Type 1, 2 or LADA?

[MarthaD]

I find your experience with hypos when walking particularly interesting because that's exactly what happens to me. Hopefully, we'll get answers.

 

[George775]

I find your experience with hypos when walking particularly interesting because that's exactly what happens to me. Hopefully, we'll get answers.

That's quite interesting. I've been reading everything I can on this and I keep stumbling across posts from other users on places like reddit about the same but most of them seem to be adjusting to using insulin.

I will let you know what happens after I get a referral. Which I hope should be later this week.

 

[MarthaD]

I've an appointment to get antibody tests in March, so I'll let you know too.

 

[George775]

I've an appointment to get antibody tests in March, so I'll let you know too.

Good luck, hopefully you get some answers.

 

[DEBBIESCOTT]

Another one bmi in the 18’s fit & active & libre shows b/s dropping to low high 3’s & low 4’s at 3am every day (plastic cover & plaster over libre so no compression)no diabetes either side of family but diagnosed with MODY 1
Gym days eating all day to keep b/s up

 

[mariavontrapp]

I would look into Reactive Hypoglycaemia. However, tests that are performed for this are often disappointing. Also, make more use of finger-prick testing . The libre is predictive. If your glucose is dropping it tends to over estimate how low this will go

 

[Lamont D]

FYI.
There are many types of hypoglycaemia, and other forms of metabolic conditions.
I have come across many rare conditions, which could be asymptomatic with what has been described here.
Until the tests rule it out, we just won't know.

 

[George775]

Another one bmi in the 18’s fit & active & libre shows b/s dropping to low high 3’s & low 4’s at 3am every day (plastic cover & plaster over libre so no compression)no diabetes either side of family but diagnosed with MODY 1
Gym days eating all day to keep b/s up

That's interesting you mention eating all day ahead of going to the gym. I've started doing the same. I even ate half a Snickers one day just to push my blood glucose up so I wouldn't have to stop early. Same last night right around 1am I'm right at 3.6 mmol/L spring wide awake and my BG goes back up again.

 

[Antje77]

Another one bmi in the 18’s fit & active & libre shows b/s dropping to low high 3’s & low 4’s at 3am every day (plastic cover & plaster over libre so no compression)no diabetes either side of family but diagnosed with MODY 1
Gym days eating all day to keep b/s up

Are you still on gliclazide?
That's a med known for causing hypos.

 

[DEBBIESCOTT]

Are you still on gliclazide?
That's a med known for causing hypos.

Still on 20mg a day (1/2 of the lowest therauptic dose there is, I’ve got the insulin & insulin sensitive, just the message to release it doesn’t work properly)

 

[George775]

10 months later I finally get a referral, then wait 3 months for blood work and all comes back mostly normal. These results are fasting.

C-Peptide 1.48 ng/ml
A1C 5.9
BG 151
GAD 65 Ab <5 IU/mL

They ran a comprehensive metabolic panel all within range other than glucose. Heart rate, blood pressure are all normal. I have not yet seen my endo for an official diagnosis.

I've been able to stabilize sugar crashes when working out by eating some protein and/or some sugars before working out. I've cut almost all carbs from my diet at this stage and eating before bed helps keep me from crashing while sleeping. However just waiting up causes my sugars to climb unless I eat. I have noticed bowel movements causes a significant crash in sugars. BMs are almost always triggered by high sugars as is extreme fatigue.

 

[OrsonKartt]

10 months later I finally get a referral, then wait 3 months for blood work and all comes back mostly normal. These results are fasting.

C-Peptide 1.48 ng/ml
A1C 5.9
BG 151
GAD 65 Ab mL

They ran a comprehensive metabolic panel all within range other than glucose. Heart rate, blood pressure are all normal. I have not yet seen my endo for an official diagnosis.

I've been able to stabilize sugar crashes when working out by eating some protein and/or some sugars before working out. I've cut almost all carbs from my diet at this stage and eating before bed helps keep me from crashing while sleeping. However just waiting up causes my sugars to climb unless I eat. I have noticed bowel movements causes a significant crash in sugars. BMs are almost always triggered by high sugars as is extreme fatigue.

Thanks so much for sharing

 

[George775]

According to the doc I'm a type 2, no explanation as to why I'm not overweight or how I'm a type 2 without abusing sugars. Your a type 2 he said, then proscribed metformin and said that'll help with my sugar dips which dips because I exercise after I eat or walk to bring the number down.

 

[Melgar]

According to the doc I'm a type 2, no explanation as to why I'm not overweight or how I'm a type 2 without abusing sugars. Your a type 2 he said, then proscribed metformin and said that'll help with my sugar dips which dips because I exercise after I eat or walk to bring the number down.

Several things come to mind @George775 , the panel of tests you took: C-peptides, Ac1 and GAD tests show you are normal. Your C-Peptides are normal when seen in the context of your Ac1 test, which shows you are in the prediabetic range. Your C-Peptides show that you are not over producing insulin. High normal C-Peptides are associated with T2, so really your C-Peptides are inconclusive at this time. Insulin resistance is usually high in T2’s which usually means the pancreas has to produce lots of insulin to counter this resistance to insulin. Generally C-Peptides correlate with insulin production, the peptides are more stable so that is why they are tested, rather than insulin. Your‘s are normal, but not high. There are 3 other types of autoantibodies that can be produced with autoimmune diabetes, they tested for GAD which is the most common.

In Canada and the UK it would be unlikely they would prescribe Metformin for Prediabetes, they would suggest lifestyle changes like dietary and exercise, but it is obviously different in the US. Other types of diabetes, such as LADA take the same trajectory at T2. By that I mean that it is difficult, in the early stages, to differentiate T2 from LADA. It is only later when those suffering from autoimmune diabetes will be unable to control their blood sugars despite lifestyle changes and increasing levels of blood sugar lowering meds . C - peptide tests would then show very low levels of C-Peptides . They would then retest for autoantibodies, which if positive would confirm T1.

 

[George775]

Several things come to mind @George775 , the panel of tests you took: C-peptides, Ac1 and GAD tests show you are normal. Your C-Peptides are normal when seen in the context of your Ac1 test, which shows you are in the prediabetic range. Your C-Peptides show that you are not over producing insulin. High normal C-Peptides are associated with T2, so really your C-Peptides are inconclusive at this time. Insulin resistance is usually high in T2’s which usually means the pancreas has to produce lots of insulin to counter this resistance to insulin. Generally C-Peptides correlate with insulin production, the peptides are more stable so that is why they are tested, rather than insulin. Your‘s are normal, but not high. There are 3 other types of autoantibodies that can be produced with autoimmune diabetes, they tested for GAD which is the most common.

In Canada and the UK it would be unlikely they would prescribe Metformin for Prediabetes, they would suggest lifestyle changes like dietary and exercise, but it is obviously different in the US. Other types of diabetes, such as LADA take the same trajectory at T2. By that I mean that it is difficult, in the early stages, to differentiate T2 from LADA. It is only later when those suffering from autoimmune diabetes will be unable to control their blood sugars despite lifestyle changes and increasing levels of blood sugar lowering meds . C - peptide tests would then show very low levels of C-Peptides . They would then retest for autoantibodies, which if positive would confirm T1.

This is in line with what I've been reading. The annoying thing is I exercise 4 and now 5 times a week. I walk multiple times daily every day. I do this in order to control my sugars which is why my A1C is 5.9 and not like 7. Over Christmas with less exercise and more eating I was 6.8. i told the doc this but I felt like he wasn't listening and more interested in the lab results. To be fair he probably has people teling him lies daily. I was hoping for a conclusive result but I still don't think I fit type 2 because I'm very lean, muscular and I don't eat junk in excess.


I expected it i was a true type 2 my c-peptides would be through the roof along with my sugar. It's within the normal range and my fasting sugar was still high. Like you said this may well be early stages and I'll have to wait for more definite results. I'm hoping the medication proscribed don't have any significant adverse effects since I can't do anything more in terms of lifestyle changes.

I did explain i go low at night usually about once a month. He said I was probably laying on the sensor. I showed him I was low 2 hours after being awake and he said the sensor might be bad and I should do a finger prick which is good but I was driving. I always go low 100% of the time while working out. To combat that I eat a protein bar before or during workout depending on my sugar levels.

 

[Melgar]

I’m like you, lean, fit and I don’t each junk food. I do the distance of 3 full marathons a week to keep my blood sugars in check. I do resistance training as well. I’ve always been fit, so this is my go to. I also go low, I do have unstable fasting blood sugars. Yesterday my fasting blood sugars were 9 mmol/ls, today they were 4 mmol/ls.
I certainly hear you. There are quite a few atypical so called T2’s on the forum . Trying to maintain blood sugars becomes a challenge when you have no weight to lose, you are exercising and your food is not full of carbs. It’s very frustrating. Your Dr was right about the sensor. If you lay on the thing it tends to throw a wobbly and reads low, but as soon as you move, up goes the graph. Your glucometer is your friend, pricking your finger to test will always trump the sensor. I have a Contour Next One. Even though I use a Libre 2 I test with my glucometer.

 

[OrsonKartt]

I’m like you, lean, fit and I don’t each junk food. I

I’m a skinny ( bmi-19) active but not athletic diagnosed around 9 years ago. - then I could get away with a low carb diet to get prediabetic hba1c results. I had a private c-peptide done which showed low but still in range levels

My diet has gone through keto to now almost totally carnivore to maintain similar yearly hba1c levels , currently 47.

It’s a tough one isn’t it? You have my sympathy

 

[George775]

I’m like you, lean, fit and I don’t each junk food. I do the distance of 3 full marathons a week to keep my blood sugars in check. I do resistance training as well. I’ve always been fit, so this is my go to. I also go low, I do have unstable fasting blood sugars. Yesterday my fasting blood sugars were 9 mmol/ls, today they were 4 mmol/ls.
I certainly hear you. There are quite a few atypical so called T2’s on the forum . Trying to maintain blood sugars becomes a challenge when you have no weight to lose, you are exercising and your food is not full of carbs. It’s very frustrating. Your Dr was right about the sensor. If you lay on the thing it tends to throw a wobbly and reads low, but as soon as you move, up goes the graph. Your glucometer is your friend, pricking your finger to test will always trump the sensor. I have a Contour Next One. Even though I use a Libre 2 I test with my glucometer.

It's interesting alright. I've the Libre 3 and spot checking with a finger prick is usually accurate unless I'm going high or low, then it lags behind. I've had a few false positives but that wasn't one of them. Regardless they've proscribed metformin 500mg. So hopefully that gets things in order.