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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well, everybody's different. As my CDE says, it' about metabolism, and every one's is different.

My endo was also of the belief that 1 unit was not going to do anything. But when she saw me crashing at night at 2 units, she changed her tune, a bit.

This is one reason I test a lot. I am coming to believe/accept that I am unusual, and I like to keep track of what's going on.

Instead of questioning it as much as I did, I am trying to enjoy my low insulin needs, much like Shawnmarie, for now!

yes...and we all eat differently, weigh different amounts, exercise differently - or not, low carb, or not..it all matters and fits into the 'insulin' equation. I increase my levemir by 1/2 units when I do adjustments, for many 1/2 wouldn't do anything, for me it does. so, i hear ya.

I had a crazy rash, too! You are the first person I heard that had one..thought I was the only one. I am just like you! I was dx 6 months ago and the past month I have been on less than 1 unit of basal a day (on omnipod), and crashing all the time. SO dropped the basal and increase the I:C ratio and it has been great :) Until these past few mornings at 140-160, hopefully high because of my period. We will see...

MeganB! I read that you had a rash! I was so excited! which is weird to be excited about your rash, but I know you know what I mean. I think you should do (insulin wise) whatever you need to keep you safe and healthy. Sounds like your needs are similar to mine.

Bummer you have been high the past mornings. Hope it's just the period. Do what you need to be healthy! good luck!

MeganB, I know this is a dated thread, but I was wondering what you decided to do with the Omnipod. My situation is a lot like yours. I love the fact that on the omnipod it does such fine increments, but I can't turn off all basal, so I was having to temporarily basal to OFF every 12 hours. Is that what you did or did you get off the pod entirely and do pen shots? That beep every hour on the temporary bugged me a lot, but I am undecided on which is best, to do a bunch of temporary basals or to just go off the pod and do shots until I need a basal.

I have been diagnosed for only about 3 weeks. Initially they started me with basal only-- 20 units of lantus a day. This was not having the desired effect, by BG was still off the charts all day. They added novolog with meals, which quickly brought my numbers down. Appearantly I'm in the honeymoon period now, because they have continuously had to reduce my doses of both types, but particularly of the lantus basal dose. Starting tomorrow I'll be down to 4u once a day with the lantus and only a 20:1u ratio on the Novolog with meals. Wondering what would be considered a typical dose for other people my age / size, etc with the Lantus?

It is definitely all different. I have found my insulin to carb ratio is about 1:50. Since I am just using the FlexPen, I just try to eat in quantities of 50. Since we are honeymooning, I do find that if we are off by a little, our pancreases do a good job of compensating for us, or at least mine does. If I knew that I was going to be honeymooning for a few years, I think it would be worth getting some type of "smart" pen, or at least those that deal in half units. I am afraid though, since my insurance approved me for the pump, that it would all come out of my pocket.

One week I say that I am just going to do the pods for the exact dosage, then I get tired of it and say I am going to do the shots. At first it seemed like such a hassle, but after reading about those that have no beta cells left and how even the smallest things like taking a run affects their blood sugar, I just am enjoying everyday that I have a fraction of my pancreas still working, even if it's just for a few more months.

About to get GAD and C-peptide testing done but for the last month I have not needed hardly any insulin. In fact for the last 2 weeks I have not been on any insulin or other Diabetes medications. I am going low without it so when I take it I go even lower. My last A1C was 5.5 and my initial diagnoses was DKA, A1C 16.5, LADA BOOM have a nice day. My BG at the time of my hospital visit was 650 mg/dl. I am sure I will go back on insulin and should probably be taking some small amount to preserve beta cells now but I really can't or I drop out. Great topic as I was wondering if other LADA were as sensitive as I am in this early stage. Almost like I am not Diabetic right now. I eat really careful and I exercise every afternoon when I get home from work. So right now life is OK. hope yours is long lasting and makes your days easy. Have a great weekend.

I'm finding myself to be very sensitive to insulin also-- my A1C was just over 11 when initially diagnosed. Luckily my mom is a doctor so she recognized the signs early when I mentioned things like excessive fatigue and excessive thirst to her and had be get tested.

Since starting insulin and getting my levels back down to normal, I've been requiring less and less insulin. I'm suspecting they may eliminate by basal dose altogether, because I am trending lower than anyone really likes as well.

I understand what it is you speak of, onset was 10.7 BG was 500somethin', now I can go low the next day, just from not eating enough carbs the day of an endurance road ride or Mountain bike race.
I even did a Glucose tolerance test this week, at 1 hour I went from 90 to 234, then back down to 188 at two hours. After the test I went and enjoyed a large breakfast with lots of protein and fat, and just enough carbs to "balance" everything. Within an hour after eating, I was at 58 then 56, then 50. I had to drink a juicy juice just to correct. I am hyper sensitive to my own Insulin, so we have not started exogenous yet. I have Humolog on hand for correction but am afraid to take the first 1/2 unit.

Not sure if this was the right thing to do or not, but I decided to get back on a little insulin once my spikes were greater than 60-80 mg and then they lingered there. This was so easy for me to see since I am fortunate enough to have a CGM, but I would just say to test on the hour, and if your numbers aren't coming down like they should, then you know you will need a little bolus.

I asked the same question that you did. Why take insulin if it makes me go low? I didn't understand how that saved beta cells, because that means obviously the cells are working at the same rate if they bring you down to normal on their own and added insulin makes you go lower. I say (in my non-educated personal experience only, although my endo essentially said the same thing) if you are getting good numbers without insulin, then don't take the insulin. Just play around with small doses. Again, what I did, and it may be the worst way to do it, was not take any insulin for a few days. I saw where my body needed the extra "help" and just supplied it. I'm with you, it's good to know we aren't anomalies!

After talking it over with my PCP (who's the only doctor I've got at this point... live in remote area of Alaska) We've decided to join your club of bolus only no basal. I'm a little apprehensive about making a change when I'm just starting to feel like I'm getting to my stride-- but without snacks between every meal I am going low, and not until after the point at which, in theory, the novolog should be gone-- so we'll see what happens. Will keep in touch on this one as we may be able to compare notes again here

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