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Type 1.5/LADA Diabetes
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<blockquote data-quote="LucySW" data-source="post: 912678" data-attributes="member: 113749"><p>Hi Cova, </p><p></p><p>Don't be too fazed by the semantics. If you have a positive GAD result, it means you have auto-immune diabetes. That means, some of your immune system cells have been attacking your own body's insulin-producing cells (the beta-cells). That means diabetes Type 1 or Type 1.5 (which is a subset of Type 1 that comes on slowly with adults). </p><p></p><p>(Whereas Type 2 is the result of insulin resistance and thus too much insulin .) </p><p></p><p>Either way, Type 1 or Type 1.5, that means your body can't manufacture enough insulin for your metabolism to function properly. So you'll need to inject it.</p><p></p><p>That 's not awful. </p><p></p><p>Edit: adding this part repeat from an earlier post because it says all I have to add: </p><p></p><p>Here is my advice on what to do next, based on my own experience (you have to judge how well that fits you). I think it's better to start with insulin now rather than pussyfoot around with other drugs, because only insulin will arrest/reverse the decline and ensure that you can keep your daily insulin dose low into the long term, perhaps even permanently. That’s important, because insulin should be kept as low as possible, for two reasons: 1) you will preserve your residual basal insulin capacity and this means you will have enviably stable BG levels and will avoid the horrible lows that full T1s undergo; 2) low levels of insulin (i.e. insulin sensitivity) is associated with longer life expectancy. No other drugs can prevent diabetes progressing and keep insulin needs low, except possibly metformin, which can be taken alongside insulin for Type 1s and is an incredibly benign drug with other protective effects, if your stomach can tolerate it. I would agitate strongly to avoid any other kind of drug like sitagliptin etc: they may stimulate the pancreas, but will also burn it out quicker.</p><p></p><p>Your consultant may suggest one of these three alternatives.</p><p></p><p>1) Basal insulin only. I tried this; for me it was a waste of time, because the issue with me was post-meal spikes. I was incredibly good, ate less and less, exercised more and got more and more miserable, and my BG levels just continued to rise slowly. Once I took bolus, end of problem. My fasting levels went right down again.</p><p></p><p>2) Mixed insulin, on the grounds that you are new to all this and you need something simple. Here you are given a 70:30 mix of basal and bolus insulin, and you have to take it twice a day and match your meals to it. You may like this; I wouldn’t. It’s rigid, and you will have to eat to your insulin.</p><p></p><p>3) Full basal/bolus (or MDI, multiple daily injections). This is what I would recommend. Contrary to what you might think, it’s not difficult. Usually you have two basal injections (night and morning), or sometimes one only. Then you inject bolus 30 mins before each meal. You have to carb count for this. No problem – we are adults and this can be quickly learnt. I use the <em>Carbs & Cals </em>app, and you’ll need to weigh stuff for the first few weeks. Then you’ll know it.</p><p></p><p>4) They may suggest tablets which stimulate Insulin production in the pancreas. These will work for a time but will hasten your descent into full diabetes, with a high TDD and attendant risk of hypos. Personally, I think these drugs should be avoided at all cost. </p><p></p><p>I would also recommend getting the Abbott Freestyle Libre, a continuous blood glucose monitor system that you stick on your arm. The point here is that it tells you what is actually going on in real time, so you can adjust (food, timings, insulin doses). It costs about £130 for the reader and the first two sensors, thereafter £50 for a two-week sensor. But it will teach you more than anything, and you don’t need to run one all the time. I run one every month or so. </p><p></p><p>So there you are, for what it's worth. I would also read up all the posts on the 1.5 forum. </p><p></p><p>Good luck!</p><p></p><p>Lucy</p></blockquote><p></p>
[QUOTE="LucySW, post: 912678, member: 113749"] Hi Cova, Don't be too fazed by the semantics. If you have a positive GAD result, it means you have auto-immune diabetes. That means, some of your immune system cells have been attacking your own body's insulin-producing cells (the beta-cells). That means diabetes Type 1 or Type 1.5 (which is a subset of Type 1 that comes on slowly with adults). (Whereas Type 2 is the result of insulin resistance and thus too much insulin .) Either way, Type 1 or Type 1.5, that means your body can't manufacture enough insulin for your metabolism to function properly. So you'll need to inject it. That 's not awful. Edit: adding this part repeat from an earlier post because it says all I have to add: Here is my advice on what to do next, based on my own experience (you have to judge how well that fits you). I think it's better to start with insulin now rather than pussyfoot around with other drugs, because only insulin will arrest/reverse the decline and ensure that you can keep your daily insulin dose low into the long term, perhaps even permanently. That’s important, because insulin should be kept as low as possible, for two reasons: 1) you will preserve your residual basal insulin capacity and this means you will have enviably stable BG levels and will avoid the horrible lows that full T1s undergo; 2) low levels of insulin (i.e. insulin sensitivity) is associated with longer life expectancy. No other drugs can prevent diabetes progressing and keep insulin needs low, except possibly metformin, which can be taken alongside insulin for Type 1s and is an incredibly benign drug with other protective effects, if your stomach can tolerate it. I would agitate strongly to avoid any other kind of drug like sitagliptin etc: they may stimulate the pancreas, but will also burn it out quicker. Your consultant may suggest one of these three alternatives. 1) Basal insulin only. I tried this; for me it was a waste of time, because the issue with me was post-meal spikes. I was incredibly good, ate less and less, exercised more and got more and more miserable, and my BG levels just continued to rise slowly. Once I took bolus, end of problem. My fasting levels went right down again. 2) Mixed insulin, on the grounds that you are new to all this and you need something simple. Here you are given a 70:30 mix of basal and bolus insulin, and you have to take it twice a day and match your meals to it. You may like this; I wouldn’t. It’s rigid, and you will have to eat to your insulin. 3) Full basal/bolus (or MDI, multiple daily injections). This is what I would recommend. Contrary to what you might think, it’s not difficult. Usually you have two basal injections (night and morning), or sometimes one only. Then you inject bolus 30 mins before each meal. You have to carb count for this. No problem – we are adults and this can be quickly learnt. I use the [I]Carbs & Cals [/I]app, and you’ll need to weigh stuff for the first few weeks. Then you’ll know it. 4) They may suggest tablets which stimulate Insulin production in the pancreas. These will work for a time but will hasten your descent into full diabetes, with a high TDD and attendant risk of hypos. Personally, I think these drugs should be avoided at all cost. I would also recommend getting the Abbott Freestyle Libre, a continuous blood glucose monitor system that you stick on your arm. The point here is that it tells you what is actually going on in real time, so you can adjust (food, timings, insulin doses). It costs about £130 for the reader and the first two sensors, thereafter £50 for a two-week sensor. But it will teach you more than anything, and you don’t need to run one all the time. I run one every month or so. So there you are, for what it's worth. I would also read up all the posts on the 1.5 forum. Good luck! Lucy [/QUOTE]
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