Relatively newly diagnosed...Jan 2024

[seblish2000]

I'm only on long actin insulin, and at the beginning it worked somewhat but I have been increasing the dose but the post meals has becoming high. I was just curious if there is anyone here on long actin insulin only and how do you safely increase without getting a lot of hypos?. Maybe it's time for me to get short acting insulin since my fasting glucose is okay but post meals has been high

Any suggestions would be great. Thanks

 

[Antje77]

I'm only on long actin insulin, and at the beginning it worked somewhat but I have been increasing the dose but the post meals has becoming high. I was just curious if there is anyone here on long actin insulin only and how do you safely increase without getting a lot of hypos?. Maybe it's time for me to get short acting insulin since my fasting glucose is okay but post meals has been high

Any suggestions would be great. Thanks

Hi @seblish2000 , we can't give dosing advice, that's between you and your endocrinologist or diabetes nurse.

Like you said, if your basal dose covers you when not eating, you can't safely increase it without going low or having to eat every couple of hours to feed the insulin.
I'd contact your team to let them know about your meal spikes and ask what the next step is.

It's common for LADA's to start on a basal only, for a while, many of us are still producing some insulin. During this honeymoon period our own insulin production reduces and at some point we need insulin, both basal and bolus.

 

[In Response]

The OP does not have insulin resistance.
The way to manage Type 1 (or which LADA is a variant) is not through diet but through correct insulin use.
The "ideal" diet for someone with Type 1 diabetes is that same as that for someone without diabetes.
Adjusting diet when insulin is needed could result in DSN suggesting the wrong insulin dose, especially as a low carb diet (avoiding the foods that "will spike the sugar") is shown to increase insulin resistance.

If the OP is finding their BG is increasing after meal, it suggests to me (not a health care provider) that they need bolus, fast acting insulin.
Unless they are eating a very unhealthy diet and want to take this opportunity to change, the advice is to continue to eat as you currently do and plan to continue doing.

(mod edit to remove quote of deleted post)

 

[Just-a-little-prick]

The OP does not have insulin resistance.
The way to manage Type 1 (or which LADA is a variant) is not through diet but through correct insulin use.
The "ideal" diet for someone with Type 1 diabetes is that same as that for someone without diabetes.
Adjusting diet when insulin is needed could result in DSN suggesting the wrong insulin dose, especially as a low carb diet (avoiding the foods that "will spike the sugar") is shown to increase insulin resistance.

If the OP is finding their BG is increasing after meal, it suggests to me (not a health care provider) that they need bolus, fast acting insulin.
Unless they are eating a very unhealthy diet and want to take this opportunity to change, the advice is to continue to eat as you currently do and plan to continue doing.

Excellent response - I think it's the first time that I have read such a clear statement on this Forum about insulin use.

 

[Melgar]

The OP does not have insulin resistance.
The way to manage Type 1 (or which LADA is a variant) is not through diet but through correct insulin use.
The "ideal" diet for someone with Type 1 diabetes is that same as that for someone without diabetes.
Adjusting diet when insulin is needed could result in DSN suggesting the wrong insulin dose, especially as a low carb diet (avoiding the foods that "will spike the sugar") is shown to increase insulin resistance.

If the OP is finding their BG is increasing after meal, it suggests to me (not a health care provider) that they need bolus, fast acting insulin.
Unless they are eating a very unhealthy diet and want to take this opportunity to change, the advice is to continue to eat as you currently do and plan to continue doing.

I'm not challenging you @In Response , and I understand where you are coming from, but coincidentally, I have just responded to another post about AM lows. I have been reading research papers (Yes I am that nerdy and sad) around diurnal variations in insulin sensitivity. The study involved metabolically healthy people. It has been found that insulin resistance in metabolically healthy people rises around late afternoon. I believe it is something to do with cellular fatty acid metabolism. So even in metabolically normal people, insulin sensitivity is reduced later in the day.

 

[Hopeful34]

I'd be interested to read that paper @Melgar as I need less insulin to carbs in the afternoon and evening than in the morning.

 

[Melgar]

Here you go @Hopeful34. I have attached three studies.

Roles of Circadian Rhythmicity and Sleep in Human Glucose Regulation*

I. IntroductionII. Characteristics and Causal Mechanisms of 24-h Rhythms of Glucose Regulation in Normal Young SubjectsA. 24-h variations in glucose tolera

academic.oup.com

Diurnal Variation in Insulin Sensitivity of Glucose Metabolism Is Associated With Diurnal Variations in Whole-Body and Cellular Fatty Acid Metabolism in Metabolically Normal Women

Context:. The mechanism(s) responsible for diurnal variations in insulin sensitivity of glucose metabolism in healthy people are unclear.Objective:. The ob

academic.oup.com

Human adipose tissue expresses intrinsic circadian rhythm in insulin sensitivity

In humans, insulin sensitivity varies according to time of day, with decreased values in the evening and at night. Mechanisms responsible for the diurnal variation in insulin sensitivity are unclear. We investigated whether human adipose tissue (AT) expresses ...

www.ncbi.nlm.nih.gov

 

[Hopeful34]

Thank you @Melgar I'll read them later today hopefully.

 

[Melgar]

Thank you @Melgar I'll read them later today hopefully.

Enjoy, hopefully you don't glaze over and fall asleep reading them lol

 

[Melgar]

@Hopeful34 , I can say without question that my blood sugars definitely rise in the evening. I am metabolically healthy and I am very insulin sensitive.

 

[seblish2000]

Thanks for all the responses, they were very helpful. I have started using bolus insulin and now I have a much better BG control. It Went from 6.5 GMI to 6.3, in about 2 weeks, so I'm happy. But I have to say that as someone said it here, my sugar level raises in the evening Even after it seem like I gave a correct dose of insulin after dinner, it would be controlled for 2 to 4 hrs but it slowly increase and I always have to correct it with additional doses before going to bed.... Anyone experience this? Anyway, thanks for all the helpful info and papers