Any LADA people on here?

[Vectian]

Doctors are undecided if I have T2 or LADA so having to wait 6 long weeks for test results, which is very frustrating. Been put on insulin just in case but may not need it if T2. I'm trying to learn more about the difference as there isn't much online, so it would be helpful to know what the experiences of people who have been confirmed with LADA are. How much insulin was your body producing on diagnosis? How many units and what type of insulin did you need initially and how long did it take to decline? Did you try a low carb or calorie diet and did it have any effect? Thanks

 

[helli]

There is no official diagnosis of LADA although it is variant of Type 1. But if you are asking whether there are any of us diagnosed with Type 1 diabetes as adults, yes, there are plenty.
This is not surprising when you consider that more than half of the people with Type 1 were diagnosed above the age of 20.
I was diagnosed in my mid 30s in the days when tests for GAD and cPeptide were very rare. So I have absolutely no idea how much insulin my body was producing on diagnosis. At the time, I was told “you are too slim to have type 2 so you must have Type 1”. I have subsequently learnt that this is not necessarily true for everyone but it was correct for me and I was glad not to have to deal with the uncertainty that seems to come with a diabetes diagnosis today.
If you have Type 1, a low carb diet will not stop you needing insulin. Type 1 is an autoimmune condition - our body kills off insulin producing beta cells. And we cannot live without insulin.
There are some people who chose a low carb diet but it can increase insulin resistance and make insulin dose calculation more complex. Therefore, it is not as common for Type 1 as it is for type 2. The ideal diet for someone with Type 1 is the same as the ideal diet for someone without diabetes. The only difference is that we have to inject insulin.

 

[Vectian]

There is no official diagnosis of LADA although it is variant of Type 1. But if you are asking whether there are any of us diagnosed with Type 1 diabetes as adults, yes, there are plenty.
This is not surprising when you consider that more than half of the people with Type 1 were diagnosed above the age of 20.
I was diagnosed in my mid 30s in the days when tests for GAD and cPeptide were very rare. So I have absolutely no idea how much insulin my body was producing on diagnosis. At the time, I was told “you are too slim to have type 2 so you must have Type 1”. I have subsequently learnt that this is not necessarily true for everyone but it was correct for me and I was glad not to have to deal with the uncertainty that seems to come with a diabetes diagnosis today.
If you have Type 1, a low carb diet will not stop you needing insulin. Type 1 is an autoimmune condition - our body kills off insulin producing beta cells. And we cannot live without insulin.
There are some people who chose a low carb diet but it can increase insulin resistance and make insulin dose calculation more complex. Therefore, it is not as common for Type 1 as it is for type 2. The ideal diet for someone with Type 1 is the same as the ideal diet for someone without diabetes. The only difference is that we have to inject insulin.

Thanks. I too am not overweight, although 1 in 6 people diagnosed with T2 aren't, and can still have visceral fat without having an overweight BMI. I have previously had pre-diabetes but put it in remission 7 years ago but they are unsure whether this is LADA or T2. I am trying to sit on the fence with the ridiculously long wait of 6 weeks for results, as if T2 then injecting lots more insulin when the issue is essentially insulin overload then it surely won't help, so low carb helps to put less strain on. When you say low carb can increase insulin resistance do you mean with T1? As that is one of the main ways of putting T2 into remission and reversing insulin resistance (I know as have done this before and been basically non diabetic for at least 5 years).
Do you have the classic T1 that progresses very quickly to needing insulin, or a slower decline like LADA that meant you gradually needed more as the pancreas function decreases?

 

[everydayupsanddowns]

Welcome to the forum @Vectian

6 weeks may sound like quite a long time to get your results, but there are only a few UK labs that undertake the antibody and cPeptide checks, as they are quite specialist, so it isn’t an unusual wait time in forum members’ experience.

We have a variety of people who developed variants of T1 in adulthood and later life, some who were initially classified as T2, others who were given the label T1 straight away, and still others who were told they had LADA. Some clinicians seem to dislike LADA as a term, even when the beta-cell loss is slow and diagnosis happens in adulthood.

We have adults who proceeded rapidly from symptoms to diagnosis, and others who had a period of years managing on oral meds and/or lower carbohydrate menus before their beta-cell loss reached a tipping point and no amount of carb reduction could suffice, because they simply lacked enough residual insulin production to cope.

I wouldn’t worry about adding insulin to help with glucose management at this stage. If you are T2, and end up being able to come off insulin it won’t have done any harm (I believe your body will produce less insulin if it detects there is sufficient in circulation). And if you are LADA, then a little exogenous insulin might help support your last remaining flagging beta cells which might currently be working quadruple shifts to make up for their ‘staff shortages’.

Let us know what you find out when your results come back 🙂

 

[Vectian]

Welcome to the forum @Vectian

6 weeks may sound like quite a long time to get your results, but there are only a few UK labs that undertake the antibody and cPeptide checks, as they are quite specialist, so it isn’t an unusual wait time in forum members’ experience.

We have a variety of people who developed variants of T1 in adulthood and later life, some who were initially classified as T2, others who were given the label T1 straight away, and still others who were told they had LADA. Some clinicians seem to dislike LADA as a term, even when the beta-cell loss is slow and diagnosis happens in adulthood.

We have adults who proceeded rapidly from symptoms to diagnosis, and others who had a period of years managing on oral meds and/or lower carbohydrate menus before their beta-cell loss reached a tipping point and no amount of carb reduction could suffice, because they simply lacked enough residual insulin production to cope.

I wouldn’t worry about adding insulin to help with glucose management at this stage. If you are T2, and end up being able to come off insulin it won’t have done any harm (I believe your body will produce less insulin if it detects there is sufficient in circulation). And if you are LADA, then a little exogenous insulin might help support your last remaining flagging beta cells which might currently be working quadruple shifts to make up for their ‘staff shortages’.

Let us know what you find out when your results come back 🙂

Thanks, I didn't know that your body produces less insulin if you inject it so that is helpful. One thing I am confused about is if you have insulin resistance, does that mean that your body is also resistant to the insulin you inject? Or just the natural insulin your body makes (I am definitely making some, as I don't need the long acting insulin). Can you measure in a way the degree of insulin resistance by how many units of fast acting are needed to compensate for meals? At the moment I need 1 unit per 10g carbs, sometimes a little more, is that a lot or not much?

 

[everydayupsanddowns]

Yes. People with T2 generally (but not always) need much larger doses of insulin than people with T1, because their doses have to overcome their resistance and have enough oomph left to work properly. T2 can have a combination of insulin resistance and over time problems with insulin signalling (so beta cells can sort of ‘deactivate’)

Some of the results from the DIRECT trial (and ReTUNE for lower weight people) suggest that in some people with T2 pancreatic function can be sort of be ‘rebooted’ in certain circumstances allowing normal function to resume.

 

[Vectian]

Yes. People with T2 generally (but not always) need much larger doses of insulin than people with T1, because their doses have to overcome their resistance and have enough oomph left to work properly. T2 can have a combination of insulin resistance and over time problems with insulin signalling (so beta cells can sort of ‘deactivate’)

Some of the results from the DIRECT trial (and ReTUNE for lower weight people) suggest that in some people with T2 pancreatic function can be sort of be ‘rebooted’ in certain circumstances allowing normal function to resume.

I have seen the ReTUNE study, which would apply to me as not overweight if I have T2. I know it's possible to put T2 in remission as I have done it before myself 7 years ago (although from a pre-diabetic position) so I am keen to do that if it is T2. Also Dr. Jason Fung has done a lot of good work on that. Is 1 unit per 10g carbs, sometimes a bit more, a lot or not much? If your body was producing insufficient insulin as in T1/LADA wouldn't it then be quite sensitive to it so need less than that?

 

[everydayupsanddowns]

1u:10g of carbs is a pretty standard T1 starting dose. If you had significant insulin resistance my non-medically-qualified thinking would be that you might need quite a bit more than that.

If you do end up being LADA / slow-onset T1 do bear in mind that the approaches you had success with in the past were when you had greater remaining beta-cell mass. If your immune system has been gradually destroying insulin-producing cells, you won’t have that “production capacity” any longer.