LADA or just type 1

[fairylights]

I was diagnosed with LADA in May 2012 (at 50 and overweight), I went to GP, hospital and injecting insulin the next day. I did stop insulin for about 2 months as they said I was in the honeymoon period - but it didn't last long. Since then my insulin requirements have risen and risen.

I am now taking 55 units of a 70/30 mix - so I guess abou 40 basal and about 15 bolus. I have to eat more carbs than I would like particularly in the evening - but if i reduce the dose my BGL goes sky high probably because I don't have enough basal.

I am basically struggling - my BGL goes from ridiculously high to ridiculously low - I think I need a proper basal and bolus regime.
Also diagnosed with an underactive thyroid at the same time.
Now I am wondering if I have a gluten allergy as well - I have to eat some carbs to mop up the 30% bolus in my insulin and I have noticed if it's bread or pasta - then I have terrible stomach problems and horrendous diarrhoea. Rice and potatoes seems a bit better.

Does this sound like type 1.5 or more just type 1 - the endo said I had extermely high GAD levels but initially I still had a measurable c-peptide. But from what I read 1.5 struggle with spikes after meals - I think I struggle to get enough basal into me to keep my BGL steady - if I have enough basal then I have a tendency to hypo about 4 hours after taking insulin.

I have an appointment with the endo in a few weeks - what would you be asking him???

 

[JConnor]

Personally I would be asking to go on to desperate injections so you don't have to eat as much, will mean maybe 3 extra injections but should help to prevent hypos.
Good luck with your appointment and hopefully others will be able to give you more advice


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[smidge]

Hi Fairylights!

JConnor is right - you need a seperate bolus/basal so that you can work out exactly how much basal you need for the day and then adjust your bolus depending on what you eat. You really do not want to be in the position of having to 'feed the insulin' as it will cause you to gain weight which will exacerbate any insulin resistance you have and you could end up with double-diabetes which is a nightmare to control.

Perhaps you could ask your consultant why they feel mixed insulin is appropriate to you - they might have a reason we don't know about. My guess, though, is that it is easier for them because they don't need to support you through carb-counting etc.

As for whether you are LADA or full Type 1, the only way you'll know is to have another c-peptide test. Having said that, as you have already progressed to insulin, it's pretty irrelevant now as the treatment will be the same. A more important thing for you to try to find out is whether you have insulin resistance involved as that could account for the larger doses of insulin required - I'm not sure how/whether there are any tests for that, though. Maybe someone else knows?

Smidge

 

[elaine77]

Hi fairy lights!

The general consensus is that with 1.5 your fasting is ok because ur still producing base insulin but u spike after meals, however, i am and always have been the opposite! My fasting levels are my worst usually and always sit between 7 and 8 mmol whereas my post prandial are usually always under 7.5 mmol. I would assume the difference between LADA and type 1 is the insulin production and so I agree with the others that the only way to test would be another c-peptide... Once you have no more detectable insulin I would assume they would class you as type 1, but, I have read a few medical journals where they have found evidence that there are more differences between type 1 and type 1.5 than that and so they are looking into it further. I would have posted links but I can't find them but one journal I read said that in patients with type 1.5 they found that beta cell regeneration could occur and that the immune system wasn't ALWAYS attacking the cells and so you can be up and down with regard to insulin requirements.... Most of these studies were done in Scandinavian countries, they tend to know and study diabetes a lot more than the UK unfortunately.....


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

 

[Pilgrim22]

T1 and T1.5 are the same thing.
T1 is diagnosed in children and young adults. T1.5(LADA) is diagnosed in older adults.

I was first put on mixed insulin (novomix30) but had to eat at certain times and had to have supper or I would have a hypo.
Am now on novorapid and levemir, and haven't had a hypo since.


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[elaine77]

I'm type 1.5 and the onset is very slow and I would say I was a young adult, not an older adult, as I was 23 when i got GD and 25 when fully diagnosed (26 now) so its not as simple as that I'm afraid.


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.