I've seen several references to other T1/LADAs who say when they were diagnosed they initially needed only basal, but no bolus. I'm just the opposite. I need small amounts of bolus, but my pancreas is still covering my basal needs. If I skip bolusing for a meal that needs it (e.g., >20g carbs), I'll go up into the 200's, but will come down by the four hour mark (which is why I only skip if it's a low carb meal or I'm going to be exercising after I eat). I'm curious if there are others out there like me. I'd also love to hear from the science minded folks why they think it might be that some folks need only basal, but others need only bolus. I know it may simply come down to the fact that every individual body is different, but I always love hearing the theories you all come up with.
I had noticed from your posts that we seem to be pretty similar. I only take novolog with meals and for bigger snacks and I am very sensitive to insulin. Insulin to carb ratio was 1:60 at first and took a nosedive to 1:20 at the end of November. My pancreas seems to do just fine for my basal needs and even breakfast. Generally I go low after breakfast and have to eat my "second breakfast". I was diagnosed at 46, no positive antibodies fo LADA, tentative MODY diagnosis by my endo, but at my last visit I showed positive for Hasimotos antibodies. I was diagnosed by my A1C of 6.9 because my fasting numbers are always normal. It's nice to see someone else out there who has similar symptoms.
It does sound like our situations are very similar. I was diagnosed a month before I turned 47. An I:C ratio of 1:60? That must have been fun to try and work with. Mine varies from 1:20 to 1:30, depending upon the time of day and the time of month. Even at that ratio, I wish I could do half units with my pen. I can't imagine what a pain 1:60 must have been.
I tested GAD positive and I've been hypothyroid for several years, so it looks like mine is classic T1/LADA. Sounds like yours might be a bit more difficult to pin down.
I'm trying to enjoying the fact that the disease is not yet fullblown in my body, but the challenge for me is feeling like it's just sitting there waiting for me down the road and I don't know when it will come. Sometimes I feel like I'm wishing my fasting numbers would go up so I can just stop waiting for the dreaded basal requirement. I try to stop that feeling as soon as it arises and remind myself to enjoy life the way it is right now.
I use the flex pen jr. you can dose in 1/2 units with it. Makes it a bit easier! I also feel like I'm just waiting for things to go south. Right now I'm waiting for the doctors office to call to set up CGM testing for the lows I've been having during the night (7-8 hours after last dose of Novolog))and in the morning.
Does it start at 1/2 unit or do you have to give a full unit and then have the option of half increments from there? I'm currently using Apidra because it's said to work faster and have a shorter tail. As it is, somethings off today and I'm riding a high -- not pleasant.
Sorry, haven't been online till now. The instuctions said to start at 1 unit but my endo had me taking just .5 for 30 carbs and I was doing that for a good 6 months before things changed and I was getting good consistant control. I have found that if i'm over 150 even at 1.5 hours after a meal I can barely function.. crashed on the couch until its down to the 120s, I hate that feeling!
So your pen does start at .5 -- that's great! I'd seen discussions on here previously that it started at 1.0 and then went up at .5 increments. I'd love to be able to do just .5 with the pen. I, too, hate being over about 150. It's like my body processes carbs very quickly and even with pre-bolusing, I can spike up over 200, but then by 2 hours I'm down to the 120's. I hate even that short amount of time up there.
It "starts" at 1 but it takes 2 clicks to get to 1 so I was just turning 1 click. Got to thinking about this and thought I should clarify!
SM, have you always used Aprida...I keep deliberating whether I want to use that vs. Novolog (especially in a pump). I have to wait so long sometimes, especially if i'm high, to eat with Novolog. Most Endos say they all work the same. So, just wondering if you've ever tried any of the other fast actings to compare to Aprida. did you see Carlson - PC yet?
I've only used Apidra so far and I try to inject at least 10 minutes before meals unless I'm already fairly low. I keep wondering about switching so I could try a .5 unit pen. I've practiced drawing .5 unit from the pen and it just seems really hard to be sure you've actually gotten it correctly. Consequently I've not yet injected that way. The first appointment Carlson had was for the beginning of May so that's when I'll be seeing her.
do you have 1/2 syringes? a 1/2 unit is so small, it's literally like just drops of insulin. but, when we're insulin sensitive, a 1/2 unit can do a lot for us, both in terms of basal, bolus and corrections.
Yes, I have the syringes, which is how I practiced with them. I just haven't been able to trust that the few drops are actually .5 unit. I may try it when I need 1.5 just to get used to doing it.
that's what I give my corrections with, only 1/2 units with the 1/2 marker syringes (it's why they want me on a pump because it's not that percise)..but a 1/2 unit works...it's only drops we need sometimes. I literally use a magnifing glass to do it, OK..I'm OCD about my insulin..ha!