
February 4, 2005
Hyperglycemia and DKA, LADA and MODY
Question from Dahlonega, Georgia, USA:
I have type 1/LADA and my sugar has been up to around 500 mg/dl [27.8 mmol/L] at the highest and I didn’t have any ketones. Are people with LADA as likely to have ketones at high blood sugars as someone with the traditional form of type 1?
Answer:
It is possible for both patients with usual type 1 diabetes and patients with LADA to have high blood sugars at any time. What this suggests is that high sugars in the absence of ketones are a function of enough insulin to stay out of major problems with diabetic ketoacidosis, but still not enough to keep glucose levels down. The major issue with LADA is the rate of decline in insulin secretion. At some point, patients with LADA continue to have beta cell fall-out and can develop diabetic ketoacidosis with absolute loss of insulin. It may just take more time because the loss is more protracted.
JTL