Just wondering what people eat as T1.5s…

[ShelleyDubs]

I was diagnosed as LADA (1.5) two years ago after 4 years of misdiagnosed T2. I went Keto and still tend to stick to low carb and like to make lots of LC puddings to ease the restrictions. Hello LC rhubarb crumble! Just lately I’ve been introducing more carbs (potatoes) and upping my insulin - sometimes successfully, sometimes giving myself a 3am hypo! How often do you eat carby foods and how well does it work for you? Does anyone eat bread without spiking? Or pasta? Or rice? Any and all stories appreciated. I know we all react differently, but interested in others’ experiences with food. Thanks.

 

[In Response]

I eat the same healthy diet as i did before diagnosis.
I eat bread, pasta, rice, cakes, ... as well as lots of fresh vegetables.
I am not afraid of "spiking" as long as my levels remain in single figures and return to lower levels within about an hour. If you look for Libre graphs of people without diabetes, you will see this is normal.
I often need a split bolus, especially for high carb, high fat meals such as pizza and curry
This is easier now I have an insulin pump

You mentioned 3sm hypos. Are these real hypos tested with a finger prick or compression lows reported by your Libre when you lie on it?

 

[Jaylee]

I was diagnosed as LADA (1.5) two years ago after 4 years of misdiagnosed T2. I went Keto and still tend to stick to low carb and like to make lots of LC puddings to ease the restrictions. Hello LC rhubarb crumble! Just lately I’ve been introducing more carbs (potatoes) and upping my insulin - sometimes successfully, sometimes giving myself a 3am hypo! How often do you eat carby foods and how well does it work for you? Does anyone eat bread without spiking? Or pasta? Or rice? Any and all stories appreciated. I know we all react differently, but interested in others’ experiences with food. Thanks.

Hi,

What insulin/s are you prescribed. A year or so back, you mentioned you were just using a basal?

 

[ert]

I was diagnosed as LADA (1.5) two years ago after 4 years of misdiagnosed T2. I went Keto and still tend to stick to low carb and like to make lots of LC puddings to ease the restrictions. Hello LC rhubarb crumble! Just lately I’ve been introducing more carbs (potatoes) and upping my insulin - sometimes successfully, sometimes giving myself a 3am hypo! How often do you eat carby foods and how well does it work for you? Does anyone eat bread without spiking? Or pasta? Or rice? Any and all stories appreciated. I know we all react differently, but interested in others’ experiences with food. Thanks.

Unlike normal insulin, injected insulin follows a fixed curve so if you eat normally, you will spike. On DAFNE they teach you to ignore the spikes. As long as your blood sugars return to pre-meal levels 5 hours after eating, your dose was correct.

 

[michita]

Hello. I am adult onset type 1 or Lada. I went strict low carb at diagnosis. Now its been about 5+ years I'm now more relaxed with what I eat. But I do find eating low carb is the easiest way to maintain good bs level. Unfortunately i also notice its more difficult to maintain good bs level compared to when i was newly diagnosed. I think we just need to find the way that suits us the best and that could be different for each of us.

 

[ShelleyDubs]

I eat the same healthy diet as i did before diagnosis.
I eat bread, pasta, rice, cakes, ... as well as lots of fresh vegetables.
I am not afraid of "spiking" as long as my levels remain in single figures and return to lower levels within about an hour. If you look for Libre graphs of people without diabetes, you will see this is normal.
I often need a split bolus, especially for high carb, high fat meals such as pizza and curry
This is easier now I have an insulin pump

You mentioned 3sm hypos. Are these real hypos tested with a finger prick or compression lows reported by your Libre when you lie on it?

That’s brilliant that you can eat the same as before and not worry about it. I wish I was the same, but I just can’t help but worry about spikes. So many contrasting opinions about exactly when high blood glucose starts to cause damage. You mention single figures, do you never go above 9 eating carbs? That’s awesome…

 

[ShelleyDubs]

Hello. I am adult onset type 1 or Lada. I went strict low carb at diagnosis. Now its been about 5+ years I'm now more relaxed with what I eat. But I do find eating low carb is the easiest way to maintain good bs level. Unfortunately i also notice its more difficult to maintain good bs level compared to when i was newly diagnosed. I think we just need to find the way that suits us the best and that could be different for each of us.

Seems to be a time thing - people relax more about the carbs thing. That’s good to hear but I’m not there quite yet. LC seems to be the only way I can control the BS but I’d like to eat a few more carbs!

 

[ShelleyDubs]

Hi,

What insulin/s are you prescribed. A year or so back, you mentioned you were just using a basal?

Hi, I had little idea about what I was injecting back then! I’m not in the UK and don’t have a team around me to explain things. I’ve just kind of worked carbs/insulin out as I’ve gone along. I’m on a combined 70/30 pen injection at the moment but would like to separate that out. However, Dr isn’t prescribing it… she thinks all is well as it is. And I guess it is. But I’d just like to eat a more varied (carby) diet! Haha.

 

[ShelleyDubs]

Unlike normal insulin, injected insulin follows a fixed curve so if you eat normally, you will spike. On DAFNE they teach you to ignore the spikes. As long as your blood sugars return to pre-meal levels 5 hours after eating, your dose was correct.

Thanks for this. I wonder if I can get on a DAFNE course if I’m not in the UK. I had no idea about the 5 hrs thing.

 

[Jaylee]

Hi, I had little idea about what I was injecting back then! I’m not in the UK and don’t have a team around me to explain things. I’ve just kind of worked carbs/insulin out as I’ve gone along. I’m on a combined 70/30 pen injection at the moment but would like to separate that out. However, Dr isn’t prescribing it… she thinks all is well as it is. And I guess it is. But I’d just like to eat a more varied (carby) diet! Haha.

Hi,

Are you saying you’re on a fixed Novomix dose, self prescribed?

what diabetes meds did your doctor prescribe before?

 

[In Response]

That’s brilliant that you can eat the same as before and not worry about it. I wish I was the same, but I just can’t help but worry about spikes. So many contrasting opinions about exactly when high blood glucose starts to cause damage. You mention single figures, do you never go above 9 eating carbs? That’s awesome…

I do go over 9 but I use insulin to make sure my levels don’t stay ther long.
I was diagnosed nearly 20 years ago and following this approach, I have no complications.

 

[In Response]

Thanks for this. I wonder if I can get on a DAFNE course if I’m not in the UK. I had no idea about the 5 hrs thing.

You may have access to the online version, bertie www.bertieonline.org.uk

 

[Antje77]

Hi, I had little idea about what I was injecting back then! I’m not in the UK and don’t have a team around me to explain things. I’ve just kind of worked carbs/insulin out as I’ve gone along. I’m on a combined 70/30 pen injection at the moment but would like to separate that out. However, Dr isn’t prescribing it… she thinks all is well as it is. And I guess it is. But I’d just like to eat a more varied (carby) diet! Haha.

Being on a mixed insulin is very relevant in light of your question.
It used to be a usual treatment, but nowadays a basal and bolus regime is pretty much the norm.

With a mixed insulin you're pretty much stuck with adjusting your meals to your insulin, as you can't adjust the bolus for your meals according to what you eat without also adjusting your basal.

Most of us use a basal insulin, which more or less stays the same, and we use the bolus insulin to cover for food.
So I can dose depending on what I eat.

Are you under the care of a GP or an endocrinologist?

 

[ShelleyDubs]

Hi,

Are you saying you’re on a fixed Novomix dose, self prescribed?

what diabetes meds did your doctor prescribe before?

No - I’m on a prescribed fixed dose (by my doctor). I think I want to split that into separate long / rapid acting but she wants me to keep me on the fixed.
Not sure of the benefit of this as I feel it’s bad to keep chucking lots of long acting in as well as the rapid acting to cover a more carby meal. That’s my understanding. Sorry for confusion.

 

[ShelleyDubs]

Being on a mixed insulin is very relevant in light of your question.
It used to be a usual treatment, but nowadays a basal and bolus regime is pretty much the norm.

With a mixed insulin you're pretty much stuck with adjusting your meals to your insulin, as you can't adjust the bolus for your meals according to what you eat without also adjusting your basal.

Most of us use a basal insulin, which more or less stays the same, and we use the bolus insulin to cover for food.
So I can dose depending on what I eat.

Are you under the care of a GP or an endocrinologist?

I am under an ‘Internal medicine’ specialist. Can’t find an endocrinologist here that supports a LC diet for diabetics. In fact they only recently recognised LADA here (UAE) and for insurance purposes I am insulin dependent T2 even though I’ve had the antibody test to confirm LADA. Hence my interest in what people can eat. The bolus / basal is where I want to head, it seems. I will keep asking. Thank you for replying.

 

[ShelleyDubs]

You may have access to the online version, bertie www.bertieonline.org.uk

Oh thank you so much. I did not know about this!

 

[ShelleyDubs]

I do go over 9 but I use insulin to make sure my levels don’t stay ther long.
I was diagnosed nearly 20 years ago and following this approach, I have no complications.

That’s great to hear. Congratulations and thank you for sharing.

 

[Jaylee]

No - I’m on a prescribed fixed dose (by my doctor). I think I want to split that into separate long / rapid acting but she wants me to keep me on the fixed.
Not sure of the benefit of this as I feel it’s bad to keep chucking lots of long acting in as well as the rapid acting to cover a more carby meal. That’s my understanding. Sorry for confusion.

Hi,

a prescribed by your doc regarding a fixed dose of which particular insulin?

 

[Speedbird]

You may have access to the online version, bertie www.bertieonline.org.uk

For some reason the link does not work.

 

[EllieM]

Not sure of the benefit of this as I feel it’s bad to keep chucking lots of long acting in as well as the rapid acting to cover a more carby meal. That’s my understanding. Sorry for confusion.

Disclaimer, I am not a doctor and I may be misunderstanding your situation.

The basal is meant to carry you through when you're not eating, so it's a fixed amount depending on your metabolism. (Note it can change with time.) If you're on a mixed basal/bolus insulin you don't really have any flexibility in carb amounts, as you need the right amount of insulin to cover your basal needs and then you'll have to eat the right amount of carbs to match the bolus that's bundled with that basal dose,

The T1s posting here about balancing insulin to meals are mostly on basal/bolus regimes (or insulin pumps) where they can vary their bolus to match their carb consumption. It doesn't sound to me that you are in that position at the moment.

Maybe you need to remind your doctor that you are now T1 and not T2, and/or ask to see an endocrinologist?