LADA
LADA – Latent Auto-immune Diabetes of Adults is a condition that is frequently initially misdiagnosed as having Type 2 Diabetes. I was diagnosed in early 1992 with Type 2 Diabetes, and five months later the diagnosis was Type 1 Diabetes.
I was diagnosed in early 1992 with Type 2 Diabetes, and five months later the diagnosis was Type 1 Diabetes. I weighed a healthy 59kg for my 160cm frame and I was working happily in a full-time music teaching capacity with 250 students in my charge. One day at work I felt an unquenchable thirst and drank water all day. The inevitable trips to the bathroom followed. The thirst became more pronounced and eventually I had to stay at home on sick leave because I could not drink water all day in front of the students and was not allowed to leave the classroom every hour to go to the bathroom. I also felt very ill and wondered what was wrong with me. Time went on and I was not getting any better. I became heavy and found it difficult to lift my legs and put one foot in front of the other. Being barely able to walk up a short hill near the shopping centre one day, I visited a GP who told me I must have Ross River Fever and to go home with another two-week medical certificate and to rest. That was 19 years ago.
Another two weeks dragged on and I felt dreadful. My eyes were burning, my mouth was parched, I fell asleep often through the day. My whole life came to a standstill. Such was the disability that I had to hire cleaners and a cook to help me get through the day. Realising that I could not get back to my teaching without a fast improvement in health, I visited a doctor who did not know what could possibly be wrong with me until I told him that I smelt like a honey pot. He straight away ordered a Full Blood Count (FBC), and his receptionist rang back later that afternoon with a result. I had Diabetes, and was rushed to a local hospital where my whole existence went into a spin with little food, tablets for Diabetes and lots of spectator medical students.
I was given constant supervision, blood tests, and continued vomiting even with medication, and found it increasingly annoying repeating my family history to doctors too many times. A different team was sent in intermittently and they would all ask for my history. I began to think they did not believe me. Later in the week I underwent intensive Diabetic Education and while hardly comprehending a single word the medical team was telling me, I became anxious as to when I would return to my work. My blood glucose level had dropped from the 29.5bgl on admission to a more comfortable 15.6bgl. I was discharged, some days later with a prescription for Metformin tablets, but not before spending AUD$250 for a blood glucose monitor and paying an Annual Ambulance Levy which was compulsory for people with Diabetes. Frequent visits to a Diabetic Clinic followed, and being unable to return to my work, I spent 5 months on sick leave, and required constant medical appointments.
One evening while trying to eat my dinner, I could not lift the food to my mouth, as I had no energy. My husband tried to feed me, but when given the food, I could not chew it. My husband, now my Full-Time Carer,took me to the hospital, and told the Endocrinologist he thought that I needed to start insulin injections straight away as I had no energy and my levels were raging. After being admitted I spent the next few days learning how to inject insulin and what that meant, and also to come to terms with the fact of having to give myself several injections a day for the rest of my life. A week later I was discharged with a prescription for insulin and a book on the subject of Living with Diabetes, which I still refer to these days.
12 months at home on sick leave had slipped by and in 1993 I was able to return to my teaching job at the beginning of the school year. Everything seemed to be going along well for the next three years and I managed my insulin routine out of sight of other staff members, but I did notice more frequent episodes of hypoglycaemia occurring after I did the extra curricula activities required of me at school. This was because I could not eat in front of the class while conducting ensembles and therefore my blood glucose levels dropped. On one occasion, I had just finished a before-school rehearsal when a parent came up to me to ask about her child's progress, and I remember seeing a blurred vision in front of me and could not recognise which parent it was. My tongue was tingling and I started sweating and then anxiety came over me because I sensed I would have to dive for some emergency fruit juice to bring me around. I did that, much to my own embarrassment in front of the parent, who was very understanding. I could not bring myself to tell the lady that I had Type 1 Diabetes, as I was sure these words would undermine my professionalism and possibly my performance as well. I carried this attitude with me during most of the time after I returned to work.
By now it was nearing the end of 1996, and this was when I developed pneumonia, which required lengthy hospitalisation, many X-rays, change of insulin doses and steroidal medication which increased my hyperglycaemia. These high levels were accompanied by constant infections, increased antibiotics which began not to work, and blackouts with the hypoglycaemic events. It was at this time that I developed asthma and required 12 puffs of Becloforte a day, 6 Atrovent puffs and Ventolin in a respirator three times a day. My day was full of medical routine. Not long after, I started blacking out and fell down our laundry steps a few times, once missing the spare fridge by a fraction but landed on the tiles and suffered a chipped hip bone and a massive bruise to my thigh which remained for weeks, and I could not put any weight on that leg.
Two years later I still had not fully recovered from the lung damage nor the side effects of the steroidal medication. I have remained at home for the past 15 years, unable to work, however I have learnt to appreciate the most important aspect of a happy life, which is for me, being able to wake up each day and not experience a hypoglycaemic attack before breakfast!
Further reading, http://www.diabetes.co.uk/diabetes_lada.html
Ailsa E. Cooper
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