LADA or type 2 what do you think

[Lynseyshields]

Hi there I'm new to the forum, just looking for some advice. Heres a quick run down of my story had a few wee symptoms nothing drastic, managed to do a random blood sugar which was 18.5. Long story short my hba1c was 105 started on metformin 2g and gliclazide 80mg Had an emergency consultants app at the start of lockdown when they done antibody test to test for LADA (strong family history, dad was diagnosed type 1 at 33). Got the results the other day and I have tested positive for anti-1a2 but not the other 2. It also showed my c peptide levels were normal but I wasnt fasted and had taken my gliclazide 3 hours prior (they told me I didn't need to be fasted for the app) but on investigation for this test you do need to be fasted.
The test results have left me more confused, the letter states that ultimately time will tell?
Has anyone got a similar story?

Thank you

 

[everydayupsanddowns]

When I was part of the NICE guideline development group for T1 one of the topics reviewed was antibody testing, and which one(s) were most likely to provide helpful information.

I was surprised how inconclusive those measures were, and how patchy the research papers were. Some ‘classic’ T2s have measurable antobodies, and some T1s have destroyed all their beta cells so don’t have antibodies any more.

Ultimately the conclusion was that these tests can help, and/or shed some extra light on cases, but that diagnosis with T1/LADA was still best made on clinical factors and how disease was presenting - speed of onset, family history, 4Ts (tired toilet thirsty thinner), weight at dx, weight loss prior to dx etc...

If LADA, where the speed of beta-cell destruction is more gradual, you may get some apparent positive effect from oral meds (so it may look like they are working and you are T2) but as more beta cells get destroyed ultimately there will be a tipping point and you will need insulin.

 

[DaveB]

Hi. I had my C-Peptide tested privately not long after diagnosis (as a 'T2') and it was at the bottom of the normal range. I had a re-test last year and it has moved down into the T1 area. My GAD was negative and in my case for various reasons I think a virus was responsible. Yes, time will tell. I was initially refused insulin by my GP after years of increasing BS but told I had to have it one year later. Progression can occur at widely varying speeds and the most important thing is to have a good BMI and start insulin if needed early rather than stay on tablets for too long. You HBa1C will be the guide and NICE has a flow chart for that.