I am thinking about starting on a basal insulin since my fasting BG is creeping up and I also seem to be rebounding during the day. So far I have only used fast acting insulin with meals. Those of you with LADA, were you started on a basal right away, or when did you start? Also, I have heard to stay away from NPH. What are your experiences?

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These discussions are REALLY helpful. I really like hearing what other people do for insulin and diet. I recently started splitting my Lantus dose (6 U PM and 2 U AM) and it seems to be helpful this time. I'm still doing about 8 U Lantus and occasionally I bolus with .5-1 U Humalog if I know I've eaten something that will make me go higher than 140. My new endo gave me Humalog, which seems gentler to me than Novolog was. But I have a pen now for Humalog whereas for Novolog I had these horrible syringes and it seemed harder to be accurate with dosing.

My problem is that I've gained 7 pounds since Christmas! I did up my carb intake a tiny bit and I'm not exercising as vigorously (hard semester). I want to lose weight though. I'll try to post on the main page to find some weight loss strategies with insulin. But what is y'all's experience?

Speaking of experiences with medical professionals...I have studied low-carb diets for years as part of my academic research. I've published on it and I go to conferences with the "big guns" who write all the books about low-carb diets and I read the primary literature on it. It is SO painful for me to be given a nurse practitioner and listen to her lecture me about how awful low-carb eating is and how I should have my diet be 65% carbs and how "if I want that Easter chocolate bunny I should go for it." I can't get any support among the medical professionals who are in charge of me for this way of eating. They keep saying my cholesterol is high (just over the limit for high). But meanwhile my HDLs are great, my triglycerides are great, my blood pressure is great, my HbA1c was the lowest they've ever seen in a diabetic patient....

Maria
No matter how much any one person studies any subject, they can not KNOW IT ALL, published or not.

As for the go for it Easter bunny, its a matter of typical human nature, Almost all diabetics resent not being allowed (or told they should not have) candy. Its also human nature that when a person is denied something, for ANY reason, they are more likely to rebel. Yes adults, aka grow-ups rebel in their own ways, its not just kids you know.

When I first became diabetic it was a lecture how sugars were poison for me, today's approach is so much better these days. There was no room for any "if you want it" on anything, it was do or die from complications. Over the years they have learned that when people are given a little breathing room, they are less likely to feel guilty and stay astray for long periods. There is so much more to managing diabetes than the mechanics of diet and insulin balance.

Just because YOU do well on a low-carb diet, does not mean others do, keep in mind most diabetic patients that PN sees is not a published researcher on anything. You post sounds like you really have invested a lot of time and effort into your research into the subject, and you know how YOUR body handles your choice of diet, but from reading your reply, you are not your average patient in this aspect either. I am kinda odd myself, or so I thought because much of the old methods did not fit my system well, or work well for me, and that has changed as well.

I ask, WHY is it SO painful for you to deal with another person who ALSO has invested in learning to help others? Sounds to me more like two well-meaning intelligent minds knocking heads with little mutual respect.

BTW what kind of great BP & a1c numbers are you getting? My BP is not great even with meds, but my a1c has been running 5.7 to 6.0 now with 5+ shots/day, a far cry from the 8.6 on 2 shots a day.

(*&*( .
Hi Maria....I use the Humapen memoir, which I love, but it does not let me dose in .5 increments. Which pen do you use? What caused you to split your Lantus? I take 8 U's as well, and my #'s are harder to maintain in the evening...will splitting help?

I have been low carbing for a few months (with breaks for Easter candy, etc.) and I have lost weight without dieting. For me, the carb/insulin/fat thing must be true. I always thought a low carb diet sounded fad-ish...not healthy. A lot of knowledgeable people seem to feel otherwise.

One last thought. You have put a lot of time into working out what is best for you. The lack of support you feel is frustrating, but to me, your #'s say it all......Good job.
Hi, I also have a memoir pen, never use it, Px never got the carts in, so used disposeables. Neither offer 0.5u increments, but there is another pen w/o the digital stuff that I hear does. Lantus is not a true flat curve even after it becomes effective. I though I was gonna get away with one basal shot/day when I was told I was being switched from NPH to Lantus...then was hit with SPLIT the dose and its working great for me.Some people are advised to do a slightly uneven split morning/evening. That is to reduce the dawn effect many people have.

Elane, I guess I missed the NUMBERS, msut have been in another reply. Problem with numbers is what might be great numbers for one is not so great for another. My doc considers anything under 7.0 great for me, but I actually do much better..

YOu also said you thought a low carb diet sounded fadish, problem what makes a diet "low carb"? There again what might work for one person can be downright dangerous for someone else. The number of available pigeon holes is limited, the variances among people are infinate and one size does not fit all, not even me.

(*&*(
The Novopen junior lets you dose in 1/2 units. Plus it comes in fun colors! That's why I'm on Novolog rather than Humalog. I don't do less than 2 units as it doesn't seem to absorb consistently, but I do use 21/2 or 31/2 often. I like the flexibility.
Your insurance sounds wonderful.

I'm gearing up more a major effort just to get my insurance to pay for Novolog. The pen is a second battle. I will have to get letters from my doctor to get either, and my doctor isn't shall we say, "proactive" so it's not certain she'll go to bat for me.

Humalog totally didn't work for me. Not sure why, but I'd see highs followed by lows every time I used it. Novolog works perfectly when I inject before the first bite.

I'd LOVE the 1/2 unit pen, but I would be happy with a pen prescription period that doesn't end up costing me a $180 of whatever obscene amount they charge for them now.
Jenny, my doc gave me a coupon for the Memior that cut the price in half....it might not hurt to ask, there might be something floating around the office in the way of a sample, too. Of course, whatever insurance you have will probably cover more of one thing than another, so even with the pen, the required insulin vehicle might not be feasible.

OK....this is basic, I know, but what is the difference between Nova and Humalog? I was switched from the former to the later when I was first diagnosed.
It is truly hard to know....I guess my point for Maria is, she is happy with her A1c, I think it is better than her doc expects, and her gut tells her that her lipids are good, despite what's on the chart that cuts off healthy and otherwise.
Whatever you are doing must be great for you,as well.....despite whatever bar your doc sets. Do you low carb? I am trying it and it is easier for me to maintain a desired BS if I use less insulin. I initially worried that the higher fat and lack of whole grains, beans, etc. is OK. I do eat them, just way less. Right now, I am more concerned with blood sugars. We're all just trying to do the best we can, and it sounds as if both of you have found what works for you.
Maria,

The great thing about diet, is your doctor and his idiot nurse can blab on all they want about how you should be eating all those healthy whole grains, then you can go home and eat what you know is healthy.

Good thing we don't need scripts for meat!

I've been low carbing since the days when doctors were convinced a low carb diet would give people with diabetes heart attacks and kidney failure. My doctors have seen me lose weight and keep it all off. They've sent me for test after test to prove I must have heart disease and so far they all come back normal. After a few years I was told I must have been misdiagnosed, so I went to the lab after eating a single muffin and demonstrated that yes, I am diabetic. My A1cs have all been in the 5% range for 10 years except maybe 3 times when they were still under 6.4%.

Not a single doctor has ever asked me, "What the heck are you doing to get those numbers?." Not one.

Sometimes I wonder what they do to people in medical training to wipe out any curiosity they might have ever had about health.
Perhaps the seeming lack of interest in your success on the part of medical professionals is just a reflection of how utterly confusing this disease can be. I read what you knowledgeable and tenacious people have gone through trying to figure out what works just for you. Those "poor" professionals must be afraid..... these hoards of diabetics and their non-stop whining. To be fair, what works one day, might not the next. BUT you'd think they'd see the low carb/good #'s connection by now!

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