- Messages
- 397
- Type of diabetes
- LADA
- Treatment type
- Insulin
Hi everyone. 
I apologize up front for the huge post, I have a lot going on and I want to be as informative as possible!
Was diagnosed with LADA late 2014. Spent close to 1.5 years on oral meds (metformin + gliclazide) until my values were all over the place as of Jan 2016. I started basal in June and noticed a dramatic improvement in my values, but I still have some very weird ups, downs and miraculously leveled periods (which is probably no surprise in this type diabetes, yay honeymoon?).
Weight loss is also not happening. I'm 6'1", 122kg / 270lbs / 19 st. (Yes, I'm Dutch.)
I have a predisposition to being overweight genetically. My sister has the opposite problem and is chronically underweight while eating close to 3,000 calories a day through regular meals and snacks. No, she's not diabetic, she's been tested and had perfect values. I think we got unlucky and are on the opposite ends of a balanced metabolism, boo! Not too much we can do about that in particular, so we're doing our best to eat healthily and exercise plenty. My bicycle is my main mode of transportation, and I live in the deep South of the NL where everything is hills, hills and more hills, unlike the rest of my country. I wager I get about 4 hours a week of moderately intense exercise on average.
At this time I can't low carb safely because my own insulin production is too irregular and I experience hypos quickly. Gliclazide actually leveled it out for a while (1 year or so) before things got funky again. I aim for 40g carbs or less per meal at this time, although sometimes this changes depending on how my values are trending in the day. My doctor recommended that I take an extra dose of gliclazide during meals on days that I run high, and leave it out when I run low, but so far I've noticed no real difference. It has been suggested that I drop the oral meds and switch to bolus, but I'm also a little worried that I produce too much insulin of my own to make bolusing a safe alternative. How would I account for a sudden increase of my own insulin production when I inject? It's hard to gauge on which days I produce a lot and on which days I produce too little, and I know that eating to match my insulin values is not the best way to go. My values have never been better than they are now even though I occasionally spike after a meal or drop low. I feel like I'm stuck in an insulin limbo.
Some days it's like I'm eating just to keep up with all the insulin in my body. I biked for 1h 45mins last Monday, 800 cals worth of exercise for my height/weight, and I struggled staying above 6.0 throughout it all. I kept shoveling fruit biscuits down my gullet to stay on top. (Props to me, I didn't have a single hypo that day!) I know exercise requires more carbs to maintain levels but I feel like I have to eat as many carbs as I burn calories just to maintain a good level, which obviously hinders weight loss.
Is the gliclazide the cause? Could be, could not be. I was on gliclazide when my 12h+ fasting value went from 8.4 to 9.8 after 30 minutes of biking, so it's hard to tell how effective it really is. I'm on 10 units of Toujeo basal insulin, which is the perfect amount to wake up with fasting levels between 5-6.5 every morning now that I've been on it for a few weeks.. I fear reducing the dose would lead to high fasting values again.
So I feel stuck. I can't accurately tell if my moments of insulin overproduction are caused by the gliclazide, because I've had plenty of times when taking the pill did nothing to lower my bloodsugar before I started basal. I can't lower my basal because then my fasting values overnight and between meals will be too high - those are perfect right now, better than I could have ever dreamed of. I have days where I can eat half a pizza and come out with a 7.0 value on the other end and need to eat some chocolate before bed so I don't have a night time hypo, and there are days where a single slice of whole wheat bread with carb free cheese puts me at 11.0.
If I bolus on a high production day, I will get bad hypos. If I stick to oral meds, I'm off not much better than I am now with the same irregularities. I am frustrated but managing. It sure beats having constant hypers, and if I monitor properly I can avoid hypos. It does mean I am high carbing and won't lose weight.
I'm wondering if anyone has been (or is) in the same boat I am. I am more than willing to drop the gliclazide and request to be put on bolus if I know for sure that it won't cause more severe hypos than I already have. If I can bolus, I can reduce my carb intake and hopefully lose weight to be even healthier. I'm mostly scared that it will lead to me passing out while I bike (I can't detect hypos while I exercise, only when I'm idle) and I end up in a bad accident.
So any advice is really appreciated. My doctor is on vacation for the next 2.5 weeks after which I can consult with her again on the treatment options. I'd like to do that being a little more informed. Thank you for reading and have a wonderful day!
I apologize up front for the huge post, I have a lot going on and I want to be as informative as possible!Was diagnosed with LADA late 2014. Spent close to 1.5 years on oral meds (metformin + gliclazide) until my values were all over the place as of Jan 2016. I started basal in June and noticed a dramatic improvement in my values, but I still have some very weird ups, downs and miraculously leveled periods (which is probably no surprise in this type diabetes, yay honeymoon?).
Weight loss is also not happening. I'm 6'1", 122kg / 270lbs / 19 st. (Yes, I'm Dutch.
)I have a predisposition to being overweight genetically. My sister has the opposite problem and is chronically underweight while eating close to 3,000 calories a day through regular meals and snacks. No, she's not diabetic, she's been tested and had perfect values.
I think we got unlucky and are on the opposite ends of a balanced metabolism, boo! Not too much we can do about that in particular, so we're doing our best to eat healthily and exercise plenty. My bicycle is my main mode of transportation, and I live in the deep South of the NL where everything is hills, hills and more hills, unlike the rest of my country. I wager I get about 4 hours a week of moderately intense exercise on average.At this time I can't low carb safely because my own insulin production is too irregular and I experience hypos quickly. Gliclazide actually leveled it out for a while (1 year or so) before things got funky again. I aim for 40g carbs or less per meal at this time, although sometimes this changes depending on how my values are trending in the day. My doctor recommended that I take an extra dose of gliclazide during meals on days that I run high, and leave it out when I run low, but so far I've noticed no real difference. It has been suggested that I drop the oral meds and switch to bolus, but I'm also a little worried that I produce too much insulin of my own to make bolusing a safe alternative. How would I account for a sudden increase of my own insulin production when I inject? It's hard to gauge on which days I produce a lot and on which days I produce too little, and I know that eating to match my insulin values is not the best way to go. My values have never been better than they are now even though I occasionally spike after a meal or drop low. I feel like I'm stuck in an insulin limbo.
Some days it's like I'm eating just to keep up with all the insulin in my body. I biked for 1h 45mins last Monday, 800 cals worth of exercise for my height/weight, and I struggled staying above 6.0 throughout it all. I kept shoveling fruit biscuits down my gullet to stay on top. (Props to me, I didn't have a single hypo that day!) I know exercise requires more carbs to maintain levels but I feel like I have to eat as many carbs as I burn calories just to maintain a good level, which obviously hinders weight loss.
Is the gliclazide the cause? Could be, could not be. I was on gliclazide when my 12h+ fasting value went from 8.4 to 9.8 after 30 minutes of biking, so it's hard to tell how effective it really is. I'm on 10 units of Toujeo basal insulin, which is the perfect amount to wake up with fasting levels between 5-6.5 every morning now that I've been on it for a few weeks.. I fear reducing the dose would lead to high fasting values again.
So I feel stuck. I can't accurately tell if my moments of insulin overproduction are caused by the gliclazide, because I've had plenty of times when taking the pill did nothing to lower my bloodsugar before I started basal. I can't lower my basal because then my fasting values overnight and between meals will be too high - those are perfect right now, better than I could have ever dreamed of. I have days where I can eat half a pizza and come out with a 7.0 value on the other end and need to eat some chocolate before bed so I don't have a night time hypo, and there are days where a single slice of whole wheat bread with carb free cheese puts me at 11.0.
If I bolus on a high production day, I will get bad hypos. If I stick to oral meds, I'm off not much better than I am now with the same irregularities. I am frustrated but managing. It sure beats having constant hypers, and if I monitor properly I can avoid hypos. It does mean I am high carbing and won't lose weight.
I'm wondering if anyone has been (or is) in the same boat I am. I am more than willing to drop the gliclazide and request to be put on bolus if I know for sure that it won't cause more severe hypos than I already have. If I can bolus, I can reduce my carb intake and hopefully lose weight to be even healthier. I'm mostly scared that it will lead to me passing out while I bike (I can't detect hypos while I exercise, only when I'm idle) and I end up in a bad accident.
So any advice is really appreciated. My doctor is on vacation for the next 2.5 weeks after which I can consult with her again on the treatment options. I'd like to do that being a little more informed.
Thank you for reading and have a wonderful day!