What Type of Diabetes Do I Have?

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It’s been almost 4 years since my prediabetes diagnosis and I’m still struggling to get my HbA1c down from 6.5%. In layman’s terms, the HbA1c test measures the average of blood sugars over a 3-month period and ideal ranges are high 4s and low 5s. When my GP handed me the UK diabetes guidelines, I immediately doubted the dietary recommendations. This prompted me to question my diet and lifestyle and dive into the  literature. I thought I was a skinny-fat person and experimented with a vegan diet, inspired by Dr. Neal Barnard’s program for reversing Type 2 diabetes. I started weight training to build more muscle to improve insulin sensitivity and lost a little bit of weight; however, none of this reduced my HbA1c sugar levels from 6.5%. The lowest I’ve been able to get my A1c down is 6.4%, which is when I wrote a post praising veganism, which in hindsight was not a significant improvement at all.

Last year my cousins put me in touch with a doctor who gave me the best advice.  He changed my diet from low-fat, high-carb vegan to low-carb, paleo-esque carnivore. He also urged me to buy a glucose monitoring device to get a feel for how certain foods affected my blood sugar, which the NHS told me was not necessary. This was a total game changer for me and as I started measuring my morning fasting blood sugars and my postprandial sugars, I began to notice a few things:

My blood sugars would go up after I ate, which is normal, but then they stayed elevated all day. In healthy non-diabetics, blood sugars will go up within a healthy range and then return to fasting baseline levels usually 2 hours after eating and with Type 2 diabetics, depending on the severity of insulin resistance, blood sugars should eventually come down at some point after eating. Mine did not and I could never get my blood sugar as low or close to my fasting blood sugar in the mornings.

My blood sugars would spike when I ate healthy carbs, like beans or sweet potato, even in the recommended portion sizes alongside fat and protein. I noticed the fewer carbs I ate, the better my sugar readings were. Sometimes I would eat a low-carb dinner like a large piece of salmon with lots of non-starchy veggies and I would have high blood sugar afterwards and the following morning too.

I can only hit near normal blood sugar readings by eating a very low-carb diet while keeping my portions small.

This past May I was introduced to Jessica Apple, founder of the online diabetes magazine A Sweet Life. I started telling her my diabetes story and she asked me, “have you ever been tested for LADA?” In all my endless research about Type 2 diabetes, I never came across the phrase LADA or latent autoimmune diabetes in adults. LADA is similar to Type 1 in that the pancreas is losing its ability to produce insulin, and overtime will stop altogether, but it’s more gradual. LADAs are often misdiagnosed with Type 2 diabetes because of the age of onset, but LADAs are usually leaner, physically active adults. Hello light bulb!

I went to NYC in June and immediately paid for Type 1 diabetes testing, which was expensive. I had my C-peptide levels measured because this peptide can indicate how much insulin your body is producing. Low levels of C-peptide and insulin paired with high blood sugars usually points to Type 1 diabetes whereas in Type 2 diabetics, you find high blood sugars alongside high C-peptide levels which indicates high insulin levels due to insulin resistance. One exception is someone with advanced Type 2 diabetes which can affect the pancreas’s ability to make insulin. I also tested for GADA and ICA antibodies, which check if the autoimmune system is attacking the pancreas thus killing its ability to make insulin.

Out of a normal range of 1.1 to 5.0, my fasting C-peptide levels came in at 1.1 and on this day my fasting blood sugar was 104 mg/dl and my HbA1c was 6.5%. My doctor said that my C-peptide was very low, but my fasting blood sugar was in the prediabetic range and my HbA1c was in the diabetic range. After reviewing my low-carb food diary along with my lab results, my doctor said that my diabetes looked like an autoimmune issue as in Type 1. Surprisingly, I tested negative for the antibodies, but according to several diabetic forums this is not uncommon. My doctor thinks I need insulin therapy, but advised me to start working with a diabetes doctor, probably an endocrinologist.

There’s still more testing to be done and I don’t have all the answers yet, but I finally feel like I have a better grasp on my diabetes. I’ve learned that it’s so important that you do your own homework and research. I would have never gotten to where I am today if I had solely taken my GP’s advice.

 

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