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Untypical: LADA / postprandial hypos for yeeeears

K

krisakola

Newbie
Messages
4
Location
Slovenia
Type of diabetes
Type 2
Treatment type
Diet only
Hello,
first to introduce myself shortly, I'm Krisa, 25 years old, from Slovenia.

My diabetes story so far:
I've had hypoglycemic episodes since I was 12. They were not that frequent, max. 2 per month. Last few years my health started detirioating and about a year ago my hypoglycemic attacks got more frequent, even 3times/week. When I was small, my child doctor just told me to eat something when that happens so I never paid too much attention to it, especially because it was not frequent. This time, my new and awesome doctor sent me to do OGTT. It came back positive, twice, okay, I have diabetes.
BUT
My weight is normal, my cholesterol is normal, my blood presure is normal or even a bit on the lower side...Hmmm. So they send me from doctor to doctor speculating what's happening, meanwhile, I researched a looooot on the net and already formed some "opinions" on the subject. They finally got me to do insulin,c-peptid,autoantibodies test. that was back in december. yesterday, I've learned that one of the autoantibodeis came back positive. my new doctor didn't tell me which onw but I've tried to see on her side of the desk and I think it was IAA. I couldn't see the results of c-peptid and insulin, but she said nothing about it. Please, PLEASE don't judge me for not stepping up, I really get anxious in such situations.

Anyway, I'm looking for some thoughts...

-is it definitve now that I'm LADA? we don't use that terms in our country. the doctor did warn me, though, that I might/will probably slowly progress to "type 1" and start with insulin

-how long do you think this will take?.. I've tried to read more about it but most statistics mention mostly GAD as a factor that shows progress to insulin therapy in few years.. I guess I'll have to learn patience.. and not to worry all the time but just test if I feel bad/twice a month, like my doctor advised...

oh and my numbers history (sorry this will all be in mmol)
A1C
-5,5 at diagnosis in june 2013
-5,4 sep 2013
-5,6 december 2013
-5,9 yesterday

morning numbers
-always below 6 first few months after diagnosis
-I think I started seeing numbers above 6 in november or so
-now I measure above 6 often but few days ago it was the first time I saw 7,8 in the morning!! ugh

postprandial numbers
-mostly under 10 all the time, but I do spike up to max of 12,5 sometimes
-I'm still getting hypos, do you think when that stops it means my diabetes is progressing? ok the raise in a1c shows that a bit, too. but it seems my pancreas is still very much alive if it can still send me to hypo hell...

my weight is sadly also going up :(

I would really appreciate some thought on all this...
 
Hi Krisakola!

Welcome. Obviously, I can't diagnose you - your consultant must do that. The positive anti-body test really is indicative of and autoimmune form of diabetes. It can be caused by other things, but it is probably indicative of LADA.

Your good HbA1cs but spiking after food and the slowly-rising fasting levels are all also indicative of early-stage LADA, as is your profile of slim with no other metabolic markers for Type 2 e.g. blood pressure, cholestorol etc. So at a guess I would say you are developing an autoimmune form of diabetes.

The hypos are confusing, because I have never heard of people with LADA getting hypos unless they are on BG lowering medication, so i would certainly follow that up with your doctor.

As you have alluded to above, LADA is a progressive condition and does eventually require insullin treatment. How long before you need insulin is impossible to know, but most LADAs need it within about 6 years - some much sooner. For example, I've been diagosed for nearly 5 years and was on insulin within a year of diagnosis. However, I do still produce some of my own insulin - although i suspect I don't produce enough for it cause a hypo - but by the time you get to the stage where you don't produce enough insulin to cause a hypo, you will be injecting insulin which can cause hypos.

One issue I would be concerned about if I was you is putting on weight. You must try to get some control of this as it will cause the other metabolic conditions which are usually seen in Type 2 e.g. high blood pressure and can cause insullin resistance which will make it much harder for you manage LADA.

I would advise you to reduce your carb intake a bit to try to lose the weight and maintain good BG, but I am loathed to advise that in your case, because of the tendency to hypo - you really need to discuss that with the doctor.

Take care

Smidge
 
thanks a lot for your answer! will repost this in LADA section so maybe someone else replies. I've read a few times that both early type2 AND type1(LADA) can have hypo attacks because the pancreas is struggling.. which makes sense and it was explained that way to me.
My current/new doctor said the same and it makes even more sense if I know there is autoimmunity against my insulin going on. But I would like to hear from someone with similiar experience..
 
I am Type 1 but my sister (to whom I am genetically related!) has something called "reactive hypoglycaemia". This means when she eats she can get hypos, because her pancreas produces too much insulin. She has found that when she eliminates certain foods from her diet this is controllable. So it could be a similar experience to yours.

I guess you could argue I'm LADA as I was diagnosed at 29. As far as I'm concerned I don't make insulin so that means I'm Type 1. The rest is history, as they say.
 
reactive hypos can occure (when related to diabetes which they often are, long-term) when somebody is
-either insulin resistant and pancreas is struggling and over producng insulin to help lower the glucose levels
-either has some autoimmunity going on (like me) and panreas is struggling again for some or another reason (in my case, I have IAA autoantibodies so they're actually killing of my insulin so pancreas, which is still functional, is trying to compensate and does it a bit too much or a bit too late)

that's how I came to understand these things...

I've read a lot and reactive /prostpandial hypos can be indicators to either early type 2 or LADA.. I thought for a long time that I'm probably early type 2 but now, considering all other facts, I most definitely am LADA, hopefully it goes down really sloooooow (seeing I+ve been having hypos for more than 10 years it maybe will.. but on the other hand, last few years everything is going on faster and in less than a year since I was diagnosed my readings became worse quite a bit too..)


(but somehow, I'm still kinda deluded and hoping that one single positive autoantibody test doesn't necessarily mean LADA.. especially because I see that GAD is much more important for LADA diagnosis...)
 
krisakola said:
reactive hypos can occure (when related to diabetes which they often are, long-term) when somebody is
-either insulin resistant and pancreas is struggling and over producng insulin to help lower the glucose levels
-either has some autoimmunity going on (like me) and pancreas is struggling again for some or another reason

I've read a lot and reactive /prostpandial hypos can be indicators to either early type 2 or LADA.
Click to expand...

Could you explain how reactive hypos could be a sign of LADA? Maybe I should be getting my sister checked out for LADA, since she is related to me.
 
@Spiker - LADA is a slow-onset form of Type 1. In young people, Type 1 tends to develop very rapidly and the beta cells are pretty much destroyed within a few weeks of onset. LADA tends to be diagnosed diagnosed in adults (often in the 30s/40s/50s but can be at any age) but it progresses far more slowly than Type 1 and often takes years for the beta cells to be destroyed - which is why it is often confused with and misdiagnosed as Type 2. As krisakola is exhbiting the signs of an autoimmune form of diabetes with a positive IAA test, but is clearly still producing insulin at this stage, I was guessing that it is probably slowly-progressing LADA rather than full Type 1.

Smidge
 
I am LADA. Diagnosed T2 7 months ago, then LADA 4 months ago. I am not on insulin yet, not on any medication at all. I often have readings below 4.0, lowest 3.1. A quick count of 33 readings below 4.0, 5 below 3.5. A couple of weeks ago I had a 3.3 one hour after a large LcHf restaurant lunch, reading taken whilst out walking. I always take an apple and almonds with me in case I am a bit low. I try to keep my 1hr post meal readings under 7.8, through low carbs.


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