PCT says no to Levemir???!!!

[Northerner]

If I can persuade Dr to do test and I am LADA can I then go on Dafne course? What do I do if Dr just says treatment is the same so no point in finding out?
Already identifed that my time on sulphonylureas will have helped destroy beta cells even quicker if I am. And I did ask Dr about a year ago if I needed Gad or C peptide tests and he laughed at me.

I don't see why you shouldn't be entitled to go on the DAFNE course, as it strikes me that your response to insulin is no different to mine, so the argument that T2s can't follow the principles because they might be producing their own insulin, or have high insulin resistance, doesn't apply. So, regardless of whether you have the test or not, it is just bureaucracy's attempt at convenient labelling to exclude 'T2s' who are functionally identical to T1s 🙄 Yes, probably you will be on the same treatment, but that treatment is what DAFNE is designed to educate about!

No doctor should laugh at a patient's suggestions, they should give a clear and convincing argument why the suggestion would not be applicable. 😡

 

[caroleann]

My D consultant said he would do the c peptide test but he cant get the funding for it,this was last year so things might have changed by now.

 

[PattiEvans]

Many HCPs are willing to put peeps with LADA or even T2 on insulin forward for DAFNE but it seems to be the DAFNE people who refuse to let them on the course.

As to testing - I had to have a bit of an emotional turn and claim psychological distress before I got the CPeptide. Since the proper diagnosis I have already seen the difference in treatment. Yes, I'm still on the same insulins and so on, but I have had a carb counting session/education and I now have an appointment with the pump nurse. I'm not saying I will get a pump, but I'd never even have got as far as the appointment without the proper diagnosis. So yes, it IS worth pushing for.

 

[everydayupsanddowns]

One of the reasons behind HCP reticence about GADA and c-Peptide tests is also down to the fact that they are, in themselves, pretty inconclusive. If the markers exist, or if they are absent, it doesn't actually 'prove' anything. Something like 75% of T1s will show positive for GADA at diagnosis, but the presence (or absence!) of GAD markers and levels of c-Peptide change over time too. And they are likely to be more 'marginal' in atypical cases and more definitive in classic presentations.

I would suggest you ask again, and say that you are not happy about your classification (something like 2.5% - around 75,000 people with diabetes are misclassified). Say that you worry that various helpful treatment options (eg training courses/access to pump therapy) might be denied you. Suggest that if your GP is not prepared to request a lab test, you would like a referral to a specialist/consultant who can review your case at Dx (speed of onset/rapid weight loss/ketones etc) and consider your classification.