Hi, what about LADA? Latent autoimmune diabetes in adults? Characterised by gradual loss of pancreas insulin production, so the symptoms come on much more slowly than Type 1.
It took 7 years before they figured out I was actually a Type 1. I just hope I havent done irreparable damage in the meantime.The main -and very serious - disadvantage of LADA not being known amongst the medical fraternity is that it is so often misdiagnosed as Type 2. What follows is years of Metformin, diet etc etc, persistent high BGs and general disbelief that you are a 'compliant' patient until they begin the insulin regime. Typical type 1 has a very rapid onset. The years of poor diagnosis and high BG can lead to eye damage, as in my case. All I can say is that you were lucky as being classed as Type 1 not type 2!
Fascinating information thank you.Hi, I discovered years ago that carb counting ref 10g carb to 1 unit insulin just does not work.
It certainly sounds like you have LADA - as I have. I went through a very similar path to what you describe.
My main advice is that 'Novorapid' is anything but rapid for me. I could take a corrective dose but it doesn't kick in for at least six hours, if not longer. There is a much improved version of Novorapid called 'Fiasp' It is also insulin Aspart but with an additive that makes it work faster - which it does. My advice is to request a change to Fiasp, and don't take no for an answer. Also, while you still eat significant carbohydrate then it is very easy to get onto a sawtooth pattern of blood glucose - go low eat carbs, up to high, bolus jab, etc. I suggest you cut down on fast acting carbs, biscuits, cake, bread and certainly no sugar containing drinks or sweets (unless combating a hypo). I find this regime helps greatly in keeping my BGs in the target values (using Libre 2 system).
One other thing - Glargine can cause enormous hypos if it gets into a blood vessel - this happened to me once and I was almost hospitalised. I now use 'Tresiba' which can't do this - much better control with it too.
Good luck!
Thanks - In ResponseI am not convinced Fiasp is a good insulin to start on - I changed to it about 4 years ago and found its quirks meant it took some time to get used to. Especially as the speed (and dose) at which is works is very dependent upon your starting BG.
It would not surprise me if that is why NovoRapid is used as a safer starter bolus. It's much easier to focus on getting the dose right and coming back to baseline after 4 or 5 hours even if can be rather (Novo)Sluggish.
Or learn how to dose for all carbs and not restrict your diet.
I tried going low carb., It did not suit my lifestyle (frequent travelling and eating out for work) and very low carb was an absolute pest because I had to work out how to bolus for protein which, for me, was a different timing and insulin to protein ratio for every type of protein.
I can see some benefits of lower carb but whilst working out insulin to carb ratio, the usual advice is to eat "normally" so you do not need to worry about insulin to protein or the insulin resistance which low carb seems to bring to some people with Type 1.
I agree Lantus can be concerning, It was the new kid on the block when I started but I see Tresiba and Levemir have taken over.
Tresiba seems to be a bit if a marmite for basal dosage. It's long stable profile is loved by those who have a steady need for background insulin over 3 or 4 days but if your needs vary day to day or night to day, it can be challenging.
Novorapid and me are old friends - used it for 20+ yearsI find when I've injected the "correct amount" of insulin based on my carbs with any pre meal corrections added... it's doing nothing to get my levels correct ! Then later - I'm finding that when I attempt to correct my levels with a few units of Novorapid a 2-3 hours after my meal it seems to make no difference and my levels continue to climb !
Insane.
Maybe if I increase my basal insulin amount it will start to make a difference. I'll see what happens over the next few days.
Great thanks for that. All information is useful. A learning curve for me !Novorapid and me are old friends - used it for 20+ years
Its a bit mis-named as a 'fast acting insulin' - (each of us are different) but I found it did very little for at least the first half hour, and didn't really kick in till 1 hour past injection - usually needed to pre-inject for meals to get it working before the food hit my system. Active for about 4 hours (when I used syringes or MDI as its known)
I switched to Fiasp (Novorapid with 'stuff in' to make it work quicker) - that kicked in pretty much immediately (so inject when the food is on the plate). Lots of people have success, some don't - I got insulin resistance so switched to Lyumjev (humalog with 'stuff in') which works better for me.
I run everything from a pump (over 13 years now) which is set-up to be an artificial pancreas (I don't need to tell it when I eat - it just copes with it) - a DIY system from some great people on t'internet and very complicated, but it shows whats coming in the near (5 years or so) future for everyone.
Once you get your MDI Insulin set-up, there are options to make life easier (pump or hybrid loop), you just need to get through the hurdles of getting a regime that works for you - all possible, it just takes small steps to get it right. Does sound like your Carb Ratio (10g to 1unit) might need upping a bit, and pre-bolusing might help, but thats where a Diabetic Nurse can advise you what to try (crashing lows are no fun)
Thats interesting to know. Thank you.You may find as I have that the higher your bg the more insulin resistant you become , if you're up in the teens when you inject it sometimes seems that the insulin is doing nothing but if you're in the normal range it does its job perfectly .
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