LADAs preserving their beta cells

[LucySW]

Starting a new thread for clarity.

So today the consultant said, Yes, absolutely no proof abt what LADAs should do to preserve their beta cells, but also Yes, correct that I have nothing to lose by trying low doses of insulin to see if that helps beta cells.

So I am trying out teeny doses (4-6 units) of slow-acting basal insulin in the morning. (Though it might be more logical to do it at night.) And I'll see what it does to my numbers. This is Insulatard, ie NPH, the old-fashioned intermediate insulin that Bernstein doesn't like.

BTW the doc said total daily use of insulin (whether home-produced or injected) is about 0.7 units/kg per day. So my pancreas has been producing c. 52units/day - so 4 units is about 7%. Just to give a sense of perspective. That's small.

I've stopped the Metformin, on the grounds that it's supposed to be for insulin resistance and as a LADA I may not have that. Average waking BS this past week 6.3. Not much sign of increase though.

LADA, 55, BMI 23, moderately active. Diagnosed Type 1 in July 2014 after GAD antibody test. HbA1c down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.3.
Now on LCHF plus a bit of ex, plus one small daily dose of Insulatard (slow-acting basal insulin) every morning.

 

[Ian DP]

Hi Lucy
This sounds very good, very encouraging. From what my dsn said, 3 to 4 units sounds a lot (eg she said 1 unit would Lower my BS levels by 3 points). But a slow acting insulin, instead of fast sounds more appropriate. Please keep us up to date with how you get on with the insulin, and whether you are still LcHf (dr Bernstein diet).


Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 58. Requested a GAD test in November, came back very high 2,000+, doc said I would be T1 within weeks, but presently still LADA. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings as low as possible in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
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[LucySW]

Hi Ian,

Definitely sticking with LCHF into the hereafter! I'm trying to follow Bernstein's broad outlines, but slightly different carb makeup, eating more than his one cup salad or veg, because I just get too hungry. Last week, following his precept not to stuff oneself à la Chinese meal syndrome, I got so hungry that I snacked on nuts before supper three days running. Which is extra carbs. So going back to having enough greens to feel satisfied.

I honestly don't know what to expect with the 4u Insulatard. We'll have to see. I have Dextrosols. I know absolutely nothing about how the various types of insulin behave.
Let's see ...

Lucy


LADA, 55, BMI 23, moderately active. Diagnosed Type 1 in July 2014 after GAD antibody test. HbA1c down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.3.
Now on LCHF plus a bit of ex, plus one small daily dose of Insulatard (slow-acting basal insulin) every morning.

 

[Ian DP]

I will have to read his salad guidelines again. My understanding is one cup = 6g carbs, therefore 2 cups are ok since you can have 12g x 2 meals per day and 6g the other.


Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 58. Requested a GAD test in November, came back very high 2,000+, doc said I would be T1 within weeks, but presently still LADA. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings as low as possible in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
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[LucySW]

That's right, but I took fright at the bit where he says that eating till you really feel full expands the upper intestine and therefore rockets your BS regardless of limited carb content. The Chinese restaurant point. But that probably just needs to be tested, depending on the person.

But I am feeling rather hungry these days. I'll have to solve that. I've got addicted to macadamia nuts.

In general Dr B's method clearly makes excellent sense. A question of finding a practical but productive version of it.


LADA, 55, BMI 23, moderately active. Diagnosed Type 1 in July 2014 after GAD antibody test. HbA1c down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.3.
Now on LCHF plus a bit of ex, plus one small daily dose of Insulatard (slow-acting basal insulin) every morning.

 

[Daibell]

Sounds like you have a good consultant. Good idea to start some insulin with an initial low Basal dose. See how it goes

 

[LucySW]

Well, 4 units was too much. Mid-afternoon BS was 4.2, compared to 5.5 or so normally. End result, I had to eat an extra meal ( a large snack).

Trying again tomorrow with 2 units.

Lucy


LADA, 55, BMI 23, moderately active. Diagnosed Type 1 in July 2014 after GAD antibody test. HbA1c down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.3.
Now on LCHF plus a bit of ex, plus one small daily dose of Insulatard (slow-acting basal insulin) every morning.

 

[Ian DP]

Trying again tomorrow with 2 units

Sounds like a good plan.
And if you can keep your BG levels to dr Bernstein's 4.6 pre breakfast and 5.6 Max 2hr after eating you might, just might, even find your beta cells start to regrow a little, little evidence I know, but dr Bernstein has found it to occur in some patients.... So worth pursuing if you can.

I am managing to keep below 5.6 2 hr after eating but struggling to get down to 4.6 in the morning, unless I go for a 20min run at 9:00 at night, then I can. 20min hard exercise in the evening reduces my BG by 0.5 to 0.75. Even if my evening meal has zero carbs (buttered mushrooms) my BG levels still increase through the evening / night (unless I go for a run).... I can only assume It is down to protein eaten during the day.


Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 58. Requested a GAD test in November, came back very high 2,000+, doc said I would be T1 within weeks, but presently still LADA. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings as low as possible in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
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[kyrani99]

How is taking insulin going to help your beta cells?

 

[Ian DP]

Low Blood sugar levels are key to healthy beta cells (according to dr Bernstein these are 4.6 pre breakfast and 5.6 2hrs after eating). Insulin will be required to get to these levels if your beta cells have already taken a heavy hit. With patients having some healthy beta cells remaining dr Bernstein says he has seen some patients regrow some beta cells and therefore after time become less dependent on insulin (requiring less injected insulin as the body makes more of its own).

Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 59. Then diagnosed T1 / LADA in December. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings to dr Bernstein's recommended 4.6 pre breakfast and 5.6 2hr after eating in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
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[kyrani99]

There are a lot of research studies that say that beta cell function is preserved but I am not convinced. Partly you can't just compare the subjects given insulin with the controls because they may have very different conditions affecting them. And you can't run the experiment on the subjects again. So I am not really convinced by the science. Also I saw somewhere on the net where they were saying the opposite. I can't find it again quickly but I will have another look for it.

How to stop the immune system from attacking the beta cells is what is important,

 

[Ian DP]

There are a lot of research studies that say that beta cell function is preserved but I am not convinced.,

But if you are LADA your beta cells are definitely dying fast with above normal blood sugars, and you will, without doubt have none remaining fairly quickly. Keep your blood sugar levels at normal levels (dr Bernstein says 4.6 pre breakfast and 5.6 2hrs after meals) and you have a good chance of preserving your beta cells for a long time and a small chance of re growing some more beta cells. Anyone recently diagnosed as LADA has only one chance to try to preserve / grow beta cells..... So why wouldn't you..... For me it is a one off chance worth pursuing. What have I got to lose??????

Diagnosed LADA dec 2013, BMI 22. aged 58, no meds or insulin. Following dr Bernstein's solution.

 

[LucySW]

Totally.

 

[kyrani99]

But if you are LADA your beta cells are definitely dying fast with above normal blood sugars, and you will, without doubt have none remaining fairly quickly. Keep your blood sugar levels at normal levels (dr Bernstein says 4.6 pre breakfast and 5.6 2hrs after meals) and you have a good chance of preserving your beta cells for a long time and a small chance of re growing some more beta cells. Anyone recently diagnosed as LADA has only one chance to try to preserve / grow beta cells..... So why wouldn't you..... For me it is a one off chance worth pursuing. What have I got to lose??????

Diagnosed LADA dec 2013, BMI 22. aged 58, no meds or insulin. Following dr Bernstein's solution.

Of course you must do what you believe is good for you.
I would say two things to do as well as what you're doings.
1. be very careful the thoughts you uphold. When you uphold thoughts like "Beta cells dying fast" and worse still "definitely dying fast" and "without doubt have none remaining fairly quickly" you are making selections and really they become directives to the Universe.

Instead uphold positive ideas (and in your words What have you got to lose?????? ) Ideas such as "my beta cells now regenerate, rejuvenate and I regain full beta cell function. Remember there are Ghrelin cells in the pancreas. They are the progenitor cells of alpha and beta cells. All that the body needs to do is to assign some to being beta cells by epigenetic changes. The body is purpose driven. It is in your power to command the health of your body by the thoughts you consciously uphold.

2. Be on the look out for unusual hot feelings or even unusual "good feelings" because they could be unconscious fear reaction. It is normal to react like that if there is covert danger.

At the same time be on the look out for any concurrent ideas or thoughts. I found that the immune system will over-react if it is fooled into believing that something in your body is a danger to you and will react. I have seen a dozen or more cases where cancer developed or near developed and it happened in this way. I realized the danger was external, some enemy and my immune system ceased to react and the cancer immediately went into decline. I also used mental prescriptions with ideas directing my body and I got the remission I needed every time. Now I don't even develop the cancer at all. The immune system is almighty powerful and it will react when you think something in your body is in danger or a danger.
Kyrani.

 

[LucySW]

Keep your blood sugar levels at normal levels (dr Bernstein says 4.6 pre breakfast and 5.6 2hrs after meals) and you have a good chance of preserving your beta cells for a long time and a small chance of re growing some more beta cells.

Ian, how long did it take you to get down from 6s to 4s and 5s? It's taking me ages. I got to 6s about a month ago ( after about a month), and my fasting average AM is now 5.8, but it goes down SO slowly. I get a bit down about my numbers, after their brilliant start. But am I looking for progress too fast? I've only been at it two months.

Lucy

 

[LucySW]

But if you are LADA your beta cells are definitely dying fast with above normal blood sugars, and you will, without doubt have none remaining fairly quickly. Keep your blood sugar levels at normal levels (dr Bernstein says 4.6 pre breakfast and 5.6 2hrs after meals) and you have a good chance of preserving your beta cells for a long time and a small chance of re growing some more beta cells. Anyone recently diagnosed as LADA has only one chance to try to preserve / grow beta cells..... So why wouldn't you..... For me it is a one off chance worth pursuing. What have I got to lose??????

Diagnosed LADA dec 2013, BMI 22. aged 58, no meds or insulin. Following dr Bernstein's solution.

Ian, how long did it take you to get down from 6s to 4s and 5s? It's taking me ages. I got to 6s about a month ago ( after about a month), and my fasting average AM is now 5.8, but it goes down SO slowly. I get a bit down about my numbers, after their brilliant start. But am I looking for progress too fast? I've only been at it two months.

Lucy

 

[Ian DP]

Following dr Bernstein's solution, within days I was down to his 'normal' BG levels, but now, 6 weeks on, I am struggling to get below 5s pre breakfast

 

[Spiker]

@LucySW, Dr B would say to stay on the Metformin normally for a T1. He sees it as an insulin sensitiser, like exercise is, rather than as a therapy for insulin resistance (which to be fair is how it is typically used).

However in your case when your total daily dose is down around 2u, I can see the point of avoiding Metformin.

 

[Spiker]

@Ian DP and @LucySW, I strongly encourage you to preserve beta cell function. Residual beta cell function provides the fine tuning that makes T1 (including LADA) so much easier to manage. With residual beta cell function, if get your blood glucose in the ball park with carb counting and injected insulin, your beta cells can fill in the decimal points, and compensate for the occasional error.

 

[LucySW]

Progress report on my endeavours to get my blood sugars down to the safe Bernstein levels. Pretty mixed. Since I stopped the Metformin one month ago, my numbers have been more erratic.

I had intended to get strict control over carb and protein amounts first, then try 1 or 2 units basal insulin. But I had a big problem with hunger in the afternoon. A snack mid-afternoon didn't leave enough carb allowance for supper and I went up to 35g rather than 30g. Whatever the reason, the result was my evening BS was too high (7s, sometimes even an 8 aargh) and I felt that was feeding into a higher fasting BS in the morning.

So I started taking the basal NPH (that's what I have) at night, in the hope that it would bring my morning fasting level down. Which it does. I started on 1 and 2 units, but now take 3u every night, sometimes 4. This seems to have no ill-effects and gets my fasting level down to 5.7 or so in the morning. (NPH has a hill-shaped profile where it's high between 5 and 9 hrs, then tapers down and is gone by 18 hrs. Not awfully useful for daytime, but jolly useful for dealing with Dawn Phenomenon.)

So I start the day well with 5.6/5.8 fasting, Then I have good control for breakfast and lunch - always back down to 6.2, 6.3 after two hours- and it keeps going down before supper to high 5s, unless I start snacking, which wrecks everything and pushes my evening BS up to 7s.

Which is why things like the bullet-proof coffee are good. I had two yesterday, and the result was, **I wasn't hungry before supper !!!!** I can't tell you how important that is: it stops everything going wrong.

So I'm now going to keep rigidly to the 30g carb limit, bust myself not to snack, try to bump up my fat levels (tho I'm still afraid about this - I don't want to put on any weight), keep protein to ABOUT 80g/ day, and carry on taking 3-4u basal at night. What I want to achieve is to get those **** blood sugars down to c 4.6 before and 5.x after meals. Rather than be careful and ordered, I'll just do anything that works.

So that's my progress to date.

Lucy
55, LADA diagnosed two and a half months ago.