So confused...please help

[Jeter02]

Here's my story:

Noticed frequent urination/thirst and went in for a random blood test. Sugars= ~300; A1C= ~8.5. Mid-twenties, non-obese (BMI of 24 or so). I was put on a very low-carb diet which I maintained for a week given the assumption I was a Type 2 diabetic. My blood sugar levels dropped considerably, and I have since been told to phase back carbs into my diet. Doing so has not yielded any chance in my blood sugar levels (fasting= ~95-100; Range= 85-105 during the day).

Was tested for antibodies as the docs suspected T1, but was negative across the board. Did have a lower-than-usual C-peptide, though. No one really seems to know if I'm T1 or T2, and I'm extremely confused (though not at all upset) as to why my blood sugars are doing so well when I'm on no insulin, medication, etc. I understand antibodies aren't ALWAYS present in T1...can someone elaborate on this a bit?
Reply With Quote

[MelissaC]

Jeter02....

Here is what I can tell you from our experience withmy 5 year odl daughter... Last November she was spilling sugar in her urine but all of her glucose testing came back ok... She tested for antibodies and they were present but very low... C-Peptide was in the normal range... At the time docs saif no diabetes and could not explain it - possible pre-diabetic? Long story short she was dx T1 in february... Took a looong time to finally hit on something.

I am by no means a doctor but it sounds like if you are D, it would be t2 maybe pre-d? I have a very good neighbor friend who is 42 - t2 GREAT physical shape, works out everyday, etc... but still a T2. That's what is so crazy to me about this illness, most people assume that if you are diabetic you are some overwight junk food eating person, not so! You are just one of the lucky ones to hit the D lotto!

Good luck in your findings, I hope that you find out soon and all is well.

MelissaC

[Heather(CA)]

Do you have a lot of type 2 in your family? You don't have to be over weight to get it...

[yeswe'rebothD]

Jeter02-- I would be looking at "type 1.5" or "LADA"-- you seem to fit the profile well. Type either or both of those into search engines and you will find a lot of information.

Keep us updated, as one of the few D adults here, I'd love to hear more from you.

[Jeter02]

Hey all--

I don't think LADA (1.5) is so likely because -- I think -- the GAD antibody is almost always the cause...I didn't have this or the other antibodies that I was tested for. There are, of course, non-autoimmune T1/T1.5 (I think) and I COULD simply have some other antibody that I wasn't tested for so those are possibilities too. What I do know is that my C-Peptide is on the low end, and my endo thinks it's because I'm some kind of T1 (I'm unclear as to whether this would mean I'd have SOME insulin function, but less or eventually have none...does anyone know anything about this?)

As for a family history of Type 2? Yes, I have one. I guess it's all semantics, because it seems like insulin is the way my treatment's going. Actually, I just started taking a small dose of lantus daily though I probably don't even need it (yet).

[lilituc]

I don't think LADA (1.5) is so likely because -- I think -- the GAD antibody is almost always the cause...I didn't have this or the other antibodies that I was tested for.

Levels of antibodies can vary over time, so even though the antibody may be responsible, it doesn't necessarily mean you will have a positive test at any given point. If your C-peptide was low, that does point away from Type 2, though. Have you looked at MODY, also?
http://www.phlaunt.com/diabetes/14047009.php

It's possible for insulin production to be a bit erratic with LADA, at least. I was able to get my bg under control after diagnosis by doing a low carb diet and then phasing back in carbs. I was okay for a few months before my numbers started going up again. I didn't need basal insulin for a year and a half.

There is one other possibility I can think of - Type 1b. http://www.childrenwithdiabetes.com/dictionary/t.htm (scroll down to "idiopathic diabetes" under "Type 1")

[Jeter02]

Levels of antibodies can vary over time, so even though the antibody may be responsible, it doesn't necessarily mean you will have a positive test at any given point. If your C-peptide was low, that does point away from Type 2, though. Have you looked at MODY, also?
http://www.phlaunt.com/diabetes/14047009.php

It's possible for insulin production to be a bit erratic with LADA, at least. I was able to get my bg under control after diagnosis by doing a low carb diet and then phasing back in carbs. I was okay for a few months before my numbers started going up again. I didn't need basal insulin for a year and a half.

There is one other possibility I can think of - Type 1b. http://www.childrenwithdiabetes.com/dictionary/t.htm (scroll down to "idiopathic diabetes" under "Type 1")

Thanks for the reply; I've investigated both of these things on Up-to-date (a research tool for MDs that I have access to). The Type 1b seems a legit possibility though I'm not one of the ethnic groups typically affected. Your account of your LADA bout is interesting as I experienced the same thing essentially. I have not needed any insulin -- basal or otherwise -- though. I am thinking of beginning a small dose of some kind of basal (1-2 u/day) to see what it does...any thoughts?

[lilituc]

. I am thinking of beginning a small dose of some kind of basal (1-2 u/day) to see what it does...any thoughts?

Well, generally, it shouldn't do anything. ;) I've heard that some people do experience lows when taking a small amount of basal insulin, but most do not. What's supposed to happen is that your pancreas will decrease insulin production to compensate, as long as you're not taking insulin up to your total basal need. Many people believe, however, that it can help preserve beta cell function longer in the case of an autoimmune attack.

If I had known earlier that I had LADA, I would definitely have started on a small amount of basal insulin, though.

[Jeter02]

Well, generally, it shouldn't do anything. ;) I've heard that some people do experience lows when taking a small amount of basal insulin, but most do not. What's supposed to happen is that your pancreas will decrease insulin production to compensate, as long as you're not taking insulin up to your total basal need. Many people believe, however, that it can help preserve beta cell function longer in the case of an autoimmune attack.

If I had known earlier that I had LADA, I would definitely have started on a small amount of basal insulin, though.

Interestingly, it has done SOMETHING. Since experimenting with Lantus, I wake up with a slightly lower fasting glucose level (~95ish before Lantus; ~82 now). So I guess it's worth continuing...