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Can I prove the Dr's wrong?

Hi Yorkshireman
Thanks.... But I have lowered my carb intake further over the last few months, now not having any bread, rice, pasta etc, nothing over 12g per meal.


Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 58. Requested a GAD test in November, came back very high 2,000+, doc said I would be T1 within weeks, but presently still LADA taking no insulin or medication, and striving to keep my BS readings as close to 'normal' as possible in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
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smidge said:
They seem to be focussing on the condition at Swansea now, so hopefully in the future, it will be better understood and treated more appropriately. In the meantime, we can only do our best as sort of Type 1s.
Click to expand...

It will be interesting to see what Swansea find / recommend.

Q. I have a Novo Rapid pen, the only insulin I have. It's smallest dose is one unit, my DSN says one unit will bring my BG levels down about 3 points..... Any suggestions how I can bring my BG levels down just one point or two. I am thinking overnight. If I check my BG levels before bed, I know within +1.5 and -0.5 they will be the same in the morning. So if I am 6 at night I would ideally like to take 0.5 unit of insulin, just a little to help lower them overnight. If I were to take one unit I could wake up to 2.5.... too low. Dr Bernsein says you can get diluted insulin, eg. half strength made up for you. Any experience of this?

Last week I caught a Niro virus, BG rose, getting them back down again now. It would be good to know what my options are, as I do feel high BG levels kills off beta cells, and I would like to try to keep what I have for as long as I can.... And a little insulin will likely help sometimes.


Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 58. Requested a GAD test in November, came back very high 2,000+, doc said I would be T1 within weeks, but presently still LADA taking no insulin or medication, and striving to keep my BS readings as close to 'normal' as possible in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
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Hi Ian.

You need a half unit pen. I have the Novopen Echo for my Levemir. You can get them on prescription. If you are on pre-filled pens you will need to change to cartridges. Your DSN should be able to prescribe the pen and the cartridges. It's pretty normal for early stage LADA's to need half unit pens.

Hope you're feeling better.

Smidge
 
So are you aiming for Novorapid, Ian, rather than basal? (Or whatever the long-acting kind is called, I don't know.) My DN gave me Insulatard to take to Kenya in case needed - that's a dose once a day. She was suggesting trying out 6 units, and said this kind of long-acting insulin doesn't cause hypos (which I've never had in my life). I didn't use it bec There wasn't any need: BS is still improving.

I'm reading up abt types of insulin regime now, and I'm not awfully keen .. BUT, like you, I want to get my BS down to 5.0 and do anything I can to preserve my beta cells.


LADA, 55, BMI 23, moderately active. Diagnosed Type 1 in July 2014 after GAD antibody test. On LCHF and Metformin plus a bit of ex. HbA1c currently down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.6.
 
Novorapid is what my dsn gave me a few months ago, prior to a trip to Antigua, for emergency use. Like you I have little knowledge of the different types of insulin, something I need to swat up on.

My next diabetic clinic appointment is in 6 weeks time, so I need to find out more about insulin types etc. so I can ask questions.


Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 58. Requested a GAD test in November, came back very high 2,000+, doc said I would be T1 within weeks, but presently still LADA. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings as low as possible in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
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Moving this to a new thread, Ian.

Lucy
 
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Hi Ian,

I had a very similar presentation of late onset Type 1 with GAD antibodies at the age of 50, three years ago.

I've used a Dexcom G4 CGM to keep the average BG at about 6.0 since diagnosis - all the HbA1cs have been between 40 and 45 so far. Set the low alarm on the Dexcom to 4.5 to avoid hypos. This technology has revolutionised the management of T1DM but is still not readily funded by the cash strapped NHS.

Diet and exercise are key - I'm on a low dose of levemir as a basal insulin twice a day - 8 units at night and 4 in the morning - this approach has slowed down the progression of the beta cell loss and I have not had to increase the basal insulin yet. I use humalog as a fast acting insulin before meals but usually only 0.5 to 1 unit with low GI carbs where possible - and a walk after dinner

I highly recommend 'Think Like a Pancreas' by Gary Scheiner.

Well done and the very best of luck with everything.

Ian P
 
Hi Ian
Thanks. The Dexcom G4 CGM sounds very good, had a look at their web site. I would love one, but very expensive, shame it's not on the NHS, but I can understand why with the cost.... But hopefully the price will come down soon so maybe not in the too distant future.

Having said that, following the dr Bernstein solution, at the moment i am very rarely over 6, and because I am not on insulin yet do not have to worry about hypos.

I will have a look / read of 'Think Like a Pancreas' by Gary Scheiner.


Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 59. Then diagnosed T1 / LADA in December. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings to dr Bernstein's recommended 4.6 pre breakfast and 5.6 2hr after eating in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
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emsliehenry1@yahoo.com said:
Please read Dr Bernstein's Diabetes Solution and KNOW that you are right. I've been diagnosed T1 for 4 years now and barely use any insulin as I don't eat carbs... why would I?
Click to expand...

So great to hear. Bernstein's logic seems faultless to me. I'm giving it a go. How can very lo-carbing be anything but helpful?

Lucy



LADA, 55, BMI 23, moderately active. Diagnosed Type 1 in July 2014 after GAD antibody test. HbA1c down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.3.
Now on LCHF plus a bit of ex, plus one small daily dose of Insulatard (slow-acting basal insulin) every morning.
 
Just re-read Jenny Ruhl's Blood Sugar 101 page here -
http://www.phlaunt.com/diabetes/14045678.php
- compiling the findings of research studies on what levels of BS are implicated in retinopathy and neuropathy as well as beta cell death.

The levels are 5.0 fasting and 7.0 post-prandially. (Her original figs 5.6 and 7.8 are US plasma-calibrated figs, to be divided by 1.12 for UK-style blood-calibrated equivalents.)

Her evidence supports every aspect of Richard Bernstein's work, tho he is more stringent of course.

I find this very motivating! - In case if flagging ...

Lucy



LADA, 55, BMI 23, moderately active. Diagnosed Type 1 in July 2014 after GAD antibody test. HbA1c down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.3.
Now on LCHF plus a bit of ex, plus one small daily dose of Insulatard (slow-acting basal insulin) every morning.
 
Hi Lucy
I think the Jenny Ruhl's page you put a link to is what initially prompted me to get my BG levels down to 7.8 within an hour of eating (my 1st post on this thread back in February) that and a few other web pages I found. I took copies to the diabetic clinic. They said none were real clinical trials!!!!.... But they did agree that I had nothing to loose in trying.... So my LcHf journey started from there, and then reading dr Bernstein's solution a few weeks back just emphasised it even more, only of course even tighter control. The more you read the more evidence materialises, simply keep BG levels at normal non diabetic levels.... But of course, keeping then at normal levels is not so simple, but long term it would appear this is the best solution available to avoid diabetic complications later in life. It's a shame it is not more widely recognised within the diabetic community.


Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 59. Then diagnosed T1 / LADA in December. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings to dr Bernstein's recommended 4.6 pre breakfast and 5.6 2hr after eating in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
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Now 4 weeks into dr Bernstein's solution. Wow... It seems to be working better than I thought.

1st wk looked promising, then caught a sickness bug (kids party!) which sent my BG readings up, but last 2 weeks of BG readings are very pleasing with pre breakfast average of 4.4 and 2hr after eating average of 4.7 with a Max of 5.2.... So meeting / bettering his advised BG levels.

Since I was on a low carb diet anyway, I have found eating to his dietary recommendations easier than I thought, mainly no fruit and less tomatoes and nuts.

It will be interesting to see over the next few months how my BG readings go....... Downwards will indeed indicate that beta cells are regenerating, upwards not...... Time will tell.... I will be happy if they stay the same.

Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 59. Then diagnosed T1 / LADA in December. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings to dr Bernstein's recommended 4.6 pre breakfast and 5.6 2hr after eating in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
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Gosh Ian, that's amazing. Well done! I wish I cd do as well.

Yes - we'll just watch your figs and see which direction they go in.

I have real problems keeping carb + protein amounts consistent. Family meals. I need to organise them in advance.

Many congratulations!!
 
Now 12 weeks into Dr Bernsrptein diet / low BG solution plan, and over a year since being diagnosed.

My BG levels are not quite as good as they were during the 1st four weeks of the Bernsein plan, but still good, considering I am not taking any insulin or meds.

My pre breakfast average over the last 4 weeks is 4.9, 2hr after food average 4.8, highest recording over the last 4 weeks is 5.9 (Bernstein recommends 4.6 pre breakfast).

Had a hospital diabetic consultation yesterday. My HbA1c is down to 5.2%.... Nurse thinks it is too low! But could not give me a reason why. Said my BG levels are much too low to consider taking any insulin, even 1/2 unit amounts.... But will review again when my BG levels raise...... Which is fair enough.

Had a half hour session with the diabetic dietician..... I think she learned more from me than I did from her!.... In fairness she said what I am eating is clearly working, so carry on with it.

In conclusion, the Dr Bernstein's plan is working and I plan to continue with it.
Observation 1). My BG trend is slightly up.... So no sign of a beta cell improvement.
Observation 2). My weight is slightly down, but still BMI 22
Observation 3). Insulin is round the corner, but not ready quite yet.... Though I have my pen ready if needed.
 
Ian, I know you're disappointed that the morning BGs are slightly rising, but that's fantastic. Well, well done.

Of course, now you get the double whammy, which us that bec you've done so well, no insulin. Hey-ho.

I would kill for those levels. Despite taking the Insulatard, I can't get near them. Fasting BS azbout 5.4, but 2h after meals 6.x. After several hours, back down to the 5s, but not at two hours.

Am a bit scared to raise the nightly dose for fear of my first hypo. I could test, of course ...
 
Well done Ian - great HbA1c! Your nurse is mad if she thinks that's too low for a non insulin-dependent!

It's a shame that your trend is slightly up, but not really surprising I guess. The fasting BG is the hardest to control and tends to be the one that starts to worsen first as LADA progresses - I guess because you are controlling the after food levels so well but there is limited scope for controlling that morning fasting level except eating earlier and not having carb or protein close to bed time (which you're already doing) - it might be evidence that your second phase is starting to weaken or it might just be a blip - only time will tell.

Great work though!

Smidge
 
Lucy,

I doubt you can safely get your control much tighter on an intermediate-only regime as you haven't got the finer control you get with a rapid-acting. I can adjust my injections by half unit for specific foods and it only affects me for about 3 hours, but with an intermediate if you make that adjustment it affects you for about 12 hours.

In your situation, I be tempted to experiment with a split dose to enable you to up the dose slightly without having it all active at the same time. Basically I would be aiming to try to just lower your background BG levels slightly which would have the effect of giving an overall lower level even after eating if you see what I mean - but you do risk a few mild hypos if you do that. That's what I did when I was on intermediate-only, - it worked wonders for my background and fasting levels, but I knew it would mean dropping a little low mid-morning so I planned a finger of dark chocolate kit kat (7g carb) into my morning regime. It worked and I had my lowest HbA1cs during that period, but I doubt Bernstein would have recommended it!

Smidge
 
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