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.

Tags: LADA, basal, bolus, honeymoon

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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.

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!

Hi, I was dx in Sept by a rash all over my torso, blurry vision, excessive urination, thirst, and hunger. My A1C was 12 and my BG 400...I was close to DKA. I kept going to the derm for the rash and they couldn't figure out what it was even after a biopsy. I finally chose to get a blood test to see if there was anything going on there and that is when I found out...the rash was actually what saved me from DKA because I didn't recognize the other symptoms until after dx. But hard to miss a dark red lacy rash all over me. Freaked me out. I exercise a lot, so I tend not to need more than .1 unit of basal an hour. I am on the pump, so I suspend my basal a lot, too. I do need to bolus most of the time. But, I also eat plenty of carbs to fuel my workouts.

My eye doctor was the first to suggest diabetes he said "your eyes are fine this is likely diabetes". I am sure glad he knew to suggest I go see my PCP, I would have waited (cause I am a guy) too long before I went to see my doctor.
I was able to see the PCP in time to not have any DKA, my A1C only got to 10.7 and my bg was 500. Within 3 months I was back to 6.0 and 5 months I was down to 5.2. Six months before diagnosis I had a fingerstick at the company wellness appointment and was only slightly high, not enough for them to send me to the doctor.
It took me 11 days to get my first in range(120) fasting bg after diagnosis.

OMG, I had a rash too, I too couldn't figure out what it was, weird rash too on my feet, elbows..I still get weird rashes when my blood sugars go too high, on my legs, calves...we're not sure what it is either..i think it's all blood sugars.

I'm SO glad for you they caught it before you went DKA!

Just thought I would send you an interesting note about me...I have been off my basal for a week now after reading your post. I was having a lot of lows and I was down to .05 basal rate all day and also suspending it a lot too. I was getting depressed because I couldn't finish a workout without going low, gaining weight fro eating tabs and jellybeans all day, and going low just shopping. After reading your post I asked my CDE if I could try only bolus and it has been working like a dream! I have had the best workouts now...never go low and my numbers are good :) I am doing a 1:20 ratio which is working great. So , thanks for posting and giving me the idea :) Hopefully it will last!!!

I use bolus only for now. I'm on a very low dose though because my body is still producing some of it's own insulin. My I:C is 1:40 but soon to change because I'm spiking even with that. I can skip the bolus if I'm eating under 20g of carbs but................it all depends on what I'm eating too. Anything with bread, rice, pasta requires a bolus. Oatmeal, cereal, cream of wheat and bananas are on their way out the door because I spike no matter what with them and am tired of feeling like crap so I'd rather not try to figure out the I:C ratio and just not eat them. I use a Humalog Luxura HD pen and I can dose in 1/2 units, which is nice. I do find it odd how some are on only basal and some are on only bolus..............

Pizza? Trying to remember what that tastes like, hahaha. Doc has me on 45g-60g of carbs for lunch and dinner so I only bolus for that amount. I couldn't eat just one piece of pizza, I'd have to have the breadsticks to go with it! One day I want to be able to sit down and eat carbs to my heart's content without worry of BG spiking............right now, I am just playing it safe I guess. I splurged the other day and ate cake made with splenda. Still had a little spike but I'll know next time to give myself another 1/2 unit and I'll be good.

Dear Shawnmrie,
Thanks for initiating this interesting discussion. I think I would have been like you, requiring only a bolus, not basal. Regrettably, I only became aware of the diabetes after being carbed out on conference food - Carbohydrate Central - all Danish pastry, bagels and fruit, absolutely no green vegetables to be seen - apart from a few leaves of lettuce which disappeared before everyone got through the queue. Without knowing I was LADA (I recognised the symptoms months later), I went on a roller coaster of tons of carbs, and then no time to eat, then another huge dinner, and finally, after my body underwent internal warfare and I ended up in the ICU with a BG of about 1000. Yet my A1C was 7,8. The doctors said they had never seen diabetes develop so suddenly.
Still, they put me on 10 units of Lantus - it sent my blood sugar tumbling into the 30s several nights. They allowed me to lower it, until it was settled down to two units, and still I had low blood sugars in the morning. Sadly, whatever the healthy beta cells I still had were not helped by this treatment and poor advice on diet (ADA - high carb, high target BG). Now I follow the principles of the Bernstein diet, although I eat as much as I like, and fruit when I'm a little low. My insulin needs are relatively low - but mornings I now experience the "dawn phenomenon". However, I rarely have lows (below 60), and do not worry about lows during the night. Good luck preserving the beta cell function you have! I've heard that with the right attention, you can hang on to them forever!

My endo says that I'm an atypical T2. I have some features of LADA--Hashimoto's disease (hypothyroid) and other autoimmune conditions. There are also T1 and T2 diabetics in my family. I had been having regular physicals including blood tests at least once a year, for years. My BG had been perfect all along. Near the end of last summer, I got a yeast infection that I couldn't get rid of. I was also noticing that I was thirsty a lot of the time and sometimes had to get up a couple of times during the night to go to the bathroom. I got a rope burn on my right ankle in August that was slow to heal. My partner is a T2 diabetic. One day in October, I decided that the ankle injury needed to be seen by the doctor. I asked my partner to test my BG just for the heck of it. I nearly fainted when I saw the result was 11.1 an hour after eating a cheese omelete and bacon for breakfast--no carbs! I saw my doctor the next day and had the blood work done. I had been perfectly fine in February, but in mid-October my A1c was 13.1.

I immediately went on a very low-carb diet, bought Dr. Bernstein's book and read the Blood Sugar 101 website several times. I started testing 8-10 times a day and noticed that my BG was coming down but that it would spike after meals and stay elevated for hours.

I'm fortunate that my endocrinologist and I get along beautifully. I'm an information-junkie and he likes to have patients who want to know everything about their own health care needs. We talked about what to do about my post-prandial BG. I was feeling frustrated because, if my BG was elevated, I didn't think I should eat a meal that was only going to send me higher. This was creating problems with my family and in my life, generally. I don't want my diabetes to control everything I do. I was already on Metformin, but had a lot of gastric trouble with the regular version of the medication. The endo put me on the ER version and recommended that I start taking Humalog for meals and corrections, only. He reasoned that, if my PP readings came down, my fasting levels would also drop a bit more. I seem to produce enough insulin for that.

I've been taking insulin since after Christmas. It was quite a big learning curve, calculating ISF, I:C ratios, learning how to cover protein and fat and working out the timing for my shots. I'm still testing about 8-10 times a day but I feel like I have a very good handle on my diabetes, now.

I eat 20-30 grams of carbohydrate, maximum, per day and I take between 12 and 18 units of Humalog. I've lost just over 40 pounds and am still losing about a pound a week. My A1c has dropped from 13.1 in October to 8.8 in December and, yesterday, 5.9, with my fasting BG going from 10 in October to 6.4 in December and 4.7 yesterday. I'm feeling very happy with my progress. I want to lower my A1c a bit more, but I feel confident about how to do it and I'm hopeful that I will achieve the results I want.

Me neither...I eat around 130-150 grams of carbs, so I can have energy : ). So hoping this only bolus will last!

This discussion makes me soooooo relieved! I have been struggling with insulin sensitivity since I started on insulin back in November. I am currently taking 6u Lantus and Novolog 1:25, 1:30, 1:20. Then eating snack under 15 carbs 1-2x daily with no insulin. I've been struggling with high sugars after meals and then having them tank 4 hours later. So Frustrating! But reading everyone else's comments have helped calm me down tremendously and realize that I can do this. Thank You!

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