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Insulin only Or ?

Discussion in 'Type 1.5/LADA Diabetes' started by Shecat, Dec 15, 2015.

  1. Shecat

    Shecat Type 1 · Well-Known Member

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    I have had a Diabetic Nurse tell me there is only one treatment option for type 1.5 and that oral medications have never been used to treat this. Is this Nurse correct? I know I was treated with oral medications many years ago which she says is wrong and that NO Type 1.5 Diabetics have ever or are now been treated orally.!
  2. tim2000s

    tim2000s Type 1 · Expert
    Retired Moderator

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    I guess the issue is that your beta cells are being slowly attacked by your immune system and destroyed.

    If you were to be given one of the many drugs that encourages your pancreas to produce more insulin, you'd find that the rate of auto immune attack would increase as it seems to be linked to something called pro-insulin, which is the precursor of insulin. If you increase this, you increase the immune response if you eat the normal Eatwell plate.

    If you go low carb, like a couple of people on here have, @Mike D I think was one, then in theory you create less insulin and reduce the immune system response as a result. Some people manage for years like this.

    It really depends on what you want to eat as to what the answer should be!
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    #2 tim2000s, Dec 16, 2015 at 6:11 AM
    Last edited by a moderator: Dec 16, 2015
  3. phoenix

    phoenix Type 1 · Expert

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    Oral medications like sulphonylureas have been used but found not to work as well as insulin (the one trial found quicker progression to true insulin dependency on Sulfs compared with insulin) There really hasn't been much research done http://www.cochrane.org/CD006165/ENDOC_interventions-for-latent-autoimmune-diabetes-lada-in-adults
    Its actually only in the last few years that LADA has become a bit more widely recognised, many people were (and still are) put onto oral medications because they were wrongly diagnosed as T2.

    IZ THE LEG END LADA · Well-Known Member

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    I am type LADA/1.5

    I am currently taking:

    Sitagliptin 100mg daily (this can help stimulate the beta cells to produce insulin)
    Gliclazide 160mg daily (this will lower my BG levels but can cause hypo)

    I was taking Metformin and SR neither worked for me but the BG results were perfect if you can stomach the aid effects.

    However my blood sugars have begun to rise over the last 2 weeks, I am on the maximum dose for sitagliptin so cannot increase this, however my gliclazide I can increase to 320mg per day. I have literally been to see the DSN this morning about my levels I now have insulin pens prescribed as a standby in case my condition deteriorated beyond the capability of my oral medication. Mainly due to my job and working around the world I do not have medical access close to hand at all times.

    This being said I am taking the above meds as prescribed by one of hulls leading diabetic doctors, and with watching my carb intake and exercising my levels have come down since diagnosis (last 2 weeks exempt) and I have made ntained a good control my last HB1AC was 38 and 47 before that... With 1.5 your eventually going to end up taking insulin but it should be down to you what you take there should be a discussion and you should agree your treatment not just being told what your doing...

    My team have been great, from trying different meters to suit my work and lifestyle to different meds... To be fair the nurse should be interested in you to learn about 1.5 my doctor is nuts he calls on an evening and even has me email him my results when I'm away in different climates and working conditions which is good... Bottom line if your not happy with the suggestions ask to see someone else

    Hope this helps
  5. Daibell

    Daibell LADA · Master

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    Hi. A lot depends on the rate of degradation of the beta cells. I was mis-diagnosed as a T2 despite being thin and went thru the three tablets Metformin, Gliclazide and Sitagliptin all on max dose in the end. They did work initially with low-carbing. It took around 7 years to get to insulin although it would have been useful to have started insulin 2 years earlier but my diabetes GP refused to accept I was T1. So, orals can work in the early days but it is essential to know when to give up and start insulin. The debate about sulphonylureas making things worse or not continues. The nurse is wrong to say orals have never been used as many of us were wrongly diagnosed for starters
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  6. CharlieH

    CharlieH LADA · Newbie

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    So first foray into the forum so please be gentle and apologies for asking questions which may have been asked before!

    Originally diagnosed as T2 6 years ago, i am a bit ocd about monitoring and have invested in a freestyle libre, before that finger pricking too many times a day but around 4 years ago was fit to tell my doctor that metformin was not controlling my blood sugar, it took them 6 months to agree with me and then they decided i was LADA and straight onto insulin. They told me to come off metformin which when i did sent my levels mad, so the doc agreed with me that i should continue to take the pills as well as insulin, reading above i am now thinking i should stop taking the pills, currently taking 1000mg metformin sr, what do you think, i suspect the doc would be happy for me to stop but does not push it?

    Also seeing as i am on a roll!! My hba1c is reasonable at around 7.2, however my blood sugar levels after meals regularly hit 12-15mmol and have done so as long as i can remember, i do regularly compare with finger pricks confirming libre giving accurate readings. I read somewere else on the forum that levels should be 8-10 after food but i find if i use enough insulin to peak at 10 after a meal i will go low and have to take sugar to stop hypo?

    Many more questions to ask but will leave it here for now.
  7. cz_dave

    cz_dave Type 1 · Well-Known Member

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    I think your nurse is right.
  8. Kristin251

    Kristin251 LADA · Expert

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