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LADA treatment of

Discussion in 'Type 1.5/LADA Diabetes' started by Reba, Sep 29, 2017.

  1. Reba

    Reba LADA · Active Member

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    What are the endos in Europe using to treat LADA? Are they treating them as 2 or 1? What is suggested for treatment. I am on Lantus once a day. Try to watch my carbs.
     
  2. GrantGam

    GrantGam Type 1 · Well-Known Member

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    @Daibell is in the UK, and I believe a T1.5 or LADA.
     
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  3. DCUKMod

    DCUKMod · Moderator
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  4. DaftThoughts

    DaftThoughts LADA · Well-Known Member

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    Hey Reba! I'm in the Netherlands, yeah. :) My c-peptide test came back way low in 2014, but not low enough to warrant insulin immediately. My doctors decided to try to use diet and oral medication to treat it initially. Their goal was to keep me off insulin for as long as possible, thinking this was the better alternative.

    I started with metformin and tried to stick to as many whole carbs as possible. I was bumped up from 500mg twice a day to 1000mg twice a day, then up to 2500mg total a day. After about a year or so I was also put on gliclazide to help my pancreas' remaining beta cells produce more insulin.

    This didn't work out too well in the long run though, my A1C went up quite a bit and I had massive fluctuations - high spikes, low crashes, I couldn't regulate anything anymore. It was obvious my insulin production was going down. I was given Toujeo (basal insulin only) halfway through 2016 to help with this but it only took the edge off.

    When I raised concerns with my DSN, she talked to my endo and he said that I shouldn't go on insulin, but go on Victoza. I was upset because Victoza relies on the body's own ability to produce insulin to work, which I was sure I was lacking. Nobody thought it necessary to give me a new c-peptide test when making this call, but it was obvious to me that it wouldn't work. I fought for 6 months to have my endo agree to put me on insulin, and they only did so because Victoza wasn't regulated by the insurance companies for people who were on basal insulin so it wasn't accessible yet. I 100% insisted on going on insulin full time and he finally caved. (In hindsight, my endo was an intern, and I think Victoza was a topic he had been focusing on for a while which made him push it onto patients without taking their preferences into consideration.)

    I'm finally on insulin full time now as of January this year, and my A1C dropped below 7 and I'm doing really well. My final thoughts are:
    - I think the gliclazide helped kill my remaining beta cells faster. My condition accelerated significantly when I took them.
    - There is no set treatment for LADA yet, which causes discrepancies between doctors and patients. Always stand up for yourself! You know your body best. Most LADAs vouch for starting insulin early because it takes stress off the remaining beta-cells and preserves them longer, rather than stressing them out.
    - I know there are LADAs who have been getting on well with Victoza. It's a drug meant for T2 diabetics but for as long as you produce enough insulin, it can work. Just make sure to get a c-peptide test before committing. A doctor who tries to push it on you without one should be disregarded in my opinion.

    I hope this helps. :)
     
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  5. Reba

    Reba LADA · Active Member

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    Don't know how to reply with this program, but will try. Thanks for replying. I am on Lantus daily and have Novolog for extreme. Since I have not seen her often I am hoping we can work together, but need information from others or books to help with getting knowledge. My guess is it is so new that know one knows much about it. That is bad. You are a quinea pig. Please keep me informed on how you are doing. I gather you are a LADA.

     
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  6. Reba

    Reba LADA · Active Member

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  7. Reba

    Reba LADA · Active Member

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    Thanks for the information.
     
  8. DaftThoughts

    DaftThoughts LADA · Well-Known Member

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    Yeah, opinions are strongly divided. I am indeed LADA. Right now I'm on Toujeo (basal) and Novorapid (bolus, for with meals). My own insulin production has gone down dramatically, I can't go without injections anymore.

    I'm hesitant to say we should be treated as T1 or T2 because we shouldn't be treated as either. We're LADA, which means that the course of our diabetes is very different from other types (even if we do eventually become insulin dependent). We need to go with a combination of treatments based on our current situation, AKA based on your C-peptide results and whether or not you're showing insulin resistance.

    I think diabetes management is always personal. @Kristin251 is also LADA but her approach to managing her diabetes is almost the complete opposite of mine. We're all unique, there's no one treatment or diet that fits all. The only thing we can do is listen to how others are doing, and take elements of their treatment and work them into your own wherever it fits. Go with your gut instinct, if something isn't working out, discuss it and try other things. Being too rigid about 'how LADA should be treated' can actually prevent you from figuring out what works for you!
     
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  9. cz_dave

    cz_dave Type 1 · Well-Known Member

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    I am LADA and live in the Czech Republic. I have been treated as T1 immediately after I tested positive for the GAD test. Basicallly, my endo hurried to put me on insulin.
     
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  10. Kristin251

    Kristin251 LADA · Well-Known Member

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    Yes our treatments are probably very different. My problem is my stomach sucks almost more than D so limits me even further.
    I've also never responded well to meds or supps and insulin messes me up so lower doses work better. I feel EVERY fluctuation in bs and it stinks. Either tired or jittery. Never thought I'd be here but doing the best I can to feel normal.
     
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  11. Daibell

    Daibell Type 1.5 · Expert

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    Hi. LADA is T1 but defined by coming on later in life and sometimes more slowly. As it's T1 it's usually best treated with a Basal/Bolus insulin regime although in the 'honeymoon' period whilst the islet cells fail, a mixed or just Basal insulin may be adequate. I was left on tablets for too long and insulin should be started quite early on. I was and still am treated as 'T2' as T2 is a dumping ground for any diabetes the medics don't understand or can't be bothered to investigate. At least my current treatment is correct.
     
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  12. LucySW

    LucySW Type 1.5 · Well-Known Member

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    Hi All,

    I’m in Denmark. When C-peptide test showed positive was offered basal immediately. I tried basal plus Bernsteinian carb control and that worked for six months, but my waking BG kept rising so asked for bolus after six months and have never looked back. Going straight onto insulin plus low carb has kept me on low doses and extended my honeymoon. TDD three yrs after diagnosis is now 18 U (8-9 bolus, 9 basal) but it would have been much higher if I’d gone down the gliclazide etc route, which would have clobbered the beta cells.
     
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  13. Reba

    Reba LADA · Active Member

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  14. Reba

    Reba LADA · Active Member

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    Been very sick for a while and have not wanted to inject or eat. I have no energy. Today is about the best I have felt for several weeks at a time. Don't remember, but about 10 days ago. Hope you are doing well and have lots of energy.
     
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