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.

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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.

I didn't even know a rash could be a symptom! When my vision went blurry, I took to the net for research and saw it was a symptom of diabetes. Then a friend with T2 mentioned her vision went blurry when her BG was high. First, I went to the eye doctor and she looked at my corneas and did a refraction, but said it was just part of being in your 40's. I specifically asked her if it could be a symptom of anything and she said no. I had a feeling she was wrong and after my diagnosis I wrote her a letter explaining what had happened and she said my situation caused them to change their office procedure when someone presents with an overnight vision change, which mine was. They now always tell such patients to see an MD as well.

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.

About six months before my diagnosis, a non-fasting blood test ordered by a doc for other purposes showed a BG of 128 and I was supposed to go in for a fasting test. Kept putting it off, but the blurry vision got me very scared. I finally went to the doctor after I bought a meter for myself and tested for a day. My fasting was 190 and I went to 400 after a meal. I was pretty sure something was up!

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!

Thanks everyone for your responses. For some reason, it seems to makes sense to me that the body could cover basal on its own, but need help with meals in the early stages of the disease, but I just wasn't seeing anyone who seemed to have the same situation. I guess I find it comforting to know I'm not alone in my body reacting that way.

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!!!

Thanks for sharing! That is interesting. I'm so glad your pancreas is apparently still fighting the good fight and that no basal is working out for you! I know the few days I was on basal before they figured things out right after my diagnosis I felt awful. I think part of it was that my body was just overloaded with insulin.

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..............

Definitely sounds like there are more of us than I thought. I cut out so many things at the beginning that I'm now doing the opposite of you. I'm figuring out what I can still enjoy during this period because I might have to give it up later. I successfully bolused for pizza a couple weeks ago and found it very exciting!

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.

Bernstein (in his book Diabetes Solutions) talks about some people only needing basal or bolus in the early stages of diabetes.

He is also very optimistic that if blood sugars can be normalised then the situation may remain stable (ie. basal or bolus only) for a very long time or even indefinitely.....

So that's really good news. It is wonderful when things are caught early enough to minimise / prevent progression. :)




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