Hello everyone, type 1 LADA here!

[cathshepherd]

Hi all, was first diagnosed with type 2 in summer of 2022 but was eventually confirmed as LADA after a few months. Have recently started with very low doses of insulin and initially had trouble with overnight lows but have reduced the basal dosage to only 1-2 units now and it seems better. Am on the list for a DAFNE course as haven't really got my head around carb measurement and dosing accordingly.
i have had some ups and downs with it all, but trying to stay positive. Fortunately I really enjoy sport so that is a major positive.
Would love to hear any pearls of wisdom x

 

[Tdm]

I'm only on 2 units of basal too! It took me 2 years to get on daphne so what i would say is don't wait for the course, but get carb counting now.

First of all, what basal are you on? Does it keep you flat overnight (though sometimes when you start your graphs are all over the place so its hard to say)
If you want to pop a couple of 24 hr libre graphs we'll see if there are any obvious tweeks.

As for bolus ratios ( how many carbs 1 unit of insulin can deal with) i find that can change depending on time of day and if i'm working or its a weekend (my weekend ratio is 1:18, weekday 1:8) so you may want to work out a ratio for breakfast, dinner, tea, and workdays and weekends...you may find many of these ratios are the same.

Sorry if this sounds more complex that you were expecting, but if you expect a breakfast injection on a workday to deal with the same number of carbs as a evening meal injection at the weekend.

On top of this, excercise will bring blood sugars down, especially if done when bolus insulin is still active....do keep glucose tablets or juice or full sugar drinks handy for if your blood sugar is heading down towards 4

My main tip is, take it one step at a time, it does get easier as you work out how YOUR body reacts.

 

[helli]

Welcome @cathshepherd
Great to read that you now have the correct diagnosis. As @Tdm mentioned it takes time to get your insulin doses correct ... and then they change. Sadly, they do change as you progress through your honeymoon phase and your insulin producing cells continue to die off or, more annoyingly, get a second wind as the injected insulin gives them a bit of a breather. But even at the end of this phase there are things which affect our insulin needs such as exercise. hormones and stress. Therefore, for me, it is important to understand how to adjust my insulin and not expect the same every day for the rest of my life.

You mentioned that you are now on low doses of insulin. Do you have a Libre sensor so you can tracl what is happening overnight and in response to your food, exercise, etc.?

DAFNE can take some time (TDM mentioned 2 years, for me it was 12 years and other people have mentioned there is nothing in their area) so, if you are up for it, there are on line options. The Learning Zone from Diabetes UK (the orange tab at the top of the page) is a gentle introduction and if you want anything deeper, Bertie Online is basically the online version of DAFNE.

And to supplement all the training, there is an amazing hive mind with a combined experience of 100s of years on the forum. Feel free to ask questions about anything. We have all been where you are at some point ... some of us still remember it.

TDM finished his post with his brilliant main tip so I will finish with mine - do not expect perfection. There is too much that can affect our blood sugars and we have a life to live so work out what your good enough is to balance the life you want with diabetes management (not control).

 

[Inka]

Welcome @cathshepherd 🙂 I’m pleased you’ve got the correct diagnosis. What insulins do you take and when? Carb counting is pretty simple so don’t let the ‘Look, people, you need to do a whole course!’ DAFNE thing put you off. It honestly isn’t hard.

Here’s some basic information:

The nuts and bolts of carb counting

When you live with type 1 diabetes, carb counting is a great way of managing your blood sugar or glucose levels. It can give you more freedom and flexibility in what you eat when you're preparing meals at home, grabbing food on the go or eating out. Carb counting does take some time and effort...

www.diabetes.org.uk

And here’s BERTIE:

Bertie Diabetes

Do ask anything you want here. Nothing is ‘silly’.

 

[Tdm]

If you learn by reading, I would recommend a copy of 'think like a pancreas'...it covers all the things you need to consider in managing blood sugars, sorts of insulin, excercise etc etc...
I must admit i skipped some of the calculations...

Excercise was the hardest to deal with for me. Excercising when your bolus insulin has worn off is the easiest at first

My main advice is, only one person can manage your blood sugars - you.
At first i relied on the diabetic nurses and got...well, rubbish results.
I then took on the task, and got my cgm, and everything got better from there on.

 

[cathshepherd]

Thank you so much for your replies everyone. Extremely kind. I’ve got Levemir and Novorapid pens and Freestyle Libre CGMs. Very slowly getting used to things.
That’s very interesting about often needing different ratios on work days and weekends - interested in thoughts on why that would be the case.

 

[helli]

@cathshepherd a quick question /thought: given you are on small doses, do you have half unit pens?
For some reason, these are not given out unless requested but they are brilliant if you need to adjust your dose by percentage when you are on small doses.

 

[cathshepherd]

@cathshepherd a quick question /thought: given you are on small doses, do you have half unit pens?
For some reason, these are not given out unless requested but they are brilliant if you need to adjust your dose by percentage when you are on small doses.

Ah thank you. Yes my nurse did suggest maybe getting those if my issues with overnight lows persisted but fortunately they seem to have stopped for now. Fingers crossed it stays that way

 

[helli]

Ah thank you. Yes my nurse did suggest maybe getting those if my issues with overnight lows persisted but fortunately they seem to have stopped for now. Fingers crossed it stays that way

I still recommend half unit pens. As mentioned, your dose will change. Increasing your night time dose from 2 to 3 units is a 50% change. Being able to increase it to 2.5 units gives you fat more control.
I now use a pump which allows me to adjust my dose by 0.05 units and, as I can be sensitive to insulin, this makes a difference.

 

[Tdm]

Thank you so much for your replies everyone. Extremely kind. I’ve got Levemir and Novorapid pens and Freestyle Libre CGMs. Very slowly getting used to things.
That’s very interesting about often needing different ratios on work days and weekends - interested in thoughts on why that would be the case.

If you are stressed you need more insulin. Also if you are ill, tired, inactive, and for lots of other reasons.
If you excercise or drink alcohol you normally need less insulin.
I find my work fairly stressful, and its sedentary, hence more insulin on workdays.
You may also need more insulin at breakfast to deal with 'the dawn effect' which is where the liver pumps out glucose thinking you need it to hunt the breakfast mammoth, not realising cereal now exists. I find if i don't eat breakfast 1 need a unit or so of insulin to flatten my dawn effect. You may be able to deal with it via your levimir, by giving the morning dose before the evening one has worn off.

 

[gillrogers]

Hi im type 1 lada too. Im on half unit doses too because i only need small dose basal and the ability to have half units with my boluses . Being on such a low dose can be so annoying as you cant always do a 10% or 20% change. Either 25%, 50% which can be too much or too little.

Good luck on your new journey.