Spikes

ade2020

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14
Type of diabetes
Type 2
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Hello

Well my GAD test came back as normal so Diabetic Nurse & Dr said they are considering me as not type 1.

Initially when diagnosed with diabetes they gave me background Levemir 9mg and Apidra 6mg before food.

I was diagnosed on 24th January 2020 and immediately put myself on a low carb diet and the past week my bs levels have been below 8 with spikes after food worst of which up to 13. And I have been experimenting with my insulin doses with the ok from diabetic nurse. However past 3 days I have not taken any insulin with my levels coming back down on their own without insulin. Is this dangerous or safe and good progress. I will call my diabetic nurse to ask but thought I would ask what others experiences are.
 

Mike d

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I'd ask for clearance before, but good news thus far :)
 

urbanracer

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Hello

Well my GAD test came back as normal so Diabetic Nurse & Dr said they are considering me as not type 1.

Initially when diagnosed with diabetes they gave me background Levemir 9mg and Apidra 6mg before food.

I was diagnosed on 24th January 2020 and immediately put myself on a low carb diet and the past week my bs levels have been below 8 with spikes after food worst of which up to 13. And I have been experimenting with my insulin doses with the ok from diabetic nurse. However past 3 days I have not taken any insulin with my levels coming back down on their own without insulin. Is this dangerous or safe and good progress. I will call my diabetic nurse to ask but thought I would ask what others experiences are.

Some non-diabetics can test positive for GAD Some T1's don't test positive, it isn't conclusive.

I guess you are familiar with the honeymoon phase. The theory suggests that when you start taking insulin it gives your pancreas a rest and it can start to produce a little of it's own insulin again.

You may be experiencing something similar if you have gone low carb as this will take the pressure off your system to make a lot of insulin.

To be regularly spiking (by more than 2mmol) after eating is thought to be bad for health and eyesight especially but significant hard data is difficult to find.

I was 54 when I got my T1 diagnosis, so a similar age to yourself. In later life T1 may develop more slowly than it would in the child and teenage years.
 

ert

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Personally, I'd be off insulin in a flash if I could get my numbers down without it.
In terms of diagnosis, the c-peptide test would be more helpful for your blood sugar management and diagnosis. If you have less than 0.2 nmol/l c-peptide and high fasting blood sugars then they would also consider that you have type 1. It would also confirm whether you really need insulin at present.
 

EllieM

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Well my GAD test came back as normal so Diabetic Nurse & Dr said they are considering me as not type 1.

I'm having real trouble with a newly diagnosed T2 needing insulin (other than for a very short period). Have they done a c-peptide test? My understanding us that T1s can show up negative on GAD tests... (willing to be corrected by others on this).
 

ert

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I'm having real trouble with a newly diagnosed T2 needing insulin (other than for a very short period). Have they done a c-peptide test? My understanding us that T1s can show up negative on GAD tests... (willing to be corrected by others on this).
You need an autoimmune response to be type 1. The issue with antibodies is that they only hang around for 6 months after an autoimmune response. If you don't have the antibody test straight away then you could be falsely antibody negative. Also, currently are 4 types of antibodies they can test for which are markers of beta cell autoimmunity in type 1 diabetes, with GAD only one of them: Islet Cell Antibodies (ICA, against cytoplasmic proteins in the beta cell), antibodies to Glutamic Acid Decarboxylase (GAD-65), Insulin Autoantibodies (IAA), and IA-2A, to protein tyrosine phosphatase. There could be more yet to be discovered.
 
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urbanracer

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Not being able to eat as many chocolate digestives as I used to.
You need an autoimmune response to be type 1. The issue with antibodies is that they only hang around for 6 months after an autoimmune response. If you don't have the antibody test straight away then you could be falsely antibody negative. Also, currently are 4 types of antibodies they can test for which are markers of beta cell autoimmunity in type 1 diabetes, with GAD only one of them: Islet Cell Antibodies (ICA, against cytoplasmic proteins in the beta cell), antibodies to Glutamic Acid Decarboxylase (GAD-65), Insulin Autoantibodies (IAA), and IA-2A, to protein tyrosine phosphatase. There could be more yet to be discovered.

I'm sorry @ert but I can only agree with the 6 month time frame as a generalisation. I didn't get a GAD test until a year after initial T1 diagnosis ( due to a dismissive endo') but I still tested "strongly positive" when it was eventually done.
 

Jaylee

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Retired Moderator
Messages
18,215
Type of diabetes
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Hello

Well my GAD test came back as normal so Diabetic Nurse & Dr said they are considering me as not type 1.

Initially when diagnosed with diabetes they gave me background Levemir 9mg and Apidra 6mg before food.

I was diagnosed on 24th January 2020 and immediately put myself on a low carb diet and the past week my bs levels have been below 8 with spikes after food worst of which up to 13. And I have been experimenting with my insulin doses with the ok from diabetic nurse. However past 3 days I have not taken any insulin with my levels coming back down on their own without insulin. Is this dangerous or safe and good progress. I will call my diabetic nurse to ask but thought I would ask what others experiences are.

Hi,

Your isulin dosage is what it is & the trick is stable BGs without hypos.
Adjusting the dose to the diet is key. But constant monitoring is also required.

We can't tell you to stop your meds, or diagnose what type.

What I can say is too much exogenous insulin can be dangerous. (It goes with the territory miscalculating a bolus or the timing of, sometimes.) So if your personal dosage ajustments are working right now.? Sounds like your getting a handle on it. & long may it continue.

Are you using a flash monitor? This could help you find out what's happening to BGs between the meter testing?

Do liaise with your DSN.
 

ade2020

Member
Messages
14
Type of diabetes
Type 2
Treatment type
Insulin
Hi,

Your isulin dosage is what it is & the trick is stable BGs without hypos.
Adjusting the dose to the diet is key. But constant monitoring is also required.

We can't tell you to stop your meds, or diagnose what type.

What I can say is too much exogenous insulin can be dangerous. (It goes with the territory miscalculating a bolus or the timing of, sometimes.) So if your personal dosage ajustments are working right now.? Sounds like your getting a handle on it. & long may it continue.

Are you using a flash monitor? This could help you find out what's happening to BGs between the meter testing?

Do liaise with your DSN.

I have an appointment with DN 5th March last conversation a week ago with news on GAD test and discussed experimenting with insulin doses.

I am testing myself up to 8 times a day and have sourced a Libre that I have not put on as yet. I am being very careful about my carb intake and have suprised myself on how strict I am being with my diet.

I'm uncertain if keeping BS below 8 is safe without my insulin even with spikes going more than 2 over but as I said coming down again. Or should I take the background one at least? These questions I will be putting to my DN but I am trying to gauge others experiences and what they keep levels between without insulin.

The consultation and DN at the hospital originally said I will need either tablets or insulin pens? But this was before GAD result.

I expect lots of ND convince themselves they can beat Type 2 and go into remission but so much conflicting opinions, theories and individual stories cropping up, I am tending to over analyse things.

Thanks for your reply.
 

Jaylee

Oracle
Retired Moderator
Messages
18,215
Type of diabetes
Type 1
Treatment type
Insulin
I have an appointment with DN 5th March last conversation a week ago with news on GAD test and discussed experimenting with insulin doses.

I am testing myself up to 8 times a day and have sourced a Libre that I have not put on as yet. I am being very careful about my carb intake and have suprised myself on how strict I am being with my diet.

I'm uncertain if keeping BS below 8 is safe without my insulin even with spikes going more than 2 over but as I said coming down again. Or should I take the background one at least? These questions I will be putting to my DN but I am trying to gauge others experiences and what they keep levels between without insulin.

The consultation and DN at the hospital originally said I will need either tablets or insulin pens? But this was before GAD result.

I expect lots of ND convince themselves they can beat Type 2 and go into remission but so much conflicting opinions, theories and individual stories cropping up, I am tending to over analyse things.

Thanks for your reply.

Hi,

Well they do say take it slow & steady when stabilising BGs. :)

It's great you have a Libre. They can help.
To draw an analogy; Think of your A1c as an "average speed check" on the journey. The meter, more like a speed camera? All useful tools at our disposal.

Now the Libre. Is kind of like a "Dash cam." Theres a lot more tell tale info collated.. ;)

By all means ask regarding Libre use if unsure? It is possible to send/share any data from the readings to your HCPs online.
(A little like a "Dropbox" account?)
Always back up any errant readings with your meter.
 

ert

Well-Known Member
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fasting
I'm sorry @ert but I can only agree with the 6 month time frame as a generalisation. I didn't get a GAD test until a year after initial T1 diagnosis ( due to a dismissive endo') but I still tested "strongly positive" when it was eventually done.
The six-month life span of antibodies is a generalisation for a single autoimmune response. Like other autoimmune conditions, like MS, type 1's can have continuous autoimmune responses or single attacks. I had two major responses, one when I was first diagnosed which left me with a very low-peptide and the second when I deteriorated onto insulin 2 years later, the attack which overnight left me without producing any insulin ever trace. I had no presence of GAD antibodies in-between attacks but were certainly present afterwards.