To go private for LADA blood tests?

Acacia said:

I think there's only so much you can do with a low carb diet without any insulin injections on board, if your body is producing only minimal insulin to begin with. My mum's fasting morning sugars are generally always over 7.

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I agree Acacia. I think LC is essential, but it's not enough on its own. I'm in the same sort of place as your mum and I chose to take basal insulin. So I take approx 5 units a day. I think I want to go onto bolus as well, just tiny ratios, if they'll let me.

I tried just Dr Bernsteining, but for whatever reason my levels won't go down low enough. He himself is very clear that insulin is a good thing and that if you don't have enough, you should take it.

Hi acacia
My Dr would not give me the c-peptide test. He said it was pretty obvious I was still making some insulin, and that over time this would reduce, thus the test was not worthwhile.... Which I actually sort of agree with. Your mum is clearly producing some insulin, otherwise she would need insulin injections.

If your mums carb intake is around 50g then going down to Dr Bernstein's recommended 36g per day will likely bring her pre breakfast readings down. Mine went from 6.5s (with 50g carbs) to under 5.0.

I can't consistently get down to Dr B's pre breakfast 4.6s. I think it all depends on how many beta cells we have remaining. The more that have died off, the less likely we can get down to Dr B's recommendations without insulin. I am very happy with my pre breakfast readings of around 5.0, I have kept then in this range for nearly 6 months now, hopefully I can keep them in this range for a few more months.

When my pre breakfast levels hit 7.0 I will be wanting insulin, to get them down.... Indeed I have requested a half unit insulin pen so that I can start even earlier, at around 6.0. My DSN says one unit of insulin will bring my BG levels down around 3.0mmol, which is why I have requested a half unit pen....... I am not ready for it yet, just want it to be prepared. I have had a one unit insulin for 9 months now, not used it yet. Came close when I have a sickness virus, BG levels rise when ill, but luckily they came straight back down again within a few days.

When your mum reads Dr Bernstein book, my guess is, she will either take it on board enthusiastically or decide that it's not for her..... Either way I think she will find it interesting. His methods are definitely not for all, and many don't agree with them. But I have yet to find / read of any other method that clearly works any better, and more importantly, I am finding that his solution works for me.

Like Lucy, I will still follow his solution when I am on insulin, indeed I can see even more benefits of following his solution when on insulin, primarily to keep the risk of hypos to a minimum.... And to keep the risk of complications to a minimum

Acacia said:

Dear all

My mum (62) was recently diagnosed with diabetes in March after suffering extensive weight loss, polydipsia and polyuria (no ketones). Her HbA1c was 113mmol/mol. She has a history of autoimmune disease (rheumatoid arthritis, psoriasis) and Vitamin D deficiency, nil else. She has never been overweight nor skinny.

The GP gave her a diagnosis of T2DM and started her on metformin bd and told her to return in 3 months. No fasting C-Peptide test, GAD and Islets antibody tests were done. Because of her extensive weight loss (she looks bony and has lost a lot of fat and muscle) i feel LADA is a real possibility. However, the GP has dismissed the suggestion to do the above blood tests.

On metformin and a very low carb diet her diabetes is now under control:

Date. HbA1c (mmol/mol)
March 113
May 65
September 45

She has lost further weight (4kg since diagnosis), going from 49 to 45kg (bmi 20). She is not happy about her excessive weight loss (bony).
I was wondering whether to go private for these blood tests as we would want an accurate diagnosis.

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LADA could be a possibility if anyone from your mothers family is diabetic or overweight...once these blood tests are done...the doctor can give her the right treatment.

My history is very similar to your Mums. At 62 with a new diagnosis of RA, a history of pernicious anaemia, hashimoto's thyroiditis and pre diabetes, I was started on prednisone, methotrexate and metformin. I did not accept that I was type 2, with no metabolic syndrome, normal BMI, very active and after much persuasion I convinced my GP to test me for antibodies. I came back with GAD 65, but he did not tell me. I had three months on metformin, lost 10% body weight and was controlling (badly) blood sugars by reducing carbs. My GP continued to say I was type 2, but my rheumatologist referred me to Diabetes service. My endocrinologist diagnosed T1, (not LADA as that involves some insulin resistance and I had none) and immediately started me on insulin. With the immune suppressant drugs for the RA, my antibodies have reduced and the destruction of my beta cells has slowed down. I choose to eat relatively low carb, so my insulin requirements are low, but the insulin is there if I do splash out. Hopefully your Mum has it all sorted by now, but thought she might like to hear of someone else experiencing something similar. Jennie

Hi I don't agree that LADA implies some insulin resistance. My understanding is that it is T1 that occurs later in life. I wonder where the endo got that idea from?