LADA honeymoon period- advice needed

[cageyytigers]

I was diagnosed with LADA in Sept 2017 with and Hb1ac of 111. I take 4x500 metformin a day and have followed a very low carb diet. I also use a freestyle libre which has been fantastic. My January blood test has Hb1ac was 47 and I have a BMI of 25. Tomorrow I have my first appt at the hospital clinic with a consultant.

If they want to start me on insulin- should I agree- or try to keep going with my current regime, which has had a positive effect on bloods and weight. I have read conflicting articles about preserving pancreas function. I am also worried that I will have hypos as my blood sugars currently range between 3.5 and 7.5 all day.

Any advice/experiences from those who have been in my position would be very welcome.

 

[Fido78]

Hi @Cageytigers! If you are eating very low carb, you could also take on the same strategy that I am using. I am currently using 8-10(depends on your personal profile) units of Lantus once a day injected at bed time. I some time take maybe 1 or 2 units of novorapid If i decide to eat a meal a little higher in carbs. This regime will also give you more freedom, as you will always be able to do a correction when necessary! As I realize you are newly diagnosed you may not be mentally prepared to go on a basal bolus regimen but in time you will see this as an advantage

 

[cageyytigers]

Hi @Cageytigers! If you are eating very low carb, you could also take on the same strategy that I am using. I am currently using 8-10(depends on your personal profile) units of Lantus once a day injected at bed time. I some time take maybe 1 or 2 units of novorapid If i decide to eat a meal a little higher in carbs. This regime will also give you more freedom, as you will always be able to do a correction when necessary! As I realize you are newly diagnosed you may not be mentally prepared to go on a basal bolus regimen but in time you will see this as an advantage

Thank you for the kind advice. Have you been on basal bolus from the start?

 

[catapillar]

On what basis were you diagnosed LADA? Have you had a positive antibody test?

 

[cageyytigers]

On what basis were you diagnosed LADA? Have you had a positive antibody test?

Yes- "strongly positive" result for antibodies. Also had a rapid onset of symptoms. I have other autoimmune diseases also.

 

[Pmerrill]

Hi, if you’re not ever going over 7.5 then they might not suggest insulin yet although, they’ll probably suggest you try to eat some carbs for a “balanced” diet, as Fido78 said at least you might have more choice with insulin. The point will be to get the right dose for what your body needs at the moment.

You said that you’re ranging between 3.5 and 7.5, 3.5 is hypo, as I understand anything below 4 is hypo and needs correcting with some fast glucose. I would feel pretty shaky around 4. I would be wanting to get rid of those lows if I was you.

Good luck and going on to insulin isn’t so bad I started in September last year after nearly 3 yrs relying on honeymoon, diet and exercise.

All the best

Pete

 

[catapillar]

Well then you're definitely type 1 and you're definitely going to need insulin at some point. Starting on insulin while your beta cells are still working can extend the honeymoon period. And also give you more flexibility: type 1 isn't managed by low carb diet, it's managed by insulin.

 

[Fido78]

Thank you for the kind advice. Have you been on basal bolus from the start?

I was started on novomix, a mixed insulin. But this produced far to many hypos! I don´t like mixed insulins at all. I myself asked my doctor to prescribe me basal/bolus regimen whic he agreed to do.

 

[pauly979]

Thank you for the kind advice. Have you been on basal bolus from the start?

Hi, I'm also on the exact same amounts as above and have been great for 3 months. Diagnosed October 2017

 

[spage]

I’m the same my positive antibody test was 140. But since then only on 4x metformin and 2x gliclazide. As I understand I shouldn’t be on gliclazide as it kills the beta cells quicker. But doctors are being very hard work my number sit around 4. I’ve been told shouldn’t drive if they are under 5. But mostly under 5. Dietician said I’m probs on too much meds and needs to be lowered by still not seeing any diabetes people till next week currently sitting at 4.1 waiting see if it goes up with my biscuits x

 

[Ian DP]

I was diagnosed 4 years ago, last two years on insulin. Still in the honeymoon period. Take around 15 units novorapid per day. Last hba1c was 39. Been ketogenic (LCHF) for 4 years. On dx my dr told me to come off griclazide immediately and advised coming off metformin. I understand Gliclazide can give you hypos, metformin can’t. I went on insulin when my hba1c hit 40 and some of my bg readings were above 7

 

[cageyytigers]

A really frustrating appointment- had he actually read my notes.??... Started to tell me about three different types of insulin therapy. Looked somewhat surprised that I had a Hb1ac of 47 (down from 111 in Sept). He told me to start eating 100g of carbs per day so that my blood sugar will rise. I will then feel better and start taking insulin. Is it me? seems counter-intuitive.

 

[NewTD2]

A really frustrating appointment- had he actually read my notes.??... Started to tell me about three different types of insulin therapy. Looked somewhat surprised that I had a Hb1ac of 47 (down from 111 in Sept). He told me to start eating 100g of carbs per day so that my blood sugar will rise. I will then feel better and start taking insulin. Is it me? seems counter-intuitive.

You were advised to eat more carbs so that your sugar will rise?

Sounds like a very destructive, totally irresponsible and absolutely stupid advice to me mate!

 

[spage]

Yess I’ve read about the gliclazide spoken to a diabetes nurse and dietician and they said well stay on them blah blah blah I’m really fighting for a proper specialist but it’s such a long wait. Really bringing me down. Ps what is everyone classing as a honeymoon period. Diagnosed type 2 early dec17 then LADA 3 weeks ago with no info at all only what I researched

 

[Conrad74]

I too was told to eat more carbs. My doctor said I should be eating between 45 and 75 grams of carbs per meal, 3 times a day. I was diagnosed last July. They put me in 2x500 metformin two times a day, plus 28 units of levemir at bedtime and 2 units of novorapid per serving of carbs (per 15 grams). I didn’t follow the carb instructions as I would be eating way more carbs than I ever have. I try to keep it around 30 grams per meal and seem to be doing fine. I haven’t lost or gained any weight. I am not overweight. I think sometimes you just have to figure out what works best for you. If you are a healthy weight and start loosing weight, then perhaps you should eat more carbs, and if you gained weight, perhaps try eating less carbs. And all that while trying to maintain healthy blood sugar levels.

 

[Pmerrill]

Hi @spage, sounds frustrating for you, can’t understand why Drs are recommending gliclazide or metformin as treatment for Type 1 (which you are if you are LADA). When people refer to the honeymoon period, that’s when you’re pancreas is still producing some of your own insulin. Your body hasn’t killed off all of your beta cells (which produce insulin) yet. In time that will that will stop and the only way to get insulin is by injecting. As your ability to produce your own depletes so you may need to inject to bring it to a level your body needs. Or alternatively eat less carbs, there will come a point where you need to inject though. I was diagnosed in 2014 and am still in my honeymoon period, I started injecting in sept last year only very little though. Good luck with it all, sounds like the sooner you see a specialist the better.

 

[knowlestr]

I’m the same my positive antibody test was 140. But since then only on 4x metformin and 2x gliclazide. As I understand I shouldn’t be on gliclazide as it kills the beta cells quicker. But doctors are being very hard work my number sit around 4. I’ve been told shouldn’t drive if they are under 5. But mostly under 5. Dietician said I’m probs on too much meds and needs to be lowered by still not seeing any diabetes people till next week currently sitting at 4.1 waiting see if it goes up with my biscuits x

soon as I had the T1 LADA diagnosis I was taken off Gliclazide and put onto Sitagliptin, but still have the Metformin. All seems a little random to me