Ketones not present = type 2

[Crumblebee]

Hello
I recently have had climbing blood glucose and feeling unwell,
Ignoring a gallbladder stint in hospital I've been since January becoming tired, and feeling unwell and just not myself.
I don't trust Dr's I have countless experiences of them making mistakes and people ending up dead. Myself when I had my initial onset of diabetes symptoms last year I went to the GP and explained I think I'm diabetic because of these symptoms. The Dr was reluctant to accept my request for a diabetic test because I was 33 at the time, but she said that to give me peace of mind she'd do a test. Two days later a phone call came through and that I was indeed diabetic.

A year on with taking Metformin twice a day my bloods are changing. The symptoms are coming back.
And all this time I have spoken out about how I feel like what if I'm LADA.
I'm on the highest daily amount of Metformin and they want to put me on sitagliptin. I read about them and they are both used for LADA.
After a melt down in my 3rd blood check of the year at a lovely nurse she wrote a message for my GP. And the dreaded words were said for your peace of mind we will do the test for LADA, but it probably isn't as you don't have ketones in your urine testing.

Surely it's more than for my peace of mind, and if I did have ketones in my urine so what, I try to eat a keto diet. (I fail at it but I try).

I'm terrified of being correct but also of being wrong. If the GP is correct then that would be potentially a step for me trusting them a bit, but if I'm correct my whole year of being told your type 2 because Metformin is working and that doesn't work for type 1, your type 2 because your overweight, your type 2 because type 1 is really rare in your age group, your type 2 because as a gp I say so.

I'd just like to clarify that since January last year my weight has been dropping off, in the space of 3 to 4 months I lost over 3 stones, last September it started to slow down and then hovered at 13 and a half, now it's beginning to drop again.
I'm just hoping to have answers but frightened.

Do ketones really have to be present to have type 1 and does anyone who has LADA take sitagliptin?

Sorry for blabbering on, I'm just feeling lost and alone, and when I post here it helps.
Thanks for reading

 

[Ljc]

Hi @Crumblebee . Please don’t panic about LADA,one type of diabetes is no worse than another, it’s the causes that are treatments that are different.


Have a read through this patient info leaflet for Januva (sp ?) another name for sitagliptin

JANUVIA 100mg film-coated tablets - Patient Information Leaflet (PIL) - (emc) | 7887

JANUVIA 100mg film-coated tablets - Patient Information Leaflet (PIL) by Merck Sharp & Dohme (UK) Limited

www.medicines.org.uk

Esp but not only the warnings and precautions.

They do use medications for T2 diabetes for those with LADA as often unlike T1 they do work even if only for a time ,

I was only diagnosed officially with LADA recently but realised I may have it back in 2016 soon after having to go onto insulin. , see my signature below .

To the best of my knowledge I have never had high ketones.

Apologies for I have not re read your previous posts, but was your weight loss unexpected, as unexpected weight loss ican be symptom of T1 or it’s very close cousin LADA.
Have you had a C-peptide test done to see how much insulin your pancreas is producing or a GAD antibody test to see if you have those antibodies ?
Gp practices may refuse to do them saying they can only be done by a hospital diabetes clinic, if so then ask to be referred.

I hope this helps.

But please don’t panic about LADA, it’s perfectly doable. TBTH since going onto MDI , learning to carb count and adjusting my insulin’s accordingly , it’s been much much easier.

 

[Ljc]

Here is a little bit of info from our own main site

Latent Autoimmune Diabetes in Adults (LADA)

Latent Autoimmune Diabetes in Adults is called LADA for short. It's a different form of diabetes. What is LADA? It's a type of diabetes which seems to straddle type 1 and type 2 diabetes. Bits of it are more like type 1, and other bits are more like type 2. That's why some people call it type...

www.diabetes.org.uk

 

[Inka]

@Crumblebee I understand your distrust of doctor’s. I’ve had a number of misdiagnoses myself and in my immediate family.

You mention the symptoms coming back - what’s your blood sugar? Are you testing at home? What are your actual numbers?

You can get Type 1 at any age - in fact more adults are diagnosed than children, I believe. So it’s perfectly reasonable of you to want reassurance that your diagnosis was correct. There are tests for Type 1 - the C Peptide test and the Antibodies test.

 

[Annette&Bert]

Is there a way for a lay person to know whether typ1. I have been type2 sincenI was 68, now 72.

 

[DaveB]

Hi. I think you key to this is whether you are still overweight or slim. If the former you will almost certainly be T2. If you are slim and still losing weight then T1/LADA becomes likely. As others mention, the C-Peptide test will show whether you have high or low insulin. Metformin can be prescribed regardless of type although of most relevance for T2. Sitagliptin works by controlling the output of insulin from the pancreas and extends it in time. It can be useful for T2. There seems to be some mystery surrounding ketones. My diabetes consultant I have been referred to also assumes if T1 you may have ketones when I don't. Ketones tend not to relate to type but whether you are burning fat (keto) thru very low-carbing or being T1 without enough insulin. They can be dangerous in the presence of high BS (=DKA) but in my opinion they are not a good measure of type and as you say a Keto diet would result in ketones regardless of type. BTW my diabetes GP many years ago arrogantly insisted I was definitely not T1 without any tests and I had high BS and was very slim and on all the tablets. I'm afraid many GPs are very ignorant/arrogant about diabetes typing and won't do a C-Peptide test. I've had two done privately and a more recent one by the NHS. They all show I'm just above the T1 limit so I'm a 'T1.5' which is what you might be? I need insulin and think of myself as LADA. My insulin resistance is very low and still slim so I'm not T2.