Re: Shock

[Guest guest]

I'm just reading Bernstein again - the old edition and found something

that really makes me wonder what's going on with me. Page 87, Insulin

Resistance - in a Type 1, after eating, uncorrected blood sugar won't

just rise to the level of glucose consumed, but will continue to rise

slowly throughout the day. In a Type 2 still producing some insulin the

body is more likely to correct the rise automatically.

So I'm supposed to be a T2. But my bgs don't come down automatically.

I've seen bgs over 200 for 8-10 hours when I made food errors and was

still on pills only. The numbers will actually hang - say at 227-232

for all that time. And the met/Avandia combo never touched it. Somewhere

else, tho, Dr. B said that the higher the bgs the greater the IR. Gad,

I wish I could afford an endo. I've actually told my idiot so-called

doctor about this but it didn't ring any bells for him. Well, he will

write the script for Humalog next week, or he WILL meet with every

lawyer I still know. And they whine about the legal profession - HA!

Carol

[Guest guest]

Carol, I don't remember your details...but how long since your

diagnosis? Are you apple shaped or overweight or " normal " weight? Could

it be that you're LADA?

Vicki, LADA

Re: Shock

>

> I'm just reading Bernstein again - the old edition and found something

> that really makes me wonder what's going on with me. Page 87, Insulin

> Resistance - in a Type 1, after eating, uncorrected blood sugar won't

> just rise to the level of glucose consumed, but will continue to rise

> slowly throughout the day. In a Type 2 still producing some insulin

> the

> body is more likely to correct the rise automatically.

>

> So I'm supposed to be a T2. But my bgs don't come down automatically.

> I've seen bgs over 200 for 8-10 hours when I made food errors and was

> still on pills only. The numbers will actually hang - say at 227-232

> for all that time. And the met/Avandia combo never touched it.

> Somewhere

> else, tho, Dr. B said that the higher the bgs the greater the IR.

> Gad,

> I wish I could afford an endo. I've actually told my idiot so-called

> doctor about this but it didn't ring any bells for him. Well, he will

> write the script for Humalog next week, or he WILL meet with every

> lawyer I still know. And they whine about the legal profession - HA!

>

> Carol

>

[Guest guest]

dx early Nov. 02. About 10 lbs. overweight. don't know what LADA is

unless it's that Syndrome X??? the metabolic dealy? See how much I

know about it, huh,huh, do ya?

Carol

whimsy2 wrote:

> Carol, I don't remember your details...but how long since your

> diagnosis? Are you apple shaped or overweight or " normal " weight? Could

> it be that you're LADA?

> Vicki, LADA

[Guest guest]

Carol...LADA stands for " latent autoimmune diabetes in adults " . It's

essentially type 1 diabetes, autoimmune induced, but instead of coming

on explosively like when kids get it, it comes on more slowly. I was 60

at diagnosis of LADA, hardly a kid. Very often doctors automatically

assume if you're an adult when you get diabetes you're type 2. 'Taint

necessarily so, and while pills may work for a while, eventually beta

cells are used up and it's insulin for sure.

I have a brief explanation of LADA that I'll append here for your

information and all those who haven't heard of it:

From the fact that you weren't grossly overweight at diagnosis and not

having optimal control with pills, it may be that you're actually LADA.

Only a GAD antibody test will tell for sure, and you probably wouldn't

be able to get your doctor to have it done, given what you've said about

him. However, if you're going to go on insulin anyway, the actual LADA

diagnosis is moot, I 'spose.

<<

LADA = latent autoimmune diabetes in adults

LADA is a form of autoimmune diabetes that starts in adulthood instead

of childhood. It is nothing more than type I diabetes (IDDM) starting

slowly after the age of 30-35.

In general, LADAs are not overweight, have no family history of NIDDM,

may or may not have a family history of IDDM, do not put on weight at

the time of the diagnosis (as a matter of fact, some of them may even

lose weight at that time), and they tend to have higher BGs from the

beginning.

Doctors may try to control LADA with diet, but within a short period,

from months to a few years, metabolic control fails. BGs start going up,

despite good diet and weight control, and they soon require insulin.

Oral agents may be tried first, but subsequent progress to insulin

dependency may be quite rapid.

The mechanism of DM in LADA is mostly the failure of the beta cells in

the pancreas to secrete insulin.

In the past, some of these patients were considered to have " primary

failures " to oral agents because they did not respond to them or they

respond for a short period of time.

Studies have shown the presence of markers of autoimmunity in LADA

patients. The markers of autoimmunity that can be found in a person with

LADA are the classic islet cell antibodies, or more precisely anti GAD

antibodies, which can be found even more frequently.

15-20% of all diabetic adults may have LADA, and LADA may constitute as

much as 50% of non-obese adult onset diabetes. This form of diabetes is

sometimes known as " Type 1 1/2 " .

LADA patients can be very confusing to doctors who are not aware of

this possibility. The patients with LADA may look exactly the same as

patients with NIDDM, and it becomes frustrating trying to control the

BGs with diet and pills. The doctors may blame the patient for not

following the diet well, or for not taking the pills as they should. The

truth is that the islets of Langerhans are slowly being attacked by the

autoimmune process and stopping their secretion of insulin.

In children, the autoimmune process is more acute and " explosive " with

symptoms presenting over a short period of time and being more severe

(thirst, urination, hunger, decreased weight). In adults, the autoimmune

process that destroys the islets of Langerhans seems to be slower, and

the decline in insulin production appears over several months instead

of several weeks.

As soon as the diagnosis of LADA is made, it is better to start insulin

right away. Putting the beta cells to rest by giving insulin exogenously

and normalizing the BGs is good for the beta cells. It prevents the

exhaustion of the beta cells, and it seems to decrease the autoimmune

attack on the islets.

Re: Shock

>

> dx early Nov. 02. About 10 lbs. overweight. don't know what LADA is

> unless it's that Syndrome X??? the metabolic dealy? See how much I

> know about it, huh,huh, do ya?

>

> Carol

>

> whimsy2 wrote:

>> Carol, I don't remember your details...but how long since your

>> diagnosis? Are you apple shaped or overweight or " normal " weight?

>> Could

>> it be that you're LADA?

>> Vicki, LADA

>

>

[Guest guest]

In a message dated 12/1/04 11:33:34 PM Eastern Standard Time,

whimsy2@... writes:

>

>From the fact that you weren't grossly overweight at diagnosis and not

>having optimal control with pills, it may be that you're actually LADA

>>>>>>>

My father, an undiagnosed diabetic, and my uncle, a diabetic who has never

been told he's diabetic were not fat (fat is a much preferred term to " grossly

overweight " as the term " grossly " usually brings to mind ugly or disgusting

(yes I know it can me " greatly " but the association is there)). My father had

heart failur and edema which put weight on him but it was gone once he was on

dialysis for a few days, and my uncle has been at most 10-15 lbs overweight.

The older one is, it seems, the less weight there seems to be in type 2

diabetes.

Plus, since type 2s often go undiagnosed for long periods of time, they may

have very little left in the way of beta cells at the time of diagnosis, and

those beta cells may burn out very quickly.

Stacey