Is It Possible To Recover From Ketoacidosis Without The Use Of Insulin?
I have some questions regarding the field of type one and latent autoimmune diabetes in adults (LADA).
As well as diabetic ketoacidosis.
question 1: isit possible for a patient to recover from ketoacidosis on their own without the use of insulin or any oral drugs, therefore missing the diagnosis altogether, e.g. the beta cells start working again overnight allowing the patient to recover normal bg levels of e.g. 5.2 mmol/l after displaying KDA symptoms and haveing the symptoms go away on its own.
Question 2 : For type 1.5 LADA patients, what general symptoms or signs can we use to distinguish the diagnosis prediabetes.
And what general most common synptoms should we look out for when diagnosing type 1 and LADA.
Question 3: If a prediabetic patient who has a history of autoimmune disorders, but has no apparent LADA signs such as acute ketoacidosis, and is able to maintain a normal average blood glucose level following a low carb diet , should we suspect LADA in the patient?
Diabetes
Detailed Answer:
1 Spontaneous recovery from DKA has not been reported in medical literature. It is highly improbable, if not impossible all together
2 LADA can present just like type 2 diabetes in the beginning i.e. patients respond to oral medications for some time (upto 6 years) and then unexpectedly insulin becomes necessary sooner than it would usually be. Because they are like a gradual version of type 1 diabetes.
Most common symptoms for diagnosing type 1 diabetes are typically:
rather quick onset of symptoms such as increased thirst, urination, hunger and weight loss. Often, they land up in DKA if not diagnosed in time
LADA patients typically behave just like type 2 diabetes i.e. not many obvious symptoms but can have the same symptoms as for type 1, just that they occur more slowly over months. Although DKA can occur in type 2 diabetes as well as LADA.
3 LADA is possible in individuals with other autoimmune conditions and the pre diabetic stage can be a part of the 'pre clinical' stage of the LADA.
However, just following a low carb diet alone will not mask the presentation of LADA. It is not enough to keep the disease in check.
Regarding to your third response,
So if a patient is able to significantly lower fasting and postprandial glucose levels within nondiabetic range through diet and lifestyle changes alone, and has no apparent LADA symptoms. Should the patient be suspected of possible LADA if he has a history of autoimmune disorders.
Follow up
Detailed Answer:
LADA should be considered as a diagnosis only if the individual tests positive for one or more auto-antibodies associated with type 1 diabetes such as:
anti GAD
anti Insulin
anti Islet cell
It would be uncommon to run these tests unless diabetes occurred but it is conceivable to test them in someone with a history of other autoimmune disorders, even if his or her current glucoses are normal