Hello everyone! I am a 26 year old active and seemingly healthy woman who was recently diagnosed (about 2 months ago) as a LADA Type 1. My numbers were in the upper 200's, low 300's on average and had an A1C of 9.2 upon diagnosis (up from 6.1 only 10 months prior). I have been on 7 units of Lantus a day and Humalog 2-4 units per meal. Since starting insulin, my sugar levels have come way down and I feel a lot better (more energy, not so thirsty all the time, etc). I have also gained back a few of the pounds I lost - I was told this is normal? Partially due to rehydrating my body? Has anyone else recently been diagnosed with Type 1 or LADA, started insulin and gained weight? Does it taper off eventually? Also, I have caught myself being scared to eat many carbs. I have been limiting myself to around 30 per meal because I am so afraid of spiking my sugar. I know this is not good and I met with a nutritionist last week who told me I should be eating around 150 carbs a day. Can anyone share their experience with carbs when they were new to this?
Welcome to TuD. Nutritionists are fond of pushing carbs on people. The less carbs you eat the easier to manage your blood sugar, so eat what you're comfortable with. But one thing I want to suggest: You say you take "Humalong 2-4 units per meal". That sounds like some sort of sliding scale? That's an outdated way of dosing insulin and doesn't work too well. The idea is to dose for the carbs you are eating. So you need more insulin for a plate of pasta then you do a salad! The way to do this is by figuring out your Insulin to Carb ratio (I:C). That is, one unit of insulin to cover how many carbs. Most of us have different ones for different meals. Mine is 1:5 breakfast, 1:10 lunch and 1:16 dinner. So for breakfast I take one unit for every 5 carbs I eat (I eat less carbs for breakfast). The way to figure this out is by trial and error, starting cautiously and seeing how your blood sugar is two hours after eating. A good book that talks about all you need to know is Using Insulin by John Walsh.
So once you know your I:C you won't have to be scared of carbs. And yes, a bit of weight gain is normal, your body was burning fat and very unhealthy before and now it's returning to healthy; it should level off shortly.
Right now my I:C ratio is 1 unit for every 15 carbs, so depending on the number of carbs I am eating, I take between 2 and 4 units of Humalog at meals. I think we meant the same thing, but thank you for clarifying and for the additional advice! I really appreciate it. Good to know that nutritionists are carb pushers.. I thought she was nuts for telling me to eat that many.. :)
Oh good; glad you have an I:C ratio. I see what you mean that it comes out to between 2 and 4 depending on what you're eating. My suggestion is to keep testing at the 2 hour mark and see how it is working. If you end up high a lot then try going down to 1:14 for a couple days if low go up to 1:16 and just keep working at it until you end up in range most of the time. 1:15 is a standard starting point for an I:C ratio but then you have to test from there to see what works for you as we're all different. Most of us find we have different ratios at different times a day.
Yes, not all, but many nutritionists and CDE's are negative about low carb eating or just ignorant about it imho. I have a friend who is RN and I have trusted her extensive medical knowledge for years. When I mentioned low carb, she said "for diabetes? I've only heard of that for weight loss". Well, yes, of course for diabetes! I'm not a strict Bernstein follower by any means but his "law of small numbers" makes sense to me. The more carbs you eat, the more insulin you need, the less predictable the results.
As Zoe said eat the carbs that you're comfortable with but remember carbs are energy. Carbs are important if you live a very active life that's why she probably told you how many carbs to eat, especially if she's aware of your life style.
Very true. Thank you!
The key to stable blood sugars is to match the insulin you take to the carbohydrates you eat. Some people find it very helpful to minimize the number of carbs to prevent large dosing errors and to minimize post meal spikes. I tend to do best if I eat between 45 and 75 carbs per meal. Dosing is an art and a science and you'll eventually find your own way. If you are currently using a fixed dose of insulin per meal, you should be eating about the same number of carbs each meal. If you're doing OK with 30g of carbs don't just increase the number to 50g without adjusting your insulin or you will go very high. You can have a healthy and balanced diet while eating low carb.
Your medical team may be starting you out with a simple system until you get the hang of testing and using insulin but you eventually will move on to carb counting and using ratios. If you're up to it now, you might ask your nutritionist or CDE to teach you about carb counting or you can get "Think Like a Pancreas" by Gary Scheiner or "Using Insulin" by John Walsh to learn what you need to know by yourself.
Thank you for those recommendations, I will definitely look into both. I've been carb counting for a few months now, but still have a lot to learn.
I think Dr. Richard Bernstien's latest book is worth taking a look at. The reason I say that is it sounds like your pancreas may still be producing a certain quantity of insulin, thus the LADA diagnosis. He believes that you can preserve and maybe even enhance your current functioning--not a cure but a preservation of some of your pancreatic functioning. His book explains how high carb diets burn out the last of a diabetics functioning islets. If you want a lot of good information on research regarding low carb diets, read Gary Taubes books. Long story short, the tighter you can control your blood glucose (reduction of spiking/dipping) to that of an average healthy adult, you may be able to avoid long-term diabetes related complications.
I ordered Dr. Bernstein's book this morning, thank you for the recommendation. It seems to make sense to me.. lower number of carbs, lower units of insulin. May be able to avoid long-term diabetes related complications? Not will be able to? :(
In answer to your questions, "May be able to avoid long-term diabetes related complications? Not will be able to?" I am a clinical psychologist and I have the habit of speaking like one. Nothing is for certain in research, so we tend to speak in terms of probabilities. And yes, I think it is highly probable that you if manage you blood glucose levels well, that you will not have diabetes related complications. On the other hand, managing BG levels well depends on the individual. My 10 year-old Type 1 diabetic son is not bothered by the Bernstein diet at all. I think that being diagnosed at a young age, he didn't develop the same neurological addiction to "bad" carbs. It was actually a relatively easy transition for him. So, he is able to maintain fairly tight BG levels and good A1Cs as a result.
Hey good for you on having your son on a low(er) carb diet. Seems like so many parents feel it is punishment to deprive their children of "goodies" and they are not, imho, doing the kids any favors by helping them develop bad habits they'll have to fight later. Come to think of it, it's sort of like the attitude the medical profession has to adults with "D": Don't expect too much of them and let them know they can eat whatever they want and cover it with insulin. (Then send them to another doctor when they gain weight and develop IR?). Ok, I'm being a bit cynical today. I've been stuck in the house for 10 days!
Since my diagnosis, I have dramatically changed my diet and overall lifestyle. I had always been able to eat anything I wanted and not gain an ounce, so it was a little ironic that I developed Type 1 Diabetes and now have to watch every little morsel of food I put in my mouth. I have probably consumed more lean protein, veggies and fruit in the last 2 months than I have the last 2 years. As a result of the changes in my diet combined with starting insulin injections, I received news from my endo this morning that my A1C has dropped from 9.2 to 7.9 in 8 weeks. I know that's still far from where I need to be, but it made me feel hopeful and recharged about getting there.