperlipidemia (LDL Cholesterol 170mg/dl and triglycerides 187 mg/dl, both above normal ranges). For the last couple of years, I was not exercising, gained fat around my belly (ultrasound showed moderate fatty liver) and despite the fact that I don't eat that much of sugary foods, I do eat lot of carbs like breads, pastas etc.
Initially my doctor suspected that I could be Type 1.5/lada despite my normal range C-peptide level (he told me you are pretty young for type 2 with normal BMI). He ordered GAD65 autoantibody test and the result came negative (with no history of autoimmune diseases as well).
In the first time, he put me on metformin 500 twice a day along with statins for my cholesterol, but with my scientific background (master's in marine biology) I started reading articles and decided immediately to go on a low carb diet. Also, I stopped taking metformin from the first week (came off statins as well), my belly almost disappeared, lost about 8kg and my sugar levels kept going down steadily from 190mg/dl to between 90 and 100 within 2 weeks. My post meals rarely reach 150 (1 hour and 2 hours after the meal) and generally 4 hours after a meal I'm around 105 to 115. However, sometimes blood sugar after meal gets to 140 and keeps more than 4 hours to come down to 110 ranges. I sometimes worry when BG don't come down after 2 or 3 hours of eating (it happens sometimes). I do have stress and lack of sleeping most of the days.

My question is: is there a risk I can be Type 1.5/lada? (I'm off medication since the first 10 days of diagnosis)

Thank you!

 

[Antje77]

My question is: is there a risk I can be Type 1.5/lada?

It's not impossible. Early LADA presents a lot like T2. There are other antibodies than the GAD ones as well, although they are a bit less common, and some are diagnosed with LADA despite testing negative for antibodies.
On the other hand, there are a lot of thin T2's as well (and fat LADA's, like myself) and you're reacting well to the dietary changes you've made. The family history is a strong pointer as well.

For your treatment at the moment it won't make a difference. You're seeing very healthy numbers on diet only so even if you do have latent T1 you wouldn't need insulin for now.

However, if at some point in the future your numbers keep rising despite eating low carb, be sure to remind your HCP of the initially suspected LADA.

 

[LaoDan]

Could be TOFI, if you’re responding to dietary changes, stick with it. Do maintenance measurements to make sure you’re on track.

 

[JoKalsbeek]

Hello everyone,

So happy to be in this forum where I found plenty of information. I'm going to describe the story of my diagnosis and hope to find advice from you.
I'm 37 years old, BMI of 23 (weight 78kg, height 184cm) with family history of diabetes (both parents and aunts are type 2 diabetics). 6 months ago, I went to the doctor for palpitations, stress and anxiety and I discovered that I had 190 mg/dl FBG and HbA1c of 8.8% with no symptoms (no thirst, no frequent urination, no weight loss), and also, found hyperlipidemia (LDL Cholesterol 170mg/dl and triglycerides 187 mg/dl, both above normal ranges). For the last couple of years, I was not exercising, gained fat around my belly (ultrasound showed moderate fatty liver) and despite the fact that I don't eat that much of sugary foods, I do eat lot of carbs like breads, pastas etc.
Initially my doctor suspected that I could be Type 1.5/lada despite my normal range C-peptide level (he told me you are pretty young for type 2 with normal BMI). He ordered GAD65 autoantibody test and the result came negative (with no history of autoimmune diseases as well).
In the first time, he put me on metformin 500 twice a day along with statins for my cholesterol, but with my scientific background (master's in marine biology) I started reading articles and decided immediately to go on a low carb diet. Also, I stopped taking metformin from the first week (came off statins as well), my belly almost disappeared, lost about 8kg and my sugar levels kept going down steadily from 190mg/dl to between 90 and 100 within 2 weeks. My post meals rarely reach 150 (1 hour and 2 hours after the meal) and generally 4 hours after a meal I'm around 105 to 115. However, sometimes blood sugar after meal gets to 140 and keeps more than 4 hours to come down to 110 ranges. I sometimes worry when BG don't come down after 2 or 3 hours of eating (it happens sometimes). I do have stress and lack of sleeping most of the days.

My question is: is there a risk I can be Type 1.5/lada? (I'm off medication since the first 10 days of diagnosis)

Thank you!

Not all T2's are overweight, and you do have a non-alcoholic fatty liver, (which low carb'll take care of, coincidentally) as well as family history. T2 is likely, and with you sleeping badly and feeling stressed, well.. All in all you've take the right steps in lowering your carbohydrate intake and measuring the results. Keep an eye on that, as it is quite likely you are a T2, but as has been mentioned before, LADA does present as T2 on the onset, so... No harm in being careful.

Have you noticed what meals keep you elevated for longer? What are you eating now?

Anyway, welcome, and well done on taking the bull by the horns!!!
Jo

 

[Amine83]

It's not impossible. Early LADA presents a lot like T2. There are other antibodies than the GAD ones as well, although they are a bit less common, and some are diagnosed with LADA despite testing negative for antibodies.
On the other hand, there are a lot of thin T2's as well (and fat LADA's, like myself) and you're reacting well to the dietary changes you've made. The family history is a strong pointer as well.

For your treatment at the moment it won't make a difference. You're seeing very healthy numbers on diet only so even if you do have latent T1 you wouldn't need insulin for now.

However, if at some point in the future your numbers keep rising despite eating low carb, be sure to remind your HCP of the initially suspected LADA.

Thank you so much for your valuable info! I will keep tracking as I always do.

 

[Amine83]

Could be TOFI, if you’re responding to dietary changes, stick with it. Do maintenance measurements to make sure you’re on track.

Yes I feel I'm most likely TOFI. The lady performing ultrasound was shocked about the amount of fat around my organs despite my normal weight. Fatty liver and type 2 diabetes match well.

 

[Amine83]

Not all T2's are overweight, and you do have a non-alcoholic fatty liver, (which low carb'll take care of, coincidentally) as well as family history. T2 is likely, and with you sleeping badly and feeling stressed, well.. All in all you've take the right steps in lowering your carbohydrate intake and measuring the results. Keep an eye on that, as it is quite likely you are a T2, but as has been mentioned before, LADA does present as T2 on the onset, so... No harm in being careful.

Have you noticed what meals keep you elevated for longer? What are you eating now?

Anyway, welcome, and well done on taking the bull by the horns!!!
Jo

Thank you so much!
Well, no specific foods keep me elevated for longer (sometimes the same meal increases my BS by 10 or 30 points depending on the day). But I have clearly noticed that it happens when I don't sleep well during that day or I'm stressed. It is amazing how stress and lack of sleep impacts my BG the same day. When I take a nap or go for meditation, it goes down almost immediately.

For my diet, here is it:
Breakfast: (always)
Handful of berries, nuts (almonds, walnut, cashew), seeds (ground flaxseeds and chia) all mixed with unsweetened almond milk with half an apple. And i love it! It's filling, nutritious and low glycemic. Sometimes followed by american coffee (without sugar of course).

Lunch (and this is super important):
I always start with a big salad filled with many ingredients (green salad + beans + chickpeas + tuna or mackerel + ground flaxseeds and chia + lemon juice + extravirgin olive oil). I mix the whole thing and I start with it. Once I do, i filled my stomach by 70% with nutrient dense foods.
The rest, sometimes grilled chicken breasts, most of the times grilled fish, cooked veggies, different kind of soups. And lot of other things low carb from tunisian cuisine (my home country).

Dinner: (never later than 7h30pm)
Always the same bowl of salad like at lunch time.
Then I add sometimes fish, or many other light options, always low carb or no carb.

By 9 or 10 pm I have coffee or tea with friends.

That's my diet, it covers all macronutrients (healthy fats, proteins, complex carbs from beans etc.) and micronutrients (vitamins, minerals, phytochemicals) + plenty of fiber.

Since I eat this way, my belly disappeared within a month, I'm more energetic, and acid reflux I used to have has gone for ever!

 

[LaoDan]

Thank you so much!
Well, no specific foods keep me elevated for longer (sometimes the same meal increases my BS by 10 or 30 points depending on the day). But I have clearly noticed that it happens when I don't sleep well during that day or I'm stressed. It is amazing how stress and lack of sleep impacts my BG the same day. When I take a nap or go for meditation, it goes down almost immediately.

For my diet, here is it:
Breakfast: (always)
Handful of berries, nuts (almonds, walnut, cashew), seeds (ground flaxseeds and chia) all mixed with unsweetened almond milk with half an apple. And i love it! It's filling, nutritious and low glycemic. Sometimes followed by american coffee (without sugar of course).

Lunch (and this is super important):
I always start with a big salad filled with many ingredients (green salad + beans + chickpeas + tuna or mackerel + ground flaxseeds and chia + lemon juice + extravirgin olive oil). I mix the whole thing and I start with it. Once I do, i filled my stomach by 70% with nutrient dense foods.
The rest, sometimes grilled chicken breasts, most of the times grilled fish, cooked veggies, different kind of soups. And lot of other things low carb from tunisian cuisine (my home country).

Dinner: (never later than 7h30pm)
Always the same bowl of salad like at lunch time.
Then I add sometimes fish, or many other light options, always low carb or no carb.

By 9 or 10 pm I have coffee or tea with friends.

That's my diet, it covers all macronutrients (healthy fats, proteins, complex carbs from beans etc.) and micronutrients (vitamins, minerals, phytochemicals) + plenty of fiber.

Since I eat this way, my belly disappeared within a month, I'm more energetic, and acid reflux I used to have has gone for ever!

Great work! Great diet too!

 

[JoKalsbeek]

Thank you so much!
Well, no specific foods keep me elevated for longer (sometimes the same meal increases my BS by 10 or 30 points depending on the day). But I have clearly noticed that it happens when I don't sleep well during that day or I'm stressed. It is amazing how stress and lack of sleep impacts my BG the same day. When I take a nap or go for meditation, it goes down almost immediately.

For my diet, here is it:
Breakfast: (always)
Handful of berries, nuts (almonds, walnut, cashew), seeds (ground flaxseeds and chia) all mixed with unsweetened almond milk with half an apple. And i love it! It's filling, nutritious and low glycemic. Sometimes followed by american coffee (without sugar of course).

Lunch (and this is super important):
I always start with a big salad filled with many ingredients (green salad + beans + chickpeas + tuna or mackerel + ground flaxseeds and chia + lemon juice + extravirgin olive oil). I mix the whole thing and I start with it. Once I do, i filled my stomach by 70% with nutrient dense foods.
The rest, sometimes grilled chicken breasts, most of the times grilled fish, cooked veggies, different kind of soups. And lot of other things low carb from tunisian cuisine (my home country).

Dinner: (never later than 7h30pm)
Always the same bowl of salad like at lunch time.
Then I add sometimes fish, or many other light options, always low carb or no carb.

By 9 or 10 pm I have coffee or tea with friends.

That's my diet, it covers all macronutrients (healthy fats, proteins, complex carbs from beans etc.) and micronutrients (vitamins, minerals, phytochemicals) + plenty of fiber.

Since I eat this way, my belly disappeared within a month, I'm more energetic, and acid reflux I used to have has gone for ever!

You're doing really well, congratulations! I would suggest you remember that, should you plateau or get stuck at some point, there are still some things you can tweak. The apple, cashews, beans etc are relatively high in carbs, some faster absorbed than others... Some can have pulses just fine, others like me, can't. The meter'll let you know on which side you fall. You seem to be able to handle considerably more carbs than I can, considering your numbers, so just another example of why diet is so very, very personal. I can't eat what you eat, also because the seeds would trigger other problems for me for instance, but if it works for you, it works. A rise between 10 and 30 is excellent. So far as I can see you're doing what you can there.

Now... That leaves the insomnia and the stress. Those can and will up blood sugars due to liver dumps, so you want to calm that down a little. Some CBD oil may help there. (Holland & Barrett sell Hooy, that's a good, consistent brand). I've suffered insomnia and 2 anxiety disorders my entire life, and that stuff worked well in getting me back to a regular sleep pattern, and relax a little in certain situations. You might also want to look into weighted blankets, if you haven't already. (You'd want one that is about 10% your body weight, if you go that route.). Just some ideas that worked for me, as pills don't seem to make a dent.

Good luck!
Jo

 

[Amine83]

You're doing really well, congratulations! I would suggest you remember that, should you plateau or get stuck at some point, there are still some things you can tweak. The apple, cashews, beans etc are relatively high in carbs, some faster absorbed than others... Some can have pulses just fine, others like me, can't. The meter'll let you know on which side you fall. You seem to be able to handle considerably more carbs than I can, considering your numbers, so just another example of why diet is so very, very personal. I can't eat what you eat, also because the seeds would trigger other problems for me for instance, but if it works for you, it works. A rise between 10 and 30 is excellent. So far as I can see you're doing what you can there.

Now... That leaves the insomnia and the stress. Those can and will up blood sugars due to liver dumps, so you want to calm that down a little. Some CBD oil may help there. (Holland & Barrett sell Hooy, that's a good, consistent brand). I've suffered insomnia and 2 anxiety disorders my entire life, and that stuff worked well in getting me back to a regular sleep pattern, and relax a little in certain situations. You might also want to look into weighted blankets, if you haven't already. (You'd want one that is about 10% your body weight, if you go that route.). Just some ideas that worked for me, as pills don't seem to make a dent.

Good luck!
Jo

Highly appreciate your input here! For the stress and insomnia, it's totally outside the diet/diabetes issue. I don't call it insomnia though (I still sleep a minimum of 6 hours a day) but 3 in 7 days a week I lack of it. I wake up at least 2 or 3 times at night (just like that!) and it takes time for me to get back to sleep afterwards. Dealing with stress, that's my everyday struggle, but still manageable, and it does impact blood sugar a lot.
Also, I now weigh 70 kg, still stabilized in this range with the diet I eat. Now I'm preparing myself to go to a gym soon, and still trying to figure out how to solve the dilemma of gaining muscle mass on a low carb diet.. It's a bit tricky. I need to increase calories intake from more fats and of course increase protein intake. Will see what happens!

Good luck for you too!

 

[LaoDan]

Highly appreciate your input here! For the stress and insomnia, it's totally outside the diet/diabetes issue. I don't call it insomnia though (I still sleep a minimum of 6 hours a day) but 3 in 7 days a week I lack of it. I wake up at least 2 or 3 times at night (just like that!) and it takes time for me to get back to sleep afterwards. Dealing with stress, that's my everyday struggle, but still manageable, and it does impact blood sugar a lot.
Also, I now weigh 70 kg, still stabilized in this range with the diet I eat. Now I'm preparing myself to go to a gym soon, and still trying to figure out how to solve the dilemma of gaining muscle mass on a low carb diet.. It's a bit tricky. I need to increase calories intake from more fats and of course increase protein intake. Will see what happens!

Good luck for you too!

You certainly can add muscle doing low carb, are you doing weight training? I’ve been hitting the weights pretty hard for the last six months and have had really good results.

 

[JoKalsbeek]

Highly appreciate your input here! For the stress and insomnia, it's totally outside the diet/diabetes issue. I don't call it insomnia though (I still sleep a minimum of 6 hours a day) but 3 in 7 days a week I lack of it. I wake up at least 2 or 3 times at night (just like that!) and it takes time for me to get back to sleep afterwards. Dealing with stress, that's my everyday struggle, but still manageable, and it does impact blood sugar a lot.
Also, I now weigh 70 kg, still stabilized in this range with the diet I eat. Now I'm preparing myself to go to a gym soon, and still trying to figure out how to solve the dilemma of gaining muscle mass on a low carb diet.. It's a bit tricky. I need to increase calories intake from more fats and of course increase protein intake. Will see what happens!

Good luck for you too!

You might find that waking at night will actually trigger a response from the liver, which'll dump glucose... It's called Dawn Phenomenon, and if you wake a few times a night, it can get triggered early and even multiple times over. Could be it doesn't affect you at all, but I know my fasting blood glucose in the morning is up when I have woken a few times in a night, had nightmares or just was awake for an hour or two. Stress will trigger the same liver glucose dump, so yeah... Just some things to keep an eye on, when you can't explain away a rise in blood sugars with what you've eaten. There's more at work than just what we ingest, sometimes. (Statins, a cold, everything in between... Anything can affect us, basically)

As for the gym, protein, protein, protein, far as I've understood it.... But I've never been much of a gym type. Not since that snot nosed lug of a trainer told me to "work through the pain", and got me to permanently ruin my left hip, 10 years or so ago.

 

[Resurgam]

Singe being diagnosed and going low carb I have become stronger - I don't know if it is more muscle or if it is just working better, but I can now haul knitting machines around once more and have gone back to work servicing them.