Can I prove the Dr's wrong?

cz_dave

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Agree with Tim - if you take small doses, a half-unit can make at least a 1 mmol BG difference, and I think it's important if you're insulin sensitive.

So yes, @cz_dave, I use a Novopen Echo, which is the half-unit pen for Novo Nordisk insulins. Other insulins have their own pens. They come in blue and in red so I got one in each (for Novorapid and Insulatard). Really important for bolusing. Though, oddly, they're rarely used in Denmark.

The Echo ought to be available on prescription. I would really, really press for one. No one should take more insulin than they need, general principle but also too much insulin very nasty stuff.

L.

Also the Echo pens have this really useful memory feature on the bottom, so they record dose and approx time elapsed from your last dose.

Thanks, @tim2000s and @LucySW. I was not sure how to get hold of a 0.5 unit pen as I have only been using pre-filled pens and these are not available in half units for NovoRapid here. The Echo pen sure looks interesting.
 

cz_dave

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Hi folks, I have just posted a summary of my struggle with LADA diabetes over the past year. It was not all rosy. However, I got great satisfaction during my last visit at the diabetic ward. I wish you could have witnessed the scene. After my diabetic consultant downloaded the BG data from my CGM, he started staring at it, completely motionless for at least 5 minutes. The line with my BG values was so flat, he could not believe the data.

This was my way of proving him wrong: about the suitability of normal/high-carb diet for type ones, etc. However, I have to give him credit too: for putting me on basal/bolus regime (albeit with very small amounts) from the first day of my diagnosis.
 
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Nidge247

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I use a half-unit pen for Novorapid, and this was available on prescription so your surgery/doctor should be able to sort this for you. To folk who (like me) are insulin sensitive, a half unit of insulin can make a huge difference between managing and over-correction.
I was warned by the nurses on my DAFNE course, to always make sure any doctor wrote my ratio down correctly. I only use 1 unit of insulin for every 30g of carbs, but the medics would often write this down as a ration of 3 : 1 whereas I was told to display it as a ratio of 0.5 : 1.5 to make the half unit distinction to show how low a dose I need.
When I was coming off insulin (started out at 36 units a day on regular high carb diet), the pen gave me the confidence to make decisions of change where a full unit pen would have been too big a step.
Using the half unit pen gives me much more freedom, and keeps my figures tight.
 
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Ian DP

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Another update. Now 2 1/2 years since diagnosis and nearly 2 years following Dr Bernstein diet, T1 honeymoon period, without insulin. Just back from 3 weeks in Australia where my BG levels rose above 7.0, so started taking morning and evenin insulin doses, typically about 5 units per day. Back in the UK for a week now and my BG levels are back to normal, without insulin. Just one shot of 2 units a few days ago. Can only be the heat in OZ, typically around 27c. Did quite a bit of walking so don't think it was lack of exercise, and I kept to my Dr Bernstein diet! Taking insulin was no big deal, so not at all worried about taking it, just a bit surprised that my BG levels have dropped to the 4s and low 5s again.
 
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LucySW

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I'm v impressed that you're so unfazed Ian. How strange - well it prob was the heat - now you know. So glad you're back to normal levels again.

Well done in general, and for keeping such a cool head and for your self discipline.

So nice to hear from you.
 
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Ian DP

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Another update. I started this thread some 2 1/2 years ago, when my consultant said I was not a T2 but a T1 in the honeymoon period and that I would be on insulin within weeks. I proved him wrong for over 2 years, but he was right in the end as I am now taking small doses of insulin daily, normally 4 units before breakfast and 3 units before my evening meal. I started regularly taking insulin when my BG fasting levels went regularly above 6.0, which was a couple of months ago. I met my consultant again a couple of weeks ago. He complemented me on my long time without insulin and said if I carry on doing what I am doing (very low carb and high fat diet) I could remain in the honeymoon period for maybe many years. My hba1c was 5.8%, up 0.1% from November 2015. My cholesterol is good and my weight is holding up well. I think I probably could have extended my time without insulin further if I had carried on excecising a lot, I have cut back excercise this year, still excecising, but not excessively.

I have no plans to change my diet. My high fat (80%) very low carb diet that I have been on for over two years now works. I am still fitter, stronger, have more energy now than I had 10 years ago and feel healthier.

Taking insulin has proved to be no big deal.
 
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Fido78

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Another update. I started this thread some 2 1/2 years ago, when my consultant said I was not a T2 but a T1 in the honeymoon period and that I would be on insulin within weeks. I proved him wrong for over 2 years, but he was right in the end as I am now taking small doses of insulin daily, normally 4 units before breakfast and 3 units before my evening meal. I started regularly taking insulin when my BG fasting levels went regularly above 6.0, which was a couple of months ago. I met my consultant again a couple of weeks ago. He complemented me on my long time without insulin and said if I carry on doing what I am doing (very low carb and high fat diet) I could remain in the honeymoon period for maybe many years. My hba1c was 5.8%, up 0.1% from November 2015. My cholesterol is good and my weight is holding up well. I think I probably could have extended my time without insulin further if I had carried on excecising a lot, I have cut back excercise this year, still excecising, but not excessively.

I have no plans to change my diet. My high fat (80%) very low carb diet that I have been on for over two years now works. I am still fitter, stronger, have more energy now than I had 10 years ago and feel healthier.

Taking insulin has proved to be no big deal.
Yes Ian. Your thread inspired me to change instantly to LCHF and like you have had great results! Are you taking basal insulin or bolus? I am mostly just using 10 units Lantus and on occasions using Novorapid 1 unit.
 
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Ian DP

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Yes Ian. Your thread inspired me to change instantly to LCHF and like you have had great results! Are you taking basal insulin or bolus? I am mostly just using 10 units Lantus and on occasions using Novorapid 1 unit.
I only have novorapid, so that's all I take. I did ask my consultant for some long lasting insulin, but he said he felt I didn't need anything else yet as I was doing very well mostly keeping in the 5 to 6.5 range.
 

JTL

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I'm sure there's more.
I only have novorapid, so that's all I take. I did ask my consultant for some long lasting insulin, but he said he felt I didn't need anything else yet as I was doing very well mostly keeping in the 5 to 6.5 range.
If you're keeping your numbers under such good control why do you now need insulin?
 

LucySW

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Another update. I started this thread some 2 1/2 years ago, when my consultant said I was not a T2 but a T1 in the honeymoon period and that I would be on insulin within weeks. I proved him wrong for over 2 years, but he was right in the end as I am now taking small doses of insulin daily, normally 4 units before breakfast and 3 units before my evening meal. I started regularly taking insulin when my BG fasting levels went regularly above 6.0, which was a couple of months ago. I met my consultant again a couple of weeks ago. He complemented me on my long time without insulin and said if I carry on doing what I am doing (very low carb and high fat diet) I could remain in the honeymoon period for maybe many years. My hba1c was 5.8%, up 0.1% from November 2015. My cholesterol is good and my weight is holding up well. I think I probably could have extended my time without insulin further if I had carried on excecising a lot, I have cut back excercise this year, still excecising, but not excessively.

I have no plans to change my diet. My high fat (80%) very low carb diet that I have been on for over two years now works. I am still fitter, stronger, have more energy now than I had 10 years ago and feel healthier.

Taking insulin has proved to be no big deal.

Ah. Well, great to hear from you, Ian. And well slowed. Bravo. As you say, taking an insulin shot before meals is easy.

My TDD is slowly, slowly creeping up, bur I'm still honeymooning. My objective was to slow it as much as I could. I take 2x 4 units of basal now, and 1.5 to 2 u Novorapid before each meal, plus 2u when I wake up.

My fasting BG when I wake tho is slowly creeping up also. So I'm trying for the next three months to dose as necessary so as to get that down to 5.2 or so.

I feel very well too. We'll just do what we can.

Great to hear from you.

Lucy
 
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Ian DP

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If you're keeping your numbers under such good control why do you now need insulin?
It's because I am taking insulin that I can keep my numbers under control. If I didn't take insulin they would, I guess be not far off the double figure mark
 

Ian DP

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Ah. Well, great to hear from you, Ian. And well slowed. Bravo. As you say, taking an insulin shot before meals is easy.

My TDD is slowly, slowly creeping up, bur I'm still honeymooning. My objective was to slow it as much as I could. I take 2x 4 units of basal now, and 1.5 to 2 u Novorapid before each meal, plus 2u when I wake up.

My fasting BG when I wake tho is slowly creeping up also. So I'm trying for the next three months to dose as necessary so as to get that down to 5.2 or so.

I feel very well too. We'll just do what we can.

Great to hear from you.

Lucy
Sounds like you are doing very well Lucy. Still very low doses of insulin. Well done. It's my waking up levels that are my highest too. Last night they were 4.8 before bed and then 7.2 in the morning, probably because I was working outside yesterday in 33deg heat and got a little dehydrated. But they are always 1.5 to 2.0 higher than when I go to bed.
 
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LucySW

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Me too. They used to be 5.4-ish, but they're always in the 6's these days, sometimes 6.7-ish. That's too high for me to put up with.

We just keep on trucking, yes?

And thanks, as ever, for all your support. xxx

BTW, Do you take a little shot when you wake? I take 1.5 u on waking, then bolus 1u usually for breakfast. But once I let it get high, it stays high all day. That works well for me.
 
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Ian DP

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Me too. They used to be 5.4-ish, but they're always in the 6's these days, sometimes 6.7-ish. That's too high for me to put up with.

We just keep on trucking, yes?

And thanks, as ever, for all your support. xxx

BTW, Do you take a little shot when you wake? I take 1.5 u on waking, then bolus 1u usually for breakfast. But once I let it get high, it stays high all day. That works well for me.
I always now take insulin as soon as I awake, normally 4 units novorapid (but maybe more or less depending on my BG levels) I then eat some flacked almonds and cream and half an hour to an hour later have bacon and egg etc.
 

Fido78

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@Ian DP
You could try to ad Basal to your regime, starting out with small doses maybe 4 units before you go to bed then raise it until your morning values are in the desired range. I upped my Basal from 8 units to 10 when i was getting higher in the morning. Now I am mostly in the 4´s and low 5´s when waking up. I definetaly think basal could deal with your morning values..
 

LucySW

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The thing about basal is it takes the pressure off the quick-acting. I tried doing without it for two weeks, but I needed to whack up the QA.
 

LucySW

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@Ian DP
I definetaly think basal could deal with your morning values..

But perhaps a smaller dose. It's hard to get basal to deliver a low waking BG without dipping down too low at might. I take (now) 4u Insulatard at 8am and c. 6pm (it used to be 2 or 3 units). Then I use a QA correction dose immediately I wake to deal with the Dawn Phenomenon, and bolus a little bit extra to cope with breakfast.
 
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Ian DP

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@Ian DP
You could try to ad Basal to your regime, starting out with small doses maybe 4 units before you go to bed then raise it until your morning values are in the desired range. I upped my Basal from 8 units to 10 when i was getting higher in the morning. Now I am mostly in the 4´s and low 5´s when waking up. I definetaly think basal could deal with your morning values..
If I had some basal I would try, but my consultant advised against so I don't have any, just novorapid. I will ask again at my next appointment (6 months time).
 
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