Lada

[happydog]

If you have LADA type diabetes does diet and exercised make any difference to BG levels? Do LADA diabetics always have to use insulin? I am asking this because it has been suggested that this may be the type of diabetes that I have.

 

[everydayupsanddowns]

LADA is sometimes referred to as 'slow onset type 1'. While strictly speaking I dont think that's 100% technically accurate it does help understanding that as far as I know, yes you will need insulin. I think I may have read somewhere that having insulin early can even be beneficial so don't hold off if it is being offered to you.

 

[AlisonM]

As I understand it, diet and exercise can help any diabetic, of whatever type, only T1s need insulin anyway as they don't produce much (if any) on their own. Treatment for LADA seems to depend on where you live. Up here, I'm regarded mostly as a T2 for treatment purposes. It's been a major issue as most T2 meds don't work for me, ignoring the bad reactions I had to many of them anyway, they really didn't make much difference. Until they put me on Victoza, which makes the body produce more of it's own insulin and slows down digestion. It works for now but I've been told it's not a log term solution as my pancreas will give up the ghost at some point, probably sooner rather than later. I am on insulin as well because, unlike T2s, I can't make enough on my own. This form of Big D seems to progress at different rates for each person who has it but I was told 3-6 years before I need a 'proper' insulin regime.

Are you being tested for LADA?

 

[happydog]

Thank you both for your replies. We have a GP practice where all the doctors are part-time. Unless you specifically ask to see the doctor on whose list your name appears you will be given an appointment with whoever is available. Consequently I have seen four different doctors and three different practice nurses in 7 months. One of the doctors said that he thought that as I am not overweight, have no other diabetic people in the family and lead a healthy lifestyle but have other autoimmune problems e.g. hypothyroidism, low platelets etc that I might be 1.5. However, the senior partner in the practice, who seems now to have decided that he needs to see me and not anyone else, says that although he is not ruling LADA out he thinks that I should continue to be treated as a type 2 as the treatment is the same. He also says that the LADA test is not always accurate. I am doing fairly well on a low carbohydrate diet and exercise having reduced my HbA1c from 85 to 46 from October to December. I wondered if I was LADA whether diet and exercise would have made any difference, which is why I asked the question. I think that has been answered now thanks to you. 🙂

 

[AlisonM]

It's a simple blood test and, as far as I am aware, pretty accurate. Since the prognosis for LADA is quite different to T2 and you will need insulin sooner rather than later, your doctor really should consider doing the testing. Having said that it often takes a good few years even to get them to admit you may be LADA, so you're ahead of the game there.

I'd have another chat with him to try and get him to authorise the test.

 

[happydog]

Thank you Alison M. I will try to talk to him but he is quite fixed in this ideas, although having said that, I just collected my first batch of test strips, only taken 7 months, but I have won him round on that, yay! 🙂

 

[Mark T]

From what I understand, the LADA test is for autoimmune markers - GAD95 and IAA.

However, it is possible for you to be clear on those markers and still be LADA since there are about 6 or 7 autoimmune markers but clinical tests for only 2 or 3 of them.

This is pretty much where I am. My consultant hasn't yet given up on the possibility that I might actually be LADA but I'm negative for IAA and not positive for GAD (but not negative!).

 

[Northerner]

Well, I'm another variant I think. Diagnosed when I developed DKA, which is a clear Type 1 marker, but also nowhere near overweight at diagnosis and no T2 in my family apart from my Auntie who has developed it after me. I was immediately put on insulin - 20 units of lantus and around 40 novorapid. My lantus dose declined until I discovered (exactly a year ago!) that I didn't need it at all, plus my novorapid has dropped by half. So, I'm still producing some of my own insulin, but not enough to cope with any amount of carbs in my diet, so I'm not Type 2 and not Type 1 five years after I was diagnosed!

So there's quite a spectrum and it's possible if the diet and exercise modifications are working well for you (as clearly they are) then you may be using a declining amount of insulin more efficiently. My consultant believes that as I was running a lot before diagnosis, this may have helped me stave off the diagnosis day - then I caught a virus which overwhelmed me - up to now where I have recovered some of my insulin production!

 

[PattiEvans]

I thought for 8 years that I was LADA, but couldn't get the tests done. Eventually I was seeing an Endocrinologist for my hypothyroidism and I asked the nurse at the GPs to write to him asking if I could have the tests. He was a very nice person and explained at length to me that the GAD tests would probably no longer be showing positive since I had had D for 8 years +, but he organised a C-Peptide test to see how much endogenous insulin I was producing. It proved I was actually T1. Since the proper diagnosis I have been treated completely differently - not that my regime of basal/bolus has changed, but it has opened the door to carb-counting education and I have been able to apply to be considered for a pump. I also see a DSN 6 monthly and the Endo annually now. Previously I only saw the GP's nurse, who is very clued up but nevertheless I had to more or less sort my own doses out/research insulins myself and ask to be changed. It's been very interesting to see the contrast in people's attitude.

Oh... and I've been told that they are now discovering many different types of diabetes than they ever previously suspected.