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Suspect LADA

cmw328i

Member
Messages
8
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
medical professionals that assume that because i'm fat, i MUST be type 2... check yer facts yo!
Hi all,

My first post here. so here goes.

I was diagnosed as type 2 in June this year. So far, I have had no response to metformin or sitagliptin. My sugars have come down mostly from cutting out processed sugars and trying to reduce carby stuff where I can, mostly replacing with proteins if possible. Lately, i've been on 2x gliclizide 2x a day... my average morning fasting reading has gone from about 11-13 to 9-11 on it... during my work day when im very active and eating practically nothing, it DOES go down to normal range, but i know the gliclizide continues to pump out insulin through the day and I work in a factory environment so I'm always on the move and rarely eating anything, even lunch is rather small (cant change those circumstances unfortunately for the forseeable future). However, the moment I try to eat a proper meal, it jumps back up to 13-15 range. I've even seen it jump from 11 fasting to 19 over a simple bowl of simmer soup.

The reason I suspect LADA is that in the past, when I lived in the US, I struggled with psoriasis which seems to have gone into remission since moving to the UK. Psoriasis is most assuredly an auto-immune disease and being in remission i've been wondering when i would see my immune system express it whimsical side in other ways. Also I have IBS which is inflammatory in nature. In my family there is history of rheumatoid arthritis. I've also noted when my sugars are REALLY high, they seem to drop like a stone if I take an anti-inflammatory such as naproxen or Ibuprofen...And, as mentioned above, I dont respond to the "insulin resistance" medications.

The problem is I am a fatty, I make no secret of this, im quite the big-bellied hulking bear of a man, though I'm quite active for my size. Because of this, my practitioners just label me type 2 and have ignored the fact that the insulin resistance meds dont drop my sugar a bit and only gliclizide seems to be doing anything at all... and the medical history. I asked today if I could have the anti-GAD screening to be certain but was told there's no reason to think I'm LADA based on my weight. I happen to know a LADA who's much bigger than I am... the immune system isnt going to say "oh, you're fat, i better not attack your pancreas"....it will do this no matter what size you are.

Anyway, I was hoping to get some opinions as to whether I have a good case for believing I may have LADA instead of type 2 and how to go about convincing my nurse that its worth investigating if true. In my opinion, its worth investigating all possibilites so that there is certainty, even if I'm not LADA, I feel that considering my medical history and lack of oral med responses it still SHOULD be tested for.

Thoughts?
 
Hi. Difficult. I can understand the GP refusing a GAD test whilst you are overweight as insulin resistance will be suspected i.e. T2. Yes, you could be LADA. Don't forget Metformin has very little direct effect on blood sugar; perhaps 1-2 mmol with max dose. Gliclazide can be an indicator of the state of the pancreas. It worked a bit for a few years for me but even on max dose it stopped having any effect i.e. knackered pancreas. Sitagliptin also worked a bit for 2 years then stopped i.e. if the pancreas isn't producing much insulin then extending the output time (DPP-4 meds works that way) is extending zero to zero. I think to sort things out you HAVE to get back to normal weight by low-carbing. This will minimise any insulin resistance and if your blood sugar still isn't controlled with the 3 tablets then you have strong case to insist on a GAD test. A c-peptide test would also show whether you have too much (T2) or too little (T1/1.5) insulin.
 
I agree with Daibell that at the moment being overweight you are likely to have some insulin resistance and treating that problem is important.
You might like to read the explanation of lada here http://www.locallada.swan.ac.uk/faq.html

As you say being overweight doesn't exclude autoimmune diabetes and people with other autoimmune diseases, either themselves or in the near family are likely to develop other autoimmune diseases This certainly applies to me, my mother had RA, hypothyroid and lastly Parkinson's which many now suggest is also autoimmune, I have LADA and hypothyroid.
Personally, I was slightly overweight and had the classic signs of diabetes including rapid weight loss. This weight reduction had the fortunate effect of leaving me with sufficient insulin of my own to manage with diet and quite a lot of exercise for 2.5 years. This period ended with rapidly rising levels, more weight loss etc and DKA. I've been using insulin ever since.

(just realised it's exactly 11 years today since I first tested my glucose levels... the day of my first granddaughter's birth)
 
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