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Should I push for insulin to preserve remaining beta cells

Discussion in 'Type 1.5/LADA Diabetes' started by ReaL, Jul 30, 2020.

  1. ReaL

    ReaL · Member

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    Hi

    I am looking for some advice. I was diagnosed March 2019 with type 2 and have had good control with diet and exercise. Over the last couple of weeks I haven’t been able to control my BG and went back to GP who told me I had tested positive for antibodies back in March 2019 (no one told me this) and that I was most likely LADA. I have been started on metaformin - only been a couple of days so too early to tell how that is going. My question is should I be pushing for insulin to preserve my remaining beta cells? Also what would be the benefit of preserving them?
    Many thanks
    R
     
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  2. ert

    ert Type 1 · Well-Known Member

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    I started insulin when my HbA1c went to 6.5%. (It was 11.6% when I was diagnosed but got it down to 5.7% three months later with diet, Metformin and exercise.) High sugars destroy beta cells. They're also destroyed by your autoimmune response. I stayed off insulin for two years and have no regrets.
     
    #2 ert, Jul 30, 2020 at 11:58 AM
    Last edited: Jul 30, 2020
  3. Antje77

    Antje77 LADA · Moderator
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    I would ask for a referral for an endocrinologist. GP's aren't usually very well versed on T1.
     
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  4. KK123

    KK123 Type 1 · Well-Known Member

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    I preferred to go onto insulin on the basis that it may help my surviving beta cells cope, I was told by my Consultant that even using small amounts of insulin would give my pancreas a rest and be medically beneficial, (please don't ask me for the science though). At the moment, 3 years later I still use small amounts of basal and use bolus if I am having a carbier meal (one or two units). Sometimes I don't use any with meals, especially as I also exercise and am careful what I eat. I get that some people who are slow onset type 1 (ie LADA) may be able to carry on using diet & exercise alone but I exercised daily and had a fairly low carb diet before diagnosis and yet my hb1ac was sky high so I suspect if I did not have insulin at diagnosis I would have found it impossible to keep my levels low. It all depends as you can see but I like the insulin available to me to use when required. Also, don't feel that you HAVE to try and use diet and exercise only, at the end of the day your body has decided it can no longer produce enough (if any) insulin so all you are doing is replacing that insulin, why struggle when it is available to you?, I really do not agree with the 'insulin is a last resort meaning you've failed' approach. x
     
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    #4 KK123, Jul 30, 2020 at 1:09 PM
    Last edited: Jul 30, 2020
  5. Daibell

    Daibell LADA · Master

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    If you have antibodies and have poor BS control then you will be T1 (LADA). You are no doubt in the honeymoon period. I was refused insulin for a year and on max dose Gliclazide for a good few years as my GP didn't understand T1/LADA in adults. I regret not starting insulin earlier. As soon as Metformin and a low-carb diet don't work then start insulin Basal/Bolus. I would avoid interim tablets to prop up failing beta cells.
     
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  6. Circuspony

    Circuspony Type 1 · Well-Known Member

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    You need a referral to hospital so they can get you on insulin. LADA is really T1 by a different name!
     
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  7. ReaL

    ReaL · Member

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    Thank you all for your responses. I will seek a referral to a specialist I think. The GP did acknowledge that they sometimes wait too long to do just that.

    Thanks again
    Rhona
     
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  8. HSSS

    HSSS Type 2 · Well-Known Member

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    Isn’t that rather unkind sentiment more a type 2 issue than type 1/ LADA who really have little choice even if there’s a little delay possible in some cases? And an unpleasant way to suggest a type 2 might have other options that haven’t been presented to them to consider.
     
  9. KK123

    KK123 Type 1 · Well-Known Member

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    I think so, yes. I sometimes get the impression that a Lada diagnosis attracts the same attitude though (although not to the same extent as a type 2 obviously). I just don't understand really why anybody trying to cope with diabetes should be subject to ANY disapproval over treatment. x
     
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  10. HSSS

    HSSS Type 2 · Well-Known Member

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    I think the disapproval is, or should be, aimed at the advisors failing to give a full range of options to patients. The old idea of just add more drugs and tell people there’s no choice is very often wrong for type 2. Hardly surprising the patient then reiterates this belief if informed by the dr/nurse.
     
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  11. Diabetic Vegan

    Diabetic Vegan LADA · Member

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    Whaaaat that seems crazy they just put you on Metformin rather than insulin, also can't believe it took that long for them to tell you tested positive for antibodies!
    I'm sure everyone is different and maybe your hba1c isn't too bad, but i first got misdiagnosed as type 2 and was put on metformin then when I got the antibodies test and that came back positive I started on basal insulin within a few days and then came off the metformin being told I'm not type 2 and metformin won't do anything for me. I'd definitely be asking some questions and trying to find out about insulin.
    Oh and I have no idea if it helps persevere beta cells I'm just going off the basis that insulin will help bring you sugars down to a normal level
     
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  12. ert

    ert Type 1 · Well-Known Member

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    Oh and I have no idea if it helps persevere beta cells I'm just going off the basis that insulin will help bring you sugars down to a normal level[/QUOTE]
    As you first thought, it is the lower sugars that help preserve beta-cell function.
     
  13. jamesfitz

    jamesfitz Type 1 · Well-Known Member

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    Yes get on the insulin as soon as you can

    i have been diagnosed for 5 years 2 months and i am only on novorapid still. I strongly believe this is because i went on novorapid from day 1 despite the consultant trying to persuade me otherwise
     
  14. gto19660

    gto19660 · Member

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    I agree you should see an endocrinologist
     
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