Progressing LADA with readings that fluctuate A LOT - Page 2

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Progressing LADA with readings that fluctuate A LOT - Page 2


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Old 08-26-2014, 01:55   #11
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Hello.

I was almost 46 at diagnosis and referred to as LADA. My endo says it doesn't matter, you are Type 1, just weird in that you autoimmune disorder happened later than normal. The end result is the same as the more common juvenile/adolescent/younger adult diagnosis.

To my understanding, if you're Type 1 you are Type 1, even in the honeymoon phase, as even juvenile diagnosis have their honeymoon. Meaning, you need insulin at least from time to time. So if you have no insulin Rx now I would definitely address this with your doctor.

Also although post meal BG is important to all diabetics, Type 1s need to be especially focused on PRE-meal BG and BEDTIME BG because they dictate whether you need to inject insulin and if so how much.

Right now I am honeymooning. I am watching carbs a lot more closely. I've eliminated or reduced many foods. But even on my best days I can have a BG that requires insulin injections because I'm not really producing much if any insulin those days.

As a result I have nighttime, long lasting/slow acting Lantus for BEDTIME BG. I also have short lasting/quick Novolog for PRE-meal BG. I strongly suggest you bring this issue of having insulin available to you, when needed during your honeymoon, up to your doctor.

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Old 08-26-2014, 20:23   #12
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thank you for this information! my pre-meals are around 110 lately. I will definitely try to convince my doctor to put me on insulin, I just hope they don't have any rules how much my a1c must be or something like that

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Old 08-26-2014, 20:58   #13
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Going on insulin they will be cautious and suggest BG numbers higher than they need to be, out of fear of you going hypo. A1c is 3 month average and not really telling if doing good or bad. 80-140 mg/dL (4.4-7.8 mmol) daily numbers over 3 months will average about the same A1c as 30-190 (1.7-10.6) so A1c is really meaningless at that level, but they will want to see higher numbers for it too.

Eating high carb will make it harder to keep BG under control unless you are really good or lucky at giving the right amount of insulin at the proper time. Low carb minimizes the amount of insulin needed and reduces the risks of swings going too high or too low. Less insulin means less money spent too.

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Old 08-27-2014, 04:22   #14
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Kris - do you test after meals? Like 2 hours after maybe? 110 pre-meal seems in range, but depending upon what you eat, it could easily be twice that an hour later, w/o insulin. That's what the short acting insulin is for (Humalog/Novolog, probably others).

The Lantus I take also is a 24 hour basal insulin. I am backing that dosage down as I adjust to a new diet/exercise plan.

At some meals now, I haven't quite eliminated a pre-meal insulin injection, but close to it. Mostly I haven't eliminated them because I've been afraid to. But, I've had meals where I only took 1 or 2 units.

I'm sure everyone is different, but the rules I got from the doc were:
Novolog pre-meal to have a 80-140 reading 2 hours post meal, and
Lantus at night, to keep under 180 fasting first thing in the morning.

I woke up hypo a few times starting in week 3 (actually 3 nights in a row), so that was then I started to back down Lantus. I would like to eliminate that one if I can, but I'm not quite there yet.

Of course, I may yet be honeymooning, so this is all subject to change at any time. However, the doc thought I was out of insulin production, though he did say some honeymoon phase is possible.

Sorry for the long reply - really I meant to just say test after meals, and that will give you a better idea of whether/how much insulin you might need.

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Old 08-27-2014, 20:09   #15
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I love long replies especially if they bring useful information!

Well, yes, I do, but my post-meal readings are very different every time. I can have a week where almost all my post-meal readings will be at about 220 and the the next week around 110 (?????).
I don't quite get it how does exogenous insulin work in cases where there is still some production of insulin in the body, but I know it can cause hypos, right, meaning, if my pancreas is having a good day and does it's job and I inject insulin... I will most certainly have a hypo.. but I can't predict that?

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Old 08-27-2014, 20:54   #16
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This is a situation where you do need to know exactly what you are eating. The rule you need to apply is outlined in Dr. Richard Bernstein's book - Diabetes Solution - He calls it his 'law of small numbers' and this link discusses it Read It Online!

The idea is that if you eat a small quantity of carbohydrate, you need only a small quantity of insulin - whether it's your own or exogenous. It takes discipline to make a point of avoiding high carbohydrate meals but without that discipline, yes, you are in danger of wild swings in your blood glucose with hypos in the short term but longer term the complications caused by being permanently hyper are probably worse.

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Old 08-27-2014, 23:22   #17
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It's amazing how many people come to this site and post that they don't want to follow a low carb diet, but they still want us to tell them how to manage their diabetes because it's seriously out of control.

If any of us had that little miracle in our back pocket we'd be multi millionaires and way to busy spending our money to waste time on the internet.

The facts of life for a diabetic are pretty straight forward.It doesn't matter if your type 1 or type 2 if you eat carbohydrates your BG will go up and your body can't control it. The diabetes doesn't kill or maim you, but the high BG does. The more carbs you eat the greater the percentage of the time your BG is high enough to cause damage.

When will the damage occur and what will be damaged? That's the fun part, nobody knows. It might be tomorrow, and then again, many diabetics have gone long periods of time uncontrolled with only minor complications. It's kind of exciting isn't it? Is today the day you wake up and find out two of your toes need to be amputated, or is today a good day to go to the beach, have a few beers and a slice or two of pizza, and come home tired but happy? Makes getting up in the morning a real adventure.

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Old 08-27-2014, 23:38   #18
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kris - if you're honeymooning or not, you balance your insulin against what you're eating.

For simplicity sake, say this is your experience: 1 unit of fast acting insulin per carb keeps your numbers in line. You estimate how many carbs you'll have, then take that much insulin, then eat.

In the beginning, I found some swings, probably because my system was getting used to a very different new normal. That pretty much stopped after about 2 weeks.

If you do over-inject, and your numbers drop, then you either eat a carb, take a couple of glucose tablets, or drink some juice. They respond quickly to the glucose tabs and juice, and maybe to what to you eat, depending upon what it is.

You will have some hypos in the beginning. Once you adjust a bit, though, they become less frequent.

Before I found this site, I created my own LCHF plan, though it is not as high in fat as those recommended here. The key, though, is limiting carbs.

If you do that, you will get your numbers more in line, and keep them there.

If you are in tune with your body, you're not going to pass out and die from going hypo. You're going to feel a little light headed, then hot and sweaty, then really light headed. I've gone there about 10 times over the past 6 weeks, and each time I did what I said above, and it quickly passed. The first few times, it scared me, and I over compensated. Now, I have a pretty good idea of what I need based on where my numbers are.

For reasons I still don't know, I woke up last night at 3:30 am, feeling light headed and clammy. I took a reading (57), then took 2 glucose tabs and a small shot of orange juice, waited for it pass, then went back to bed.

When I got up for the day about 3 hours later, I was at 87.

It's trial and error, but as the above posters said, being high all the time is what causes later problems.

Insulin is a critical control agent - but so is your diet. Also, throw in some exercise - it does wonders also.

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Old 08-27-2014, 23:43   #19
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I should add, BTW, that I am only 6 1/2 weeks since DX. I know I will screw up some, but I hope that what you can take from that is this: even if it takes you 4-6 weeks to figure out, that is a blip on the timeline of your life, and you will be loads better off later for having done it.

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Old 08-28-2014, 00:47   #20
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I am hypo unaware so waking up to a nighttime low is scary. Twice I just woke up and checked my blood sugar.

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