Perhaps the first recommendation I would make for an adult with high blood sugars, not responding to weight loss, is finding out if they have LADA.
1/3 of people with the onset of diabetes after the age of 20, have LADA or Latent Autoimmune Diabetes of Adulthood, and not type 2 diabetes, and they would not respond well to oral medications.
Diabetes Type 1.5 is another name for LADA (Latent Autoimmune Diabetes in Adults). People with LADA do not have insulin resistance and instead have lack of insulin because of autoimmune attacks on the pancreas. Type 1.5 is really a variation of Type 1 and is a little different in that the onset is slower and you may not be insulin dependent at diagnosis.
In diabetes Type 2, elevated blood sugars are caused initially by insulin resistance. Some persons with Type 2 do lose their functioning cells and become insulin dependent but that does not make them a Type 1 or 1.5.
If it hasn't been done, to find out if you have LADA, ask your doctor to do an antibody panel (GAD, ICA, IAA) and a c-peptide. Here is a check list to help you decide to ask for more testing. http://api.ning.com/files/9v-anH8d1nSlO0y0NKe0XWKI3CJRRPJ6tTGzyV7sDjbaQO8U*QYRBx6PnFxSCzsm7JmG9iSaSyiFpTuCQ3zTfQ__/LADA_Are_you_at_risk.pdf
What about diet? Unlike the case with Type 2 diabetes, it is usually not possible to reverse or control LADA with carbohydrate restriction alone. That said, it is much easier to make insulin work when you are eating a lower carbohydrate diet than it is with a high carbohydrate diet. To learn more about how lowering carbs allows you to fine tune your blood sugar control and avoid dangerous hypos and soaring post-meal blood sugars, read Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars.
Though many people with LADA are able to eat higher amounts of carbohydrate than those that Dr. Bernstein recommends, the principles he explains hold true for all people with diabetes and reading this book will give you a much better idea of how to use insulin effectively.
Though many people with LADA are able to eat higher amounts of carbohydrate than those that Dr. Bernstein recommends, the principles he explains hold true for all people with diabetes and reading this book will give you a much better idea of how to use insulin effectively.One of the reasons people with LADA do better on a carbohydrate restricted diet is that there is a high rate of gluten sensitivity/celiac disease in persons with autoimmune disorders, 12 fold increase in fact. The best testing is to do a genetic test from www.enterolab.com for $US 150.00.( Anything in Ontario cost the same and is only 50% accurate).
Of course, it goes without saying, that one should exercise 30- 60 minutes a day at a pace that only just takes your breath away.
Yours in health.
Dr .Barbara
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