Prediabetic? LADA? So confused!

[Cloherty123]

I'mHello,

I just want to say this forum has given me so much info and actually made me feel mentally better many times so thank you.

About 4 years ago I was diagnosed as Prediabetic aged 25-ish. I was told to eat better etc.

Fast forward to now, I was never a big guy and now weigh only 80kgs. I went for blood tests for something unconnected and was contacted by the doctor saying my Blood sugar levels were higher than ideal.

I then had a scare after having dinner at a friends (who had diabetes while pregnant which developed into Type 2) and after testing myself at hers for fun 1 hour after a VERY carby dinner and discovered my levels at 11. This made me meet with my Doctor and he told me about Type 1.5 and due to my being very slim, it could be that.

I went for an oral glucose tolerance test about 6 months ago. They took my fasting levels which were like between 6.5-7. (I always have higher readings in the morning and 2hrs after drinking the glucose solution, my levels came back at around 7 - so Prediabetic fasting numbers but non diabetics numbers 2hrs after. They tested me for antibodies which also came back negative.

I'm so confused! I have a meter that I use and I consistently get high readings in the morning and high-ish numbers after food (depending on what I've eaten). I work out and I am in good shape yet my blood sugar levels are always prediabetic.

Any advice? Should I see the doctor again? Would they prescribe me anything to help?

Sorry for the long post!

Mike x

 

[Bluetit1802]

I'm afraid we can't diagnose you, but if you haven't had an HbA1c test there is no harm in asking your doctor to order you one. This is the correct diagnostic test for diabetes.

Just to make a few points. Testing an hour after a meal is a waste of time in your circumstances. Even healthy people will reach 11 an hour after a very carby meal. It is what happens at 2 hours and 3 hours that matters.

Fasting blood glucose is so unpredicatable it is no longer used as a diagnostic tool in the UK without an accompanying HbA1c, and even then it is only borderline if it reaches 7. There are a lot of factors that influence FBG levels, none of them connected with food. (disturbed sleep, stress, time of taking the test, hormones, and so forth)

My advice is simply to see your GP and ask for the HbA1c.

 

[Daibell]

Hi. The possibility is that you are T1.5 but in the honeymoon period which I went thru. When T1.5, aka LADA, comes on after childhood it can appear at widely varying speeds which can cause confusion on the right diagnosis. You need to have regular HBA1C tests and use the meter from time to time. There are a few tablets that can help as and when needed and then insulin if your blood sugar can't be controlled by tablets. Do have a low-carb diet to help control the BS. It isn't just anti-bodies that can cause pancreatic cell destruction, as viruses are a known cause (see today's Daily Mail). The GAD test will then show negative. A c-peptide test can help show how much insulin you are producing

 

[Cloherty123]

Hi. The possibility is that you are T1.5 but in the honeymoon period which I went thru. When T1.5, aka LADA, comes on after childhood it can appear at widely varying speeds which can cause confusion on the right diagnosis. You need to have regular HBA1C tests and use the meter from time to time. There are a few tablets that can help as and when needed and then insulin if your blood sugar can't be controlled by tablets. Do have a low-carb diet to help control the BS. It isn't just anti-bodies that can cause pancreatic cell destruction, as viruses are a known cause (see today's Daily Mail). The GAD test will then show negative. A c-peptide test can help show how much insulin you are producing

Hi Thank you for the response.

How long were you in the honeymoon phase?

 

[Cloherty123]

I'm afraid we can't diagnose you, but if you haven't had an HbA1c test there is no harm in asking your doctor to order you one. This is the correct diagnostic test for diabetes.

Just to make a few points. Testing an hour after a meal is a waste of time in your circumstances. Even healthy people will reach 11 an hour after a very carby meal. It is what happens at 2 hours and 3 hours that matters.

Fasting blood glucose is so unpredicatable it is no longer used as a diagnostic tool in the UK without an accompanying HbA1c, and even then it is only borderline if it reaches 7. There are a lot of factors that influence FBG levels, none of them connected with food. (disturbed sleep, stress, time of taking the test, hormones, and so forth)

My advice is simply to see your GP and ask for the HbA1c.

I did have a HbA1c blood test. I’ve had 3 I believe.

1st one was 47
2nd and 3rd where both 45.

Several years apart

 

[Bluetit1802]

I did have a HbA1c blood test. I’ve had 3 I believe.

1st one was 47
2nd and 3rd where both 45.

Several years apart

How long ago? All 3 of those show pre-diabetes as they are over 41 and under 48.
If you want to avoid crossing the line it is time to analyse your diet and see where changes can be made, especially when you see increases of more than 2mmol/l at 2 hours after first bite of food. (by increases I mean the difference between a reading immediately before you eat and 2 hours later)

 

[Daibell]

Hi Thank you for the response.

How long were you in the honeymoon phase?

Hi again. For me it was about 6 years; a long time. I finally had to have very few carbs and have the complete 'set' of tablets still without good control; I was often in the 20s mmol. I had GAD and c-peptide tests done privately. GAD was negative but c-peptide low showing low insulin. Your diagnosis may of course be very different but the essential thing is HBA1C tests every 6 months or so and the right medication following NICE guidelines.

 

[Japes]

Hi again. For me it was about 6 years; a long time. I finally had to have very few carbs and have the complete 'set' of tablets still without good control; I was often in the 20s mmol. I had GAD and c-peptide tests done privately. GAD was negative but c-peptide low showing low insulin. Your diagnosis may of course be very different but the essential thing is HBA1C tests every 6 months or so and the right medication following NICE guidelines.

I've had about 2.5 years and I'm currently awaiting the GAD and c-peptide results, along with several other auto-immune condition test results whilst we're at it.

But, essentially, what @Daibell describes is my experience. Fewer and fewer carbs, with higher and higher BS readings, more and more tablets - except I have a GP who decreed enough was enough and referred me before the 3rd set of meds as he could see from my spreadsheet what was going on.

 

[Cloherty123]

Hi again. For me it was about 6 years; a long time. I finally had to have very few carbs and have the complete 'set' of tablets still without good control; I was often in the 20s mmol. I had GAD and c-peptide tests done privately. GAD was negative but c-peptide low showing low insulin. Your diagnosis may of course be very different but the essential thing is HBA1C tests every 6 months or so and the right medication following NICE guidelines.

In the 20s! Wow that’s high. Most I have had is 11mmol. That was after a very meal!

 

[Daibell]

In the 20s! Wow that’s high. Most I have had is 11mmol. That was after a very meal!

Yes and my GP refused me insulin as she said I should stop starving myself and just have a normal, balanced diet. She had just come off a diabetes training course.....I now do my own research when it comes to medical conditions. The mis-diagnosis of LADA as T2 is a serious problem (I'm still listed as T2 but now getting the right treatment)

 

[Japes]

Yes and my GP refused me insulin as she said I should stop starving myself and just have a normal, balanced diet. She had just come off a diabetes training course.....I now do my own research when it comes to medical conditions. The mis-diagnosis of LADA as T2 is a serious problem (I'm still listed as T2 but now getting the right treatment)

The good news for me right now is the GP is fine with what I do food wise and once I know what I'm doing with the insulin, I'm sure I'll be fine with the adjustments.

The clinic put me on insulin, and the nurses are very unhappy about the low amount of carbs prior to last week. I am eating some carbs this week to go with the insulin ("Just take the insulin and eat what you like" when I asked how many grammes of carbs I should eat with those units. - yeah, right.) and keeping careful track of how each is affecting me.

Not telling me anything I don't already know, any amount of bread shoots me up and keeps me up, no matter what I do to walk it off. Eating grainy carbs makes me hungry before my next meal. Potatoes in small amounts and bananas, however, are OK-ish as long as I walk them off.

I am slowly coming down from the pre-dominantly 20s of the past month.

 

[Alexandra100]

"Just take the insulin and eat what you like"

I have absolutely no experience of taking insulin, but I like Dr Bernstein's Law of small numbers, that is, if you eat few carbs and inject little insulin then your mistakes will be small, but if you eat a lot and then have to inject large doses of insulin then the mistakes risk being far more serious. http://www.diabetes-book.com

 

[Cloherty123]

Hi guys,

So my GP said they don’t do C-Pepside tests there but she is going to phone the specialist to see if we can get one done. I’ve also got an appointment for another HBA1C blood test on friday.

I double checked about what tests I had done and she said both GAD and Islet cell tests were negative and that I had Fasting Glucose Intolerance.

As I said, my high blood sugar was initially picked up in 2014. It’s been a long road. Have I been in the Honeymoon phase this long? My levels are still controllable with low carb etc

Does glucose intolerance always lead to Diabetes?

 

[Daibell]

Hi guys,

So my GP said they don’t do C-Pepside tests there but she is going to phone the specialist to see if we can get one done. I’ve also got an appointment for another HBA1C blood test on friday.

I double checked about what tests I had done and she said both GAD and Islet cell tests were negative and that I had Fasting Glucose Intolerance.

As I said, my high blood sugar was initially picked up in 2014. It’s been a long road. Have I been in the Honeymoon phase this long? My levels are still controllable with low carb etc

Does glucose intolerance always lead to Diabetes?

I think you'll find that 'glucose intolerance' is just another term for 'pre-diabetes'. Neither term is useful. You just need to know your HBa1C or at least a finger prick test 2 hours after a typical meal.

 

[Japes]

I have absolutely no experience of taking insulin, but I like Dr Bernstein's Law of small numbers, that is, if you eat few carbs and inject little insulin then your mistakes will be small, but if you eat a lot and then have to inject large doses of insulin then the mistakes risk being far more serious. http://www.diabetes-book.com

I also agree, but, just to clarify, for this week, I've been given a fixed number of units to take per meal. Which is why I asked the question about how many carbs to eat and got the "Just eat what you like" response. I have been obedient and had some carbs with each meal, but hopefully, once I'm past the next appointment, I'll have some leeway to adjust insulin to suit what I'm eating rather than eating to feed the insulin. I will point out I've put weight on this week already and have eaten less than usaul!

I also think I'm dealing with a devotee of the Eatwell Plate system...

 

[Alexandra100]

I also agree, but, just to clarify, for this week, I've been given a fixed number of units to take per meal. Which is why I asked the question about how many carbs to eat and got the "Just eat what you like" response. I have been obedient and had some carbs with each meal, but hopefully, once I'm past the next appointment, I'll have some leeway to adjust insulin to suit what I'm eating rather than eating to feed the insulin. I will point out I've put weight on this week already and have eaten less than usaul!

I also think I'm dealing with a devotee of the Eatwell Plate system...

That all sounds very awkward.

 

[Cloherty123]

I think you'll find that 'glucose intolerance' is just another term for 'pre-diabetes'. Neither term is useful. You just need to know your HBa1C or at least a finger prick test 2 hours after a typical meal.

I test everyday. I’ve got a diary also with my meter results as well as what I’ve eaten

 

[TheBigNewt]

I think we stopped doing "glucose tolerance tests" in this country in the 70's. I remember I had a job drawing blood at the County Hospital one summer during college and people would come in and have their blood drawn for those tests. They had to drink some bottle of awful cola tasting stuff.

 

[Cloherty123]

Heya all!

So I just had my HBA1c results.

I’ve had 4 tests now over the last 4 yeas.

1st one was 47.

The last 3 have all been 45.

Hmmmm I’m so confused!!! HELP

 

[Bluetit1802]

Why are you confused? You are in the pre-diabetic range with your last 4 HbA1cs, and appear stable at 45.
From what you said earlier, your fasting levels are also implying pre-diabetes.

I am confused as to what your problem actually is? Can you explain?