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.
Are you able to eat meals < 20g of carbs without a bolus? If so, then it seems your pancreas is actually covering at least part of your bolus needs, too. People who are producing no insulin can't eat any amount of carbs without a bolus or their blood sugar goes up. If I ate 15g of carbs without a bolus, my blood sugar would rise significantly (i.e., likely go above 200).
Oh, I definitely understand that my pancreas is still kicking out the insulin and is covering some of my food. If I'm not going to be active, I only skip the bolus when I'm eating about 15g or less. I was just curious why for some honeymooning people the pancreas can cover mainly the meals, but not the basal and for others, it can cover mainly the basal, but not the meals.
I'm no scientist, but I'd guess it might depend on people's basal and bolus requirements. Since not everyone has a 50/50 split, some people take more of their insulin as basal and some take more as bolus. Maybe it's whichever is the lowest that your body is still able to handle without help.
That makes sense. I guess I hadn't really thought about the fact the bolus/basal split for non-honeymooners also differs by individual. It will be interesting to see how things change for me over time. I say "interesting" to encourage myself to see the process scientifically and not as a depressing march toward more insulin.
I didn't start basal until 13 mos. after diagnosis and even no bolus for like 6 mos. although my initial doctor put me on glipizide and metformin but still managed to keep my a1c 7.0 by the time I got my first endo appointment. Few months shy of three year "anniversary" and now only on insulin although have total basal barely over 4 units daily.
I feel like I would have had better overall control, been sub 6.0 a1c since going on the pump, if I had been on insulin from the beginning and may have helped preserve some of the remaining beta function by not taxing them so heavily by using glipizide to increase insulin production. My job was also very active, along with my recreational activities which may have contributed to less insulin requirements initially at diagnosis.
Thanks for the response. Thankfully, the NP who diagnosed me consulted with an Endo right away and I was only in Metformin hell for a few days before they realized I was T1/Lada. I'd be interested to hear how you were diagnosed if you don't mind sharing that information. I was nowhere near DKA. I had a few emotional trauamas in the span of a few months and had been eating lots of carby comfort foods. The constant high BGs lead to corneal edema and the resulting blurry vision is what sent me in to the doc. It sounds like you were caught early as well and I wondered if you were DKA. I know there is no predicting things with this disease, but I can't help looking for other people with stories similar to mine to see what my timeline might look like. As soon as I need to start using basal, I'm going to be pushing for a pump.
I went to an urgent care clinic after my parents visited after my brother had called them after I visited their place and had commented how I had lost over 10 lbs. while at his place, was getting very close to 120 lbs, being 5'10", they thought I might have had an eating disorder and my mom suggested I may have developed diabetes while out for lunch before work.
I had symptoms for over a month, had excessive thirst and urination, blurred vision, weight loss. I was diagnosed with 15 a1c, 499 b.s. basically fasting, waited in clinic for over 5 hours. Never was DKA to my knowledge, had just enough production left that it never set in.
Isn't it amazing the things we'll put up with thinking they're not really anything serious. After I was diagnosed I stopped eating carbs for a few days while I waited for the GAD test results to know whether it looked like T1 or T2. That allowed my BG to get back to normal and I remember the moment the cloud lifted from my body. I realized how awful I'd been feeling for so long. I thought it was just part of getting older. Thankfully, it's not, but now I get to have fun with Diabetes!
I went for months.. kept convincing myself it just had to be the stress I was under.. surely all that PU/PD and weight loss was stress..
I was never in DKA, but had plenty of glucose and ketones on urinalysis in addition to 293 fasting BG and 12.4 A1C..
Could not and still can't believe how much better I felt immediately after starting insulin.
I had no ketones and only trace glucose on urinalysis. Had no idea when I first saw the numbers what a bullet I'd dodged!
Oh and thanks for the headsup on this thread, good reading:) interesting topic.
A year or so prior to the T1D dx I was diagnosed with moderate Sleep Apnea, I thought this was the reason for the miserable way I felt. I like you, felt like a million bucks when my blood sugar got to a "normal range" and I quit taking that miserable Metformin crap. I am now starting to fel like I did back before dx, because of the sugar spikes after meals. I usually get back to feeling good within 2-3 hours but then it is time to eat again. My meals are almost solely raw veggies eggs and meat, no bread no potatoes no rice no pasta and definately no processed sugar added stuff. (it sucks:)