Specialist thinks I may be type 1 now?

NewTD2

Well-Known Member
Messages
1,563
Type of diabetes
Type 2 (in remission!)
Treatment type
Tablets (oral)
Hi. There are various LADAs on this forum including @catapillar who may also wish to add comments. If you are diagnosed as LADA then you will be somewhere along the honeymoon stage where, sadly, the pancreatic cells are failing. Some tablets such as Gliclazide can help for a while but not advisable long-term as they are suspected of speeding failure. I was on full dose Gliclazide for more than 5 years which was not a good idea. The honeymoon period can last weeks into years and you can't tell how long. The HBA1C test will guide the GP/DN. You will need to go onto insulin when the HBa1C goes above, say, 7.5% (see NICE guidelines). You should be put onto the 'Basal/Bolus' regime which means two insulins one '24 hour' one (Basal) and one meal-time one (Bolus). This means 4 to 5 injections per day. This may sound awful but it isn't and it's a relief as insulin really does give good blood sugar control with very little side effects apart from the risk of hypos which can be serious. With experience and balancing the insulins and matching to meal-time carbs you can avoid the worst hypos. Keeping the carbs down helps reduce swings into hypos and avoids weight gain thru too many carbs. Hope that helps a bit and do ask any specific questions.


Thank you so much for your help and advice I really appreciate it.

I have a few questions...

1. I would like to spread my meals in small portions throughout the day. How much insulin (bolus) do I need to inject?

2. I want to go to the gym and play tennis. What would you advice for how much carbs and how much bolus to prevent hypoglycaemia?

3. I had ketoacidosis last September and nearly died at the A & E. I was discharged the next day and didn’t hear anything from the DN for 6 weeks. She tested my bg level and it read 9 which she said it was high and my pancreas might be running out of insulin.

I was put on insulin therapy (Glargine) 14 units for just 13 days and eventually weaned down to 6 units for 3 days.

After 3 days, completely removed from insulin when my bg levels came down to 5s and 6s, (because I went low carb) and now taking Metformin 500mg.

My current bg levels are still reading between 5s and 6s.

GAD and anti body tests will be carried out end of Jan 2018.

Does it all mean I’m on honeymoon period? Or could there be a possibility it could all turn out to be negative?

Anyway I’m preparing myself mentally for next year so that I won’t have a shock.

Really appreciate your help and advice!

Andrew
 
Last edited:

NewTD2

Well-Known Member
Messages
1,563
Type of diabetes
Type 2 (in remission!)
Treatment type
Tablets (oral)
Thank you so much for your help and advice I really appreciate it.

I have a few questions...

1. I would like to spread my meals in small portions throughout the day. How much insulin (bolus) do I need to inject?

2. I want to go to the gym and play tennis. What would you advice for how much carbs and how much bolus to prevent hypoglycaemia?

3. I had ketoacidosis last September and nearly died at the A & E. I was discharged the next day and didn’t hear anything from the DN for 6 weeks. She tested my bg level and it read 9 which she said it was high and my pancreas might be running out of insulin.

I was put on insulin therapy (Glargine) 14 units for 13 days and then removed from insulin when my bg levels came down to 5s and 6s, (because I went low carb) and now taking Metformin 500mg.

My current bg levels are still reading between 5s and 6s.

GAD and anti body tests will be carried out end of Jan 2018.

Does it all mean I’m on honeymoon period? There might also be a possibility it’s all negative?

Anyway I’m preparing for next year and really appreciate your advice!

Andrew
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. This profile after DKA is quite common on the forum. People start having low-carbs and possibly some Metformin (which has a very small effect) and their blood sugar comes down. The fact that you had DKA implies you may well be on the honeymoon journey and the bs may start to creep up again. The rule with Bolus and carb-counting is to find out your ratio and use that. Most people start at 1 unit of Bolus to 10gm of carbs, but do be guided by the nurse and it's often best to use a little bit less bolus until you find what your own ratio is and that way avoid a hypo. When I go to the gym I inject a bit less Bolus at the meal before and check just after the gym and before if needed. I keep glucose tablets with me in the gym and also wear an 'Insulin Dependent' wrist band in case I keel over. Interestingly I rarely have a problem in the gym but mowing the lawn can send my bs down fast so the type of exercise is important.
 

NewTD2

Well-Known Member
Messages
1,563
Type of diabetes
Type 2 (in remission!)
Treatment type
Tablets (oral)
Hi. This profile after DKA is quite common on the forum. People start having low-carbs and possibly some Metformin (which has a very small effect) and their blood sugar comes down. The fact that you had DKA implies you may well be on the honeymoon journey and the bs may start to creep up again. The rule with Bolus and carb-counting is to find out your ratio and use that. Most people start at 1 unit of Bolus to 10gm of carbs, but do be guided by the nurse and it's often best to use a little bit less bolus until you find what your own ratio is and that way avoid a hypo. When I go to the gym I inject a bit less Bolus at the meal before and check just after the gym and before if needed. I keep glucose tablets with me in the gym and also wear an 'Insulin Dependent' wrist band in case I keel over. Interestingly I rarely have a problem in the gym but mowing the lawn can send my bs down fast so the type of exercise is important.

Thank you for your advice.

I’m preparing my mindset for whatever comes next year!
 

Kristin251

Expert
Messages
5,334
Type of diabetes
LADA
Treatment type
Insulin
I eat small meals spread throughout the day and take 1/2 unit but they really are small, more like a snack. I do have to bolus for half my protein as if it were a carb as I am ultra low carb.

Everyone’s insulin usage is different so as @Daibell said, error on the side of caution until you know how you react to meals. I eat the same meals ( varied proteins) everyday so I know my bolus for each meal at each time of day as I’m more insulin resistant in the morning.
 

NewTD2

Well-Known Member
Messages
1,563
Type of diabetes
Type 2 (in remission!)
Treatment type
Tablets (oral)
Hi. This profile after DKA is quite common on the forum. People start having low-carbs and possibly some Metformin (which has a very small effect) and their blood sugar comes down. The fact that you had DKA implies you may well be on the honeymoon journey and the bs may start to creep up again. The rule with Bolus and carb-counting is to find out your ratio and use that. Most people start at 1 unit of Bolus to 10gm of carbs, but do be guided by the nurse and it's often best to use a little bit less bolus until you find what your own ratio is and that way avoid a hypo. When I go to the gym I inject a bit less Bolus at the meal before and check just after the gym and before if needed. I keep glucose tablets with me in the gym and also wear an 'Insulin Dependent' wrist band in case I keel over. Interestingly I rarely have a problem in the gym but mowing the lawn can send my bs down fast so the type of exercise is important.


How long was your honeymoon period and how did you feel then and now?
 

NewTD2

Well-Known Member
Messages
1,563
Type of diabetes
Type 2 (in remission!)
Treatment type
Tablets (oral)
I eat small meals spread throughout the day and take 1/2 unit but they really are small, more like a snack. I do have to bolus for half my protein as if it were a carb as I am ultra low carb.

Everyone’s insulin usage is different so as @Daibell said, error on the side of caution until you know how you react to meals. I eat the same meals ( varied proteins) everyday so I know my bolus for each meal at each time of day as I’m more insulin resistant in the morning.

Thank you for this.

Can you please tell me your typical day’s meal including snacks from breakfast to dinner?
 

Kristin251

Expert
Messages
5,334
Type of diabetes
LADA
Treatment type
Insulin
Thank you for this.

Can you please tell me your typical day’s meal including snacks from breakfast to dinner?
Bf 8 am. Lettuce wrap with a thin slice of turkey / chicken hard boiled egg with mayo. 1/2 unit

9:30-10am. Make my lunch that I divide into 2 meals. 2 oz protein ( chicken, turkey, rare lamb, shrimp, tuna pr egg salad. Usually with mayo. 2 oz avocado and some chopped green onion, celery and radish. I have a big bite of it to make sure it tastes good lol. 1 unit as I need to stop the morning rise as I shower and start my activity.

12:30-1 half of my lunch 1/2 unit
3-3:30. Second half 1/2 unit

5:00. A cocktail, a slice of rare deli beef OR 1/2 egg (split with hubby)AND an ounce of melted Brie with pecans and green onion. No insulin

6:30. Dinner is 2 oz protein, most often tuna or fish. 1.5 oz avocado and a few asaparagus spears or a few brussel sprout halves and a few bites of hubbies salad. 1/2 unit.

In between I have one or two Macs, pecans or olives.

I am ultra low carb. I have a wide variety of protein that I eat in moderation following the .8-1 g per kg LEAN body mass, carbs always under 20 per day and mostly from avo, some green veggies and nuts. Then I eat just enough fat to satisfy. Mostly Mediterranean fats vs saturated fats.

I have a nasty stomach so I eat small and often. I also run out of my 1/2 units if insulin in about 2.5 hours so I need to inject or I’ll rise. If I don’t eat, I drop. So snacky meals work well for me.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
How long was your honeymoon period and how did you feel then and now?
Mine was surprisingly long which did confuse my GP. It was about 10 years starting at age 60. I did have max of all the tablets for the last few years before insulin when I should really have been on insulin earlier. I always felt well even when my sugars were in the high 20s except when I went hyper for a few days at the beginning. So I feel the same but know that my bs is under good control and the controller is me!
 

milesrf

Well-Known Member
Messages
102
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
spammers, off topic posters, side effects of a stroke
My DN said that I might be Type 1.5 (LADA).

The tests will be carried out in January.

I do not want to be shocked so I would like to learn from you how I can best prepare myself and cope with it.

Please advice, thanks.

Andrew

If you're interested in LADA, you may be interested in a site started by someone with LADA.

TuDiabetes
https://tudiabetes.org/

Offers advice on some of the less common types of diabetes, such as LADA.