Hi Fido,
Well this is what my brother says too. He says that long term I will be on insulin anyway and that it will be the best way to get good control.
I guess I'm just a little anxious about whether it will be very disruptive to my lifestyle at first? I have a 6 year old little girl and I work full time so life is pretty hectic. I guess eventually it just fits in?
At the minute they are saying that I have "gold standard" control so insulin isn't needed but I guess it is the best thing to do when the time is right.
The thing which concerns me about the LCHF diet is ketosis, is this not similar to the Atkins diet and what does it do to cholesterol?
Sorry for all the questions!
I forgot to say: I just follow a normal (healthy) diet. Of course, as well as keeping blood sugar under control, it's also important to have low-ish:I was diagnosed with LADA just over two years ago (I'm 55 now) and was started on insulin (four times per day) immediately. It just needs a bit of a routine but is worth it I think to know that I'm keeping my blood sugar under good control. The only thing that's slightly inconvenient for me is having to follow the rules about extra blood testing when driving.
More generally, I've found that exercise (I cycle a lot) has a big impact on the amount of insulin that I need: testing my blood at least four times per day enables me to make adjustments to my insulin as required.
So, for me I had no 'honeymoon period' without insulin and so I've just had to get into the routine: it's worth it for the peace of mind I think!
Good luck Sarah Ruth.
Cliff
Hi Sarah,
I too want to say, Don't be scared of insulin. You could last for a long time without it, but it would make your eventual diabetes worse by burning out your insulin function. My decision was to conserve that by starting on insulin. As a result my BGs have got no worse and sometimes, when I'm good, even improves.
This is what I'd recommend based on my own experience:
I think it's better to start with insulin now rather than pussyfoot around with other drugs, because only insulin will arrest/reverse the decline and ensure that you can keep your daily insulin dose low into the long term, perhaps even permanently. That’s important, because insulin should be kept as low as possible, for two reasons: 1) you will preserve your residual basal insulin capacity and this means you will have enviably stable BG levels and will avoid the horrible lows that full T1s undergo; 2) low levels of insulin (i.e. insulin sensitivity) is associated with longer life expectancy. No other drugs can prevent diabetes progressing and keep insulin needs low, except possibly metformin, which can be taken alongside insulin for Type 1s and is an incredibly benign drug with other protective effects, if your stomach can tolerate it. I would agitate strongly to avoid any other kind of drug like sitagliptin etc: they may stimulate the pancreas, but will also burn it out quicker.
Your consultant may suggest one of these three alternatives.
1) Basal insulin only. I tried this; for me it was a waste of time, because the issue with me was post-meal spikes. I was incredibly good, ate less and less, exercised more and got more and more miserable, and my BG levels just continued to rise slowly. Once I took bolus, end of problem. My fasting levels went right down again.
2) Mixed insulin, on the grounds that you are new to all this and you need something simple. Here you are given a 70:30 mix of basal and bolus insulin, and you have to take it twice a day and match your meals to it. You may like this; I wouldn’t. It’s rigid, and you will have to eat to your insulin.
3) Full basal/bolus (or MDI, multiple daily injections). This is what I would recommend. Contrary to what you might think, it’s not difficult. Usually you have two basal injections (night and morning), or sometimes one only. Then you inject bolus 30 mins before each meal. You have to carb count for this. No problem – we are adults and this can be quickly learnt. I use the Carbs & Cals app, and you’ll need to weigh stuff for the first few weeks. Then you’ll know it.
Lucy.
I also found the 'Carbs & Cals' book and app very helpful to begin with. I'm lucky in that my body reacts (at least for now!) very predictably to specific quantities of carbs and insulin, so two years after diagnosis I don't need to look things up any more. I find that taking a 'basal' dose of insulin at night and then topping it up with fast-acting insulin just before meals (once I know how many carbs I'll be having with that meal) works well for me: it gives me the flexibility to eat what and when I want safely. I just make sure that I don't snack between meals. In any case I tend to avoid mega-carb things such as beer and biscuits - which is probably sensible anyway!
Cliff
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