I have been diagnosed as a LADA diabetic for 7 months now and so far I have gotten by with eating a low carb diet, exercise and small amounts of Bolus insulin if I have more than 15 g carbs in a meal..
That worked great until recently, for a while now my fasting BG has crept up to what is now averaging around 115-125, I also noticed that during the day in between meals I find it hard to ever go under 100. (But then I DO see the occasional 75 too! But I used to be around 80 regularly before I ate again)
I have to admit I am a little anxious of taking that jump to having exogenous insulin in my system ALL the time, especially since I still have phases where my pancreas seems to suddenly decide to go back to work.
Because I m a photographer my daily activity level greatly varies, sometimes I run around all day on a shoot, sometimes I sit in front of my computer all day long, not moving at all.
That is why I was/am quite scared of experiencing lows/hypos frequently as soon as I go on basal.
I m worried I will have to check my BG all the time, and being forced to snack between meals not to go low.
Can anybody (esp. any LADAs maybe with some function left) share some experiences of first getting into basal and avoiding lows?
Maybe split the dose?
How about starting on a very low dose before bedtime, say 2 Units, would that do anything?
Should I do some nighttime testing the first few nights, at 4am, 6 am etc?
And is it possible that I d have to rethink my bolus (IC ratio) if I have basal on board too?
And finally, how much does my basal effect extra physical exercise - would I have to make sure to "start high" when going running, to avoid lows?
Of course I will discuss all this with my endo at my next appointment, but I ve noticed the tips I m getting from here are usually more diverse and helpful ;)
thank you, that is great advice! I m just wondering, how do you manage to keep such tight control? When you say you try to stay round 80 all the time – do you actually mean ALL the time, including your postprandial number? I ve tried so many different things (injecting earlier, eating only foods with low glycemic index, eating very low carb, exercising after eating...) but I do not manage to avoid a spike from my food, even though it might mean "only 120".
I ve come to think that thats just how it is with me, that there is just no way my injected insulin can be so fast that I stay level the whole time...So as long as I am back at target 4 hours after eating and my spike wasnt over 130, I accept it...but maybe I m too relaxed there?
Hi. I do actually manage to keep really tight control when I am eating low carb and using insulin as I have learned works (I do have some food issues, which blow things now and then - but have also learned to adjust for this mostly). I am happy if my highest spike is less than 100. And even better if its in the 80s.
I find that humalog has a much better chance of covering things well if I eat low carb. I do recommend reading Bernstein. He was my inspiration.
I don't eat the smae thing every day, but I do try to be consistent with how much protein and carbs. FOr me some veges are pretty much free (ie. the low carb, green and nonstarchy ones). Exercise has a big impact on fasting levels the next day. am just getting back into triathlon and beginning to find just how big that impact is.
You may find that adding in basal (do basal testing to determine your rates) really changes how you can manage, including the type of blood sugars your bolus gets you. (I think the basal really helps even things out).
In LADA we really do have a great window of time when it is relatively easy to get excellent numbers.
Please let us know how you go.