Wednesday 21 October 2009

I was very lucky!

If you have frequent urination,
If you drink a lot, have a dry mouth
If you have recurrent thrush
If you are losing weight

EVEN IF YOU ARE THIN,TAKE EXERCISE,AND THINK YOU EAT A HEALTHY DIET
GO TO YOUR DOCTOR. DON'T PUT IT OFF .

if you have previously been diagnosed with type 2 (particularly if you were not overweight at diagnosis) and find it difficult to control your diabetes with oral medications and diet, ie you have very high glucose readings, and are rapidly losing weight without really trying.
Insist that you see a specialist and are checked properly.

I know of several people who like me ignored diabetes symptoms, finding reasons to explain them away because they didn't fit the right categories.. Recently I came across Lees story as
told here in Mens Health 'Undiagnosed diabetes nearly killed me' 'http://www.malehealth.co.uk/userpage1.cfm?item_id=2891 I read it and realised how similar his story was to mine. Sadly his diagnosis came perhaps at a slightly later stage.
He hadn't heard of LADA, nor had I.
Why should we ? Unless you actually search for ityou're unlikely to find it on the general information sites . I did check my symptoms of various websites and realised they were those of diabetes but even then I was confused. I read statements like this
The ADA says:
'Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes.'
I was in my 50s
The site also has a risk test for type 2, I did it
I was low risk.

Diabetes UK says:
'Type 1 diabetes develops if the body is unable to produce any insulin. This type of diabetes usually appears before the age of 40. '
I was well over 40.
Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance). In most cases this is linked with being overweight. This type of diabetes usually appears in people over the age of 40.
I was over 40 but was not overweight, I was thin and getting thinner.
Other sites stress the rapid onset:
About .com
'The symptoms of type 1 diabetes usually develop quickly and over a brief period of time. '
The longer I left it, the easier it was to rationalise, it did not cause a rapid crisis

I've explained my rationalisations in an earlier post , but basically they were that I was too old, too thin , too physically active. I hadn't ended in hospital, I couldn't have type 1. If I had by any chance got type 2, the treatment was to lose weight(I'd done that) and eat a healthy diet and exercise (I did that ) so why bother the doctor. Besides the symptoms came and went.... this latter seems to happen frequently from anectotal reports but I have only seen it once mentioned in the scientific literature.

None of the statements from the Diabetes organisations and information sites are completely true. By trying to give simple information, they omit the common exceptions.

  • ‘The incidence rate of insulin-dependent (Type I) diabetes mellitus is bimodal: one peak occurs close to puberty, and the other in the fifth decade.’ (Karjalainen et al New England Journal of Medicine 1983.. pre definition of LADA !)
  • There is a percentage of people (can't find the figure at the moment) diagnosed with type 2 who are not overweight. (A proportion of these may have LADA)
  • The classic rapid onset is often seen in childhood type 1, but even then not always. In older people the onset is very ofen (but again not always) a slower onset . LADA is defined by slow onset.

Perhaps LADA affects such a small number it would only confuse

Well if this were the case, one could understand not mentioning the possibility, but according to Swansea university 10-13% of those people diagnosed with type 2 in the UK have the antibodies connected with LADA. Action LADA says 'This form of latent autoimmune diabetes of adults (LADA) is found in about 10% of initially non-insulin requiring diabetes patients and is therefore probably far more prevalent than classic type 1 diabetes. Joslin puts the figure at between 5% and 30% depending on the population. Its not rare.

OK but if you had gone to the doctor then you would have found out sooner

Possibly, and some people are very lucky and find a doctor who investigates. As my French doctor immediately diagnosed LADA this might well have been true....but I was in DKA by the time he saw me and he was a specialist.
Sweet Magazine this month tells of a young woman diagnosed at 28 . She was a yoga teacher and was losing weight, felt hungry and dizzy. She visited her GP several times but he thought that she was too old to develop type 1. Eventually she looked so ill her mother(a nurse) went with her to the GP and her glucose level was tested. She had a level of 30mmol but amazingly the GP didn't believe the result and sent her away again. Her sensible mother took her to A&E where she was immediately put on an insulin drip.(Sweet, Oct/Nov 2009)
Hopefully cases like this are rare, but this young woman wasn't even 30 yet deemed by her doctor to be too old for type 1. Unfortunately,I've read of many people who have had problems in getting a diagnosis. There are several similar stories told on the various diabete's forums to the one above. Quite frequently people are at first diagnosed with type 2 and then find that oral medications don't work for long. Sometimes they are considered to be uncompliant. On more than one occasion I have read that a person has ended up in hospital with DKA before they were diagnosed correctly.

GPs are not specialists, information on LADA is available but you need an interest and time to investigate. I feel strongly that the diabetes organisations should do more to make both the public and GPs aware of the possibility of LADA (and other possibilities such as MODY).


1 comment:

  1. This is why individuals need to take responsibility for their own health care, to ask lots of questions, to do lots of research, and to make their own informed decisions..

    Good post!

    ReplyDelete