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Newly diagnosed - some questions. Thanks.

 
Interesting to read your experience. It doesn’t sound too bad and good you have managed to continue moderate low carb and 1200 cals. I will ask if I need insulin when I first see the endocrinologist due to high GAD antibodies, if it could be slow and maybe just the background one? Basal insulin? Is the background one just once a day in morning? Can you hypo on it? I know I need to do another hba1c in March and if it’s not as good as the December 45mmol, it may definitely mean insulin. Just confused as the letter to GP says I may be LADA. Not definitely am 1.5.
 
In my case, the presence of GAD antibodies was the definitive proof of being Type 1/LADA. Yes, you need to start injecting insulin and yes, you may hypo. The good news is that CGM devices got so much better (I now use Dexcom G6) and so definitely try to get one. After some learning, you'll be able to do pretty much anything, dancing included!
 
I’ll wait to see what the endocrinologist says 12th March. The diabetic nurse that contacted me at her request contacted me regarding sugars and my hba1c which was 45mmol. She said metformin was ok for now, to wait for the March appointment and to contact her if I had three readings over 13. It’s been a long wait to see an endocrinologist. They’re obviously not worried. I feel better informed from being on this site. Have lots of questions to ask at the appointment.
 
@Millie74 @cz_dave @Hertfordshiremum @Circuspony @Swillbos

Thanks for you responses - interesting, informative and supportive. You've all really helped me overcome my intial acceptance of my diagnosis and my reluctance with taking insulin.

I have now seen the diabetic specialist nurse - she was really nice and explained everything really well. I wouldnt say she is on the cutting egde of treatment protocols but she listened and understood, and I respond well to 'nice'. She also gave me the '2-1' readings machine (ketone & blood sugar).

So after downloading my readings to view on her screen she could see it was mainly all single numbers (mostly within range, in green) and a some double digits readings here and there (in red). Based on the readings she wasnt sure whether to start me on insulin - as my blood sugars were coming back down (albeit alittle slower than normal) - and so she went to speak to the doctor to get his opinion.

I had said I was unsure / anxious about taking insulin BUT I was completely onboard with whatever was prescribed as I know its recommended that you start early to maintain the honeymoon period.

She returned and said the doctor recommended I start on 4 units of basal insulin once a day (without viewing my readings) and they can tweak it at the next review (in 7 weeks) if necessary.

So I plan to start taking it - tomorrow or Feb 1st at the lastest. I just wanted to read up on taking it in 2 doses or one. I had heard Dr Bernstein say to take it 2 doses but at that time I didnt take in the full context and I want to read his book or watch some key vidoes to see what his best practice is before proceeding.

I might even start with 1 unit for 1 week then 2 units and so on.. and see how it affects my blood sugar.

I noticed that peoples GAD antibody levels are in the thousands on this thread and another. My GAD was 182 and the nurse said that was high and strong confirmation. If 182 is high then what would 1679 be described as... It has to be under 1.0 to be normal....

Also, I said I'd had a c-peptide test - I was incorrect (I'm sure I've seen c-peptide somewhere on a blood test...). I can only find an islet cell antibody test which came back negative. Im going to ask my GP for a c-peptide test as I forgot to ask the nurse. Are there any other tests worth doing? My GP is usually quite good - hopefully he will do any tests I ask for.

Insulin type - Lantus soloStar / insulin glARGine 1ml contains 100 units (3.64mg) Insulin glargine. Any info on this? Typical?
 
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Sounds like it was a good appointment. Like you I’m not keen on insulin, but will do whatever they suggest. Is basal the long acting one. Did they suggest doing this in the morning? What was your last hba1c out of interest?

I rang the diabetic nurse this morning having read this discussion. Again she asked my fasting and post meal blood sugars and said they were ok. She said she had one LADA lady that had had it for 4 years, but still wasn’t on any meds or insulin. I told her this morning before breakfast my blood was 8.7, which is higher than usual, but wasn’t concerned.

She said she is going to send another form for blood test for c peptide and another hba1c to do before I see endocrinologist. She said the high 1679 antibodies shows define LADA. I think I am in denial. She knows I am low carbing. Said that’s ok. She said my last c peptide showed I was still producing insulin. I rarely get any blood sugars in double figures. She said there will be no more meds for LADA in addition to metformin. That the only treatment is insulin. Could be 1 month. Could be a few years. Anyway, it was just the nurse that works with endocrinologist. Not had Dr view yet.

Sounds like you are in good hands and they are starting slowly. You have researched it all well. Did they say weight should stay the same on the insulin? Good luck.
 

Sounds good. This is a small dose, I would not bother splitting it into two doses but that's just me.

Even though it's a small dose, be careful if you do sports, you may want to decrease by e.g. 25 to 50% after an intense workout.

I was started on Lantus too, later switched to Levemir. At your next appointment, you may want to ask to add mealtime insulin such as Novorapid in addition to Lantus.
 
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