No definitive diagnosis

[Honeyblossom]

I had my first appointment today with diabetes team at the hospital and was hoping for a formal diagnosis whether type 2 or Lada but after a long discussion he said I was in a grey area. I'm more confused then ever now. I'm GAD positive but low number and BMI 21. I'm negative for all the other antibodies. I was just hoping for clarification one way or another so I could move on.

 

[Lamont D]

I had my first appointment today with diabetes team at the hospital and was hoping for a formal diagnosis whether type 2 or Lada but after a long discussion he said I was in a grey area. I'm more confused then ever now. I'm GAD positive but low number and BMI 21. I'm negative for all the other antibodies. I was just hoping for clarification one way or another so I could move on.

Did they tell you that further tests would be needed?
If so, which ones? Further blood tests?

It would be great to get a true diagnosis, however, doing and making small adjustments to your dietary, exercise and health care is more important. Eating healthy for you. Would be my advice.

Then ask your team, what is next!!!

 

[Honeyblossom]

Did they tell you that further tests would be needed?
If so, which ones? Further blood tests?

It would be great to get a true diagnosis, however, doing and making small adjustments to your dietary, exercise and health care is more important. Eating healthy for you. Would be my advice.

Then ask your team, what is next!!!

Thank-you Lamont D, you are right. Perhaps I am focusing too much on this. I have been eating low carb (which worked well ) since initial type 2 diagnosis three years ago but numbers just keep creeping up. I did ask whether a c peptide would be helpful but Dr felt not. I've been prescribed a gliptin so I guess I have to give it time and see if it works.

 

[Lamont D]

Thank-you Lamont D, you are right. Perhaps I am focusing too much on this. I have been eating low carb (which worked well ) since initial type 2 diagnosis three years ago but numbers just keep creeping up. I did ask whether a c peptide would be helpful but Dr felt not. I've been prescribed a gliptin so I guess I have to give it time and see if it works.

Which gliptin? Are you aware how it works?
There must be an imbalance in your first phase insulin response. Or your insulin resistance is having an effect to maintain higher spikes, than what is normal.

an oral glucose tolerance test would be an idea, unless you have already had one?

 

[Honeyblossom]

Which gliptin? Are you aware how it works?
There must be an imbalance in your first phase insulin response. Or your insulin resistance is having an effect to maintain higher spikes, than what is normal.

an oral glucose tolerance test would be an idea, unless you have already had one?

Alogliptin 25mg - It's a new one on me tbh. The only blood test I've had is hba1c and when that kept creeping up I asked for GAD. I've never had a glucose tolerance test. Is that routine?

 

[Lamont D]

The test does what is says it does, it measures your response to 75g of glucose, which is obviously so fast acting, the spike, how quick, when and how high, the hormonal (insulin) response, and the usual one (two hours) to see how the second phase does at that second hour.
An endocrinologist can glean a lot of information from it.
An extended oral glucose tolerance test (5 hours) can be used to see other criteria of how insulin/glucose imbalance happens after two hours. For many reasons the BG levels after two hours may not be close to where a non diabetic would be.
Insulin resistance, and weak first phase insulin response is highlighted.
Hence, the gliptin!
As I said, this could reduce the spike, as it did for me, from over 12(ish) to 8.4(ish) from 75g glucose.
I have very weak first phase insulin response. So initially it helped. But if I kept to keto, I would have no spike anyway!
Doctors have shied away from the test, due to cost etc. And rely on hba1c. Which doesn't show the details of how your body reacts to carbs and sugars.

Hope that helps.

 

[Honeyblossom]

The test does what is says it does, it measures your response to 75g of glucose, which is obviously so fast acting, the spike, how quick, when and how high, the hormonal (insulin) response, and the usual one (two hours) to see how the second phase does at that second hour.
An endocrinologist can glean a lot of information from it.
An extended oral glucose tolerance test (5 hours) can be used to see other criteria of how insulin/glucose imbalance happens after two hours. For many reasons the BG levels after two hours may not be close to where a non diabetic would be.
Insulin resistance, and weak first phase insulin response is highlighted.
Hence, the gliptin!
As I said, this could reduce the spike, as it did for me, from over 12(ish) to 8.4(ish) from 75g glucose.
I have very weak first phase insulin response. So initially it helped. But if I kept to keto, I would have no spike anyway!
Doctors have shied away from the test, due to cost etc. And rely on hba1c. Which doesn't show the details of how your body reacts to carbs and sugars.

Hope that helps.

Thank-you, very informative. I had heard of it but didn't know the detail. I hope I have the similar results with the gliptin as you have!

 

[Lamont D]

Thank-you, very informative. I had heard of it but didn't know the detail. I hope I have the similar results with the gliptin as you have!

That is if you have a poor or weak first phase insulin response or insulin resistance that hampers the amount of glucose derived from your food.

I hope it will sort it out, or you don't have it! If that makes sense!