A DiabetesTeam Member
I have noticed a few younger members joining our happy little Type 2 group.
Not so long ago the average age of onset was sometime in the mid-50 years old - just prior to the pandemic the average was in the latter 40's - we are getting more lazy, too much screen time and eating more and more "crap" which has pushed down the average age of diagnosis.
But it has still been relatively rare to see someone under age 35 develop Type 2.
A couple of things have come to light.
One in the past couple decades - LADA
LADA or Latent Auto-Immune Diabetes in Adults is a type of diabetes that is very "similar" to Type 1 Diabetes which is almost always diagnosed in children with a rare diagnosis after your early teens.
Type 1 is an Auto-Immune disorder where your own body sees your Pancreas as an infection and attacks it - killing your ability to make insulin in a very short period of time - days or weeks and you need insulin.
LADA is likewise an Auto-Immune disorder but the cause is a little different then Type 1. It can take months or years before you attack the pancreas enough to need insulin.
Because of that it looks (initially) very much like Type 2 Diabetes and in it's early stages it is treated exactly the same as Type 2.
The problem however, with an incorrect diagnosis is, when it does progress, if your doctor is not aware of your actual condition they will horse around for quite a while trying to get Type 2 meds to work when you should be on insulin - doing no end of long term damage (and drastically lowering your life expectancy) before they finally send you off to a specialist who hopefully sorts it out.
The other "new development" is the Diabetes which is being linked to "long Covid".
In some that had Covid (and they can't tell who or why at this point), even if they had a very mild case, the Covid Cooties attack the pancreas with the same ferocity as Type 1 or LADA.
This Covid Diabetes is NOT Type 1, LADA or Type 2 (not auto-immune and not metabolic) but at the moment depending on how severely Covid messed with your pancreas, you will be treated like one of the other Types.
Again, if your Doctor doesn't at least consider your diabetes might be Long Covid related, again, they could horse around trying to make Type 2 meds work when actually you may need Insulin if your pancreas was really beaten up.
So if you are under 35 OR you had Covid (or both), you might ask your Doc many questions about your diagnosis.
LADA is not widely known in Primary Care/Family Doc's and neither is the Covid connection. And if they have not considered (and tested for in the case of LADA), your care could quickly get out of hand if they are treating you for the "Wrong Diabetes"....
I blame my diabeties on Covid. But after being in this group and doing research i was one before i got Covid. So my feeling is this though Covid was mild aside of back pain from hell Doc doing tests finding out i was Type prolly saved me from having a heartattack etc. I only went to doc when i was sick like flu like stuff never had time to go for physical etc. But me and my Doc are being friends all over again .LOL
Graham- Thanks so much for your explanation. It really helps. @A DiabetesTeam Member
This is very interesting I have been hearing on the news lately about non diabetics getting type 2 diabetes after having COVID. They do not explain it further and my natural curiosity about diabetes made me wonder but how and why!
There is value in any C-Peptide test but fasting and random will give different pieces of information.
A fasting C-Peptide coupled with a fast Blood Glucose will give a couple pieces of information. The (C) will tell the Doc if your Basil Insulin production is good/fair/poor (a non-diabetic produces about 8 units while fasting) and coupled with the FBG will allow them to calculate your insulin resistance.
That can give guidance as to the need of/value to adding long acting Basil Insulin (usually at night before bed) or starting/increasing Metformin use.
A C-Peptide coupled with an Oral Glucose Tolerance Test (OGTT) will tell the Doc what your Bolus Insulin production looks like and by comparing the results of that test with the BG readings from the OGTT they can calculate your insulin resistance following meals.
Since an OGTT is done at the end of a fast and simulates eating a "massive breakfast" (or either 50, 75 or 100 carbs depending on the test method), once again they can compare production to a normal "sugar eater" who would produce about 11 units of Bolus insulin to metabolize breakfast.
That increases to about 13 units after lunch or 14 units after supper (even non-diabetics develop insulin resistance as the day goes on - our problem is compounded so if we ate to our metabolism, breakfast would be are most "carb intense" meal of the day and we would eat "fewer carbs" at supper if we wanted to achieve the best sugar control possible.
A C-Peptide after the above can give guidance to the various other Type 2 medications OR the need for the addition of a Bolus (mealtime) Insulin OR Sulfonylurea - all except the insulin itself require the patient to be producing decent amounts of insulin - the C-Peptide would identify if taking them would be a "waste of time" due to lack of (their own) Insulin which would be needed for them to be effective.
The problem most of us have is there is very little clinical guidance to order such tests unless our blood sugars are going haywire.
And yes @A DiabetesTeam Member if the Sulfonylurea was still active in your system (but it does burn out in about 2 hours) it would skew your C-Peptide - not in total production levels but rather wouldn't show "unassisted" levels - but there would still be "value" in knowing both how much you produce on your own and how much the SU is helping pump out.
I don't think my diagnosis was taken very seriously. They looked at the fact that I had GD and basically wrote me off as type 2 at 30 and healthy. I pushed for insulin and C-Peptid testing (both were non-fasting because the tests were last minute, not sure if that matters) and never had a follow-up with the results before both Drs dropped me saying I just needed to be followed by my "family doctor". :/ I'm going to see if they'll email me the results then just Google it I guess lol
I have been trying to ascertain for the last two years if I have LADA. My endocrinologist told me about two years ago that maybe I had LADA. When asked if there is a test to determine that, the Dr. said no. i should have changed doctors then. Anyway,I had a C-peptide and 2 antibody test done 3 weeks ago which pointed to type2. However, It is difficult to ascertain the results depending whether done fasting or after a meal. Additionally, I take glipizide (a sulfonylurea) which forces pancreas to produce more insulin. Not sure whether that produces a false indication of how much endogenous(natural) insulin the pancreas is producing. Anyway, I will take another c-peptide test next week(fasting this time) and see how it goes.
@A DiabetesTeam Member you should minimally ask your doctor if they think your diabetes is Covid related.
Now, you may have had many other risk factors which led to your diagnosis, but what the researchers have been seeing is the Covid Diabetes has done more damage "when first detected" they the Typical Type 2 or those that already had Type 2, in some cases (again they don't know who or why) it advanced their Type 2 significantly.
Ultimately it has to be dealt with no matter what caused it, but if I had a bout of Covid and was diagnosed within the following year of recovering, I would at least want to know that my Doc is "aware" that there is good research out there now showing this new diabetes caused by Covid "could be the cause" and that they are not just treating it like regular old Type 2 where they can just write a prescription and send you on your way because Type 2 takes many years to do damage (from time of diagnosis).
This new Covid Diabetes can cause some damage pretty early on if it isn't recognized as "potentially" more serious and more advanced then what most Doctors are used to dealing with.
So no "panic" - but I would be asking questions.
Oh no this is kindof scarying me after reading this, because I did get Covid, so this is something I now I have to reconsider or talk to my doctor about ? 😞