Watching for the Slide
Reviewed by CDE Mehandi Sharma · Updated
In LADA, the treatment you are on has an expiry date. Nobody can tell you when it falls due, so the job is to notice the signs early rather than to predict them.
The signals worth tracking are:
- HbA1c climbing across two consecutive tests while your treatment and habits have not changed.
- Fasting readings creeping up week by week rather than bouncing around a stable average.
- Readings becoming more scattered — the same meal producing very different numbers on different days.
- Weight falling without you trying, which often means glucose is being lost in urine rather than used.
- Thirst, frequent urination or tiredness returning after a period of feeling fine.
None of these on its own proves anything. A month of illness, a festival season, or a course of steroids can lift readings temporarily. The pattern that matters is a sustained drift with no explanation.
The single most useful habit is keeping your HbA1c results in one place — a note in your phone is enough — so you can see the direction over two years rather than only the latest number. A rise from 6.8% to 7.4% to 8.1% tells a story that no single reading does.
When that pattern shows up, the useful conversation is not about trying harder. It is about whether your insulin production has fallen far enough to need a different treatment, and a repeat C-peptide test can help answer that.