Can I prove the Dr's wrong?

[IZ THE LEG END]

Wow this is interesting, Is this in the dr Bernstein solution book?

 

[Clivethedrive]

Wow this is interesting, Is this in the dr Bernstein solution book?

Hi! Iz, yes it is and dr bernsteins book is the authority on lchf, works for me , since oct 14, been following it and have lost 58lbs bs's down to 4.0 mmols from 26.8 mmols, and bp down to av' of 110/65 from 170/100
That and the great advice and support on this forum, all the best in your efforts to " normalise" , clive

 

[IZ THE LEG END]

Hi! Iz, yes it is and dr bernsteins book is the authority on lchf, works for me , since oct 14, been following it and have lost 58lbs bs's down to 4.0 mmols from 26.8 mmols, and bp down to av' of 110/65 from 170/100
That and the great advice and support on this forum, all the best in your efforts to " normalise" , clive

Thanks Clive, I bought it this morning I think this is the book @LucySW was mentioning before if so it comes with some great reviews I read the start this morning! Thanks again

Izzy

 

[Bill1963]

well done Ian on your latest hba1c of 5.7.I know its gone up a little but that might also be due to the time of year. Mine went up to 5.3 from 4.9 due to having a couple of colds. Have been able to get it back down to 4.9 again at my last check up. Still only on basel although this is due to the amount of exercise I do during the day.Once again well done mate keep up the good work.

 

[LucySW]

Hi Ian,

Yes, it might be colds/bit less exercise. It's still very healthy. You're this forum's poster success!

You know though, even if you do ever end up on the MDI route, you'll be on teeny doses. And safe from hypo worries. And that in itself is so, so worth having.

Very Happy New Year, by the way ! All the best,

Lucy

 

[smidge]

Well done Ian! I love to see that low-carbing is still working for you. Of course, even the great Dr Bernstein might not be able to keep the relentless LADA at bay for ever. Unfortunately no matter how careful we are, there are times like illnesses when our BG goes high enough to cause some further deterioration, but keeping the numbers low for as much of the time as possible has to be the way to go. My condition has progressed quite a bit now, but I'm still on about 50g carb per day and my HbA1c is still in the 5s and although I control it with insulin, I'm sure I have a much easier time than those with no beta cell function. 6 years in and I still use only 9 units basal and about the same bolus per day. My aim is still to keep enough beta cells alive until the researchers successfully manage to regrow them effectively - my dream is still to have enough available to be in with a shot of having the condition reversed one day!

Smidge

 

[LucySW]

Great to see you Smidge! And great news that things are stable and in good nick. Long may it continue, and I'm sure it will.

I'm trucking away too. My bolus needs are very slowly climbing a little, but not very much. I'm low carbing on 30-40 grams a day (I always will) and on 6 units basal and 6 or 7 bolus a day, SD about 1.1.

I intermittently fast quite a lot, and I exercise more and more to try and keep that TDD down.

But low carb/exercise has succeeded, generally, for me in delaying things deteriorating. Every so often, as at Christmas, I take a risk, which I shouldn't really. Things seem to come back afterwards .. This seems to be a good way to live though.

Lucy

 

[Fido78]

Hi Ian, maybe it´s time to start experimenting with insulin? I mostly still do 1 shot a day of 8 units lantus. If I eat big meals I tend to bolus with 1 unit of novorapid. I´m under the impression that you are very dedicated to your diabetes and you are obviously still producing quit a bit of your own insulin when you are managing that good numbers without insulin. I think you would get perfect numbers with a tiny amount of background insulin(even though most people would think 5.7% is perfect control )

 

[Ian DP]

Hi Ian, maybe it´s time to start experimenting with insulin? I mostly still do 1 shot a day of 8 units lantus. If I eat big meals I tend to bolus with 1 unit of novorapid. I´m under the impression that you are very dedicated to your diabetes and you are obviously still producing quit a bit of your own insulin when you are managing that good numbers without insulin. I think you would get perfect numbers with a tiny amount of background insulin(even though most people would think 5.7% is perfect control )

I have thought about doing some experimenting with small doses of insulin. I do have a half unit novorapid pen. But not sure when would be best to start.... My thinking would be shortly before my evening meal..... But I do often get mid 4s (this morning pre breakfast was 4.5), and I know from the very few times I have tested at around 3am I am always much lower then..... And then I think I would then need to test before driving, and I know I am often below 5 now, without insulin!!!!!

 

[Fido78]

those sound like very low numbers. Then maybe you should wait until your next HAB1c to see if you go lower again. As your current HBA1c is 5.7 which correlates to an average of acual bloodsugar of 6.5 mmol/L. have you noticed your post prandials getting higher than usal the last three months? might be those that are bringing your average up.

 

[LucySW]

I have thought about doing some experimenting with small doses of insulin. I do have a half unit novorapid pen. But not sure when would be best to start.... My thinking would be shortly before my evening meal..... But I do often get mid 4s (this morning pre breakfast was 4.5), and I know from the very few times I have tested at around 3am I am always much lower then..... And then I think I would then need to test before driving, and I know I am often below 5 now, without insulin!!!!!

Ian,

Night-time basal wouldn't make sense for you. If basal made sense at all, it would be as a tiny daytime dose, which would contribute to dealing with your handling meals.

But as you say, then you'd have to take account of insulin as a driver, which would be a complete pain. The rules aren't made to fit what suits diabetics. I'd stay well clear of that if I were you, unless and until you need to. I don't know if the poster has read your full history.

Actually, I suppose you could still argue with a tiny basal dose that you weren't insulin-dependent. I don't know if that would be enough to cover you legally, though.

 

[Fido78]

My comment was purely based on how to get optimal HBA1c and not regarding issues with driverslicense and other nuisances that follow insulin treatments. As to @Lucy´s comment about you not needing basal insulin does definetely have some valid arguments to that, as you are currently producing basal insulin your self and it would maybe seem more logical to just use tiny amounts of bolus to take the spikes post prandial. I do respect that point of view., as my doctor also has that perspective. I have observed what dr Troy stapleton has been dooing and he also is currently on 1 injection a day of 8 units of Lantus, and his HBA1c are mostly fluctuating in a narrow range from 5% to 5.4% 3 years in as a Lada diabetic. I my self am only 1 year in my journey and I also seem settled in with those numbers for now. I don´t think there is a way "one size fits all" in diabetic management" but I do think we can all learn of each other sharing our stories how we manage our diabetes and trying to motivate each other this way. I´m not trying to be knowingly instructive rather just saying 'here is my 2 cents'

 

[LucySW]

I don´t think there is a way "one size fits all" in diabetic management" but I do think we can all learn of each other sharing our stories how we manage our diabetes and trying to motivate each other this way

Totally agree, @Fido78. So much better together!

Lucy

 

[LucySW]

Actually Ian, when and if you do start insulin, it will make much more sense to use teeny bolus doses, rather than basal. It's that Phase 1 bolus response we lose first.

 

[cz_dave]

@LucySW, I am under the impression that you use a half unit NovoRapid pen. My doctor seems to be sceptical about half units. I suppose he would argue that the difference between taking a 1.5 and 2 units is negligible.

Your opinion?

 

[Ian DP]

Is there a bolus I can use in my novorapid pen. What do I need to ask for?

 

[tim2000s]

@LucySW, I am under the impression that you use a half unit NovoRapid pen. My doctor seems to be sceptical about half units. I suppose he would argue that the difference between taking a 1.5 and 2 units is negligible.

Your opinion?

Your doctor needs a kick. there is a huge (percentage wise) difference between 1.5u and 2u, and surprising as it may seem to clinicians who aren't on insulin, less than 0.5u can and does make a difference.

 

[LucySW]

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.

 

[LucySW]

Is there a bolus I can use in my novorapid pen. What do I need to ask for?

You want the Novorapid Penfill cartridges for your Echo, Ian. I thought you had those already. They come in packs of five. Just keep them in the fridge between 3/4 and 8 degrees. I keep mine in a Lock&Lock box with a thermometer inside.

Long may you not need them though.

 

[Ian DP]

Thanks Lucy. I do indeed have a pack of 5 penfil cartridges in the fridge.