What should I ask for, from Doc, with new tests?

[CheeseJunkie]

I've got a new pre-diabetes diagnosis (late April).

Aged 55, low BMI (20), pretty fit. (I can easily cycle 60 miles with camping panniers, or hike up a mountain to 2,500m).

Which seems to suggest I should be considering LADA as a possibility??

I have had some more blood tests (last week) and am seeing new doc in a few days.
In part, this is a repetition of stuff I have already had with a previous doc on NHS check a couple of weeks before. So there's another HbA1c (2.5 weeks after going LCHF).
Also liver function and similar.

What should I be asking for / checking for at this stage?

 

[Daibell]

The tests to help with diagnosing LADA are the GAD test for antibodies and c-peptide to measure your insulin production. A negative GAD doesn't exclude Late onset T1 as there are other causes besides antibodies. Note that many GPs don't recognise Late onset T1 and always assume T2 at your age and this was the problem I faced with my GP. It was only when my HBa1C sky-rocketed that I was moved to insulin and I'm still listed as T2 despite a low BMI all my life

 

[CheeseJunkie]

Thanks, Daibell.
Forewarned is forearmed. I don't know what to expect with the new GP, so need to consider possible ways discussion could play out.

 

[Ian DP]

I doubt very much that most GPs will have much knowledge about LADA. Agree with daibell, ask for a gad test. And tell your GP why you want it - because you are not overweight, fit, and do not tick the normal T2 boxes.... And if you were a full T1 you would need insulin. Have you lost weight recently, if so add that to the GAD test justification. The test costs around £400, so GPs don't like doing it, but my experience is, they will if YOU can justify it.

But at the end of the day, whether you are or aren't, I believe the best treatment is the same. And that is a low carb diet. Buy yourself a meter (if you do get a gad test and it is positive you will be given one) get one with cheapest test strips, and start testing 2 hours after eating. You will soon find what food elevates your blood sugar levels, and you will soon find these are high carbs.

If you are in th early stages, a low carb diet may be all you need (no meds). If you can keep your blood sugar levels down to under 5.6 two hours after eating you may be able to retain all your remaining insulin making beta cells. Some experts believe beta cells die off with blood sugar levels above 7.... If you can keep your 2 hour after meals levels below 5.6, there is a good chance you won't get above 7 at any time.

In my opinion, at the moment you have many insulin making beta cells remaining, but if you have daily high sugar levels above normal (normal means around 4.6 fasting and 5.6 two hours after eating) your beta cells are slowly being destroyed and your ability to make insulin yourself is getting less and less.

Have a read on the LADA section of this forum. There are lots of good posts on here. My story is under the 'can i prove the Drs wrong' heading.
In my opinion, the best thing you can do right now is eliminate bread, pasta, potatoes, rice and cakes etc. This way you have a chance of getting your blood sugars in the normal range and preserving your beta cells.

I learned 99% of my diabetic knowledge from this forum, 1% from the NHS.

 

[Ian DP]

I probably should add, that at this stage if you want to be diagnosed diabetic, eat lots of carbs. If you low carb as I suggested you probably will not be diagnosed diabetic. Odd isn't it. I am a T1 (LADA) yet if I went to any GP in the word (who didn't have access to my medical records) he would do a few tests and say I was not diabetic. This because my blood sugar levels are not in the diabetic range, this because I low carb. If I eat a normal carby diet I would be in hospital within days !!! I really dont think Drs understand this.

 

[CheeseJunkie]

I probably should add, that at this stage if you want to be diagnosed diabetic, eat lots of carbs. If you low carb as I suggested you probably will not be diagnosed diabetic. Odd isn't it. I am a T1 (LADA) yet if I went to any GP in the word (who didn't have access to my medical records) he would do a few tests and say I was not diabetic. This because my blood sugar levels are not in the diabetic range, this because I low carb. If I eat a normal carby diet I would be in hospital within days !!! I really dont think Drs understand this.

I see the irony.
But I have final exams this week and have to be tip-top. So have been 3 wks on low carb (diet already registered with new GP) as I was previously feeling dreadful-comatose.