LADA 1.5

[billyblue]

Hi All,
I am 40 years old and i have been wrongly diagnosed with type 2 since the last 5 years till my new DR discovered that I have LADA and was taking the wrong medications all this time, the first couple of years were fine on metformin but things started getting bad.
Now i am on insulin Novo rapid before meals and Levemir once a day at bedtime since last month, i can say things are getting better so far.
question for people using insulin since I'm new to it, can I take insulin anytime my sugar levels are high (giving 4 hours between shots)?
anyone with LADA?
thanks

 

[TheClockworkDodo]

can I take insulin anytime my sugar levels are high (giving 4 hours between shots)?

The short answer to that is yes, though do err on the side of caution because it's better to be a bit too high than to be a bit too low. Do you know how much each unit of insulin should reduce your blood sugar? - and has your doctor referred you to a diabetes specialist nurse (ie a hospital nurse who is a proper diabetes specialist, not a surgery nurse who knows a bit about it)? If not, I would ask if you can be referred to one, because a DSN will be able to talk you through things like that, and make sure you use the right correction doses.

There are quite a few people with LADA here, but effectively it's type 1 so most things which apply to type 1 will apply to you - it's just taking your pancreas a bit longer to stop producing its own insulin than it did those who had the more sudden onset of type 1.

 

[TheClockworkDodo]

PS the first bit of my reply refers only to the Novorapid, not the Levemir - just realised you didn't specify and nor did I!

 

[billyblue]

PS the first bit of my reply refers only to the Novorapid, not the Levemir - just realised you didn't specify and nor did I!

Yes it is NOVOrapid

thank you so much for your advice, ill make sure to ask for Diabetes specialist to guide me through

regards

 

[everydayupsanddowns]

Hello @billyblue

Welcome to the forum. Sounds like you’ve had quite a ride so far, but you aren’t the first member to have been reclassified to LADA after some years... and I’m sure you won’t be the last!

To correct high BG you technically *can* add insulin at any point, but it is often suggested to wait until the next meal (as you suggest approx 4 hours apart) and add the correction amount to the insulin needed for carbs at that point. There are a couple of reasons for this...

One is that it ensures the previous dose has done almost all of its work (NR works for up to 6hrs in some people, but by 4hrs most of the dose is done), so that you actually know what the insulin shortfall is. Sometimes a dose can look hopelessly short at 1-2hrs, but will have more or less caught up by 4hrs. In which case it’s the dose timing/speed of food rather than the dose itself.

Another reason is that insulin doses ‘stacked’ one on top of another can have slightly unpredictable results as their two activity curves of onset-peak-fade overlap and interreact in slightly mind-boggling fashions. You might end up with seemingly nothing happening, then a sudden dangerous crash later.

As Juliet says it’s best to get advice from your HCPs really.

 

[billyblue]

Hello @billyblue

Welcome to the forum. Sounds like you’ve had quite a ride so far, but you aren’t the first member to have been reclassified to LADA after some years... and I’m sure you won’t be the last!

To correct high BG you technically *can* add insulin at any point, but it is often suggested to wait until the next meal (as you suggest approx 4 hours apart) and add the correction amount to the insulin needed for carbs at that point. There are a couple of reasons for this...

One is that it ensures the previous dose has done almost all of its work (NR works for up to 6hrs in some people, but by 4hrs most of the dose is done), so that you actually know what the insulin shortfall is. Sometimes a dose can look hopelessly short at 1-2hrs, but will have more or less caught up by 4hrs. In which case it’s the dose timing/speed of food rather than the dose itself.

Another reason is that insulin doses ‘stacked’ one on top of another can have slightly unpredictable results as their two activity curves of onset-peak-fade overlap and interreact in slightly mind-boggling fashions. You might end up with seemingly nothing happening, then a sudden dangerous crash later.

As Juliet says it’s best to get advice from your HCPs really.

Thank you @everydayupsanddowns much appreciated
I have another question:
Since I am new to insulin, what's the normal reading range after 2 hours from having a meal, I know it should be 140 below is it the same when taking insulin?

Regards
Billy

 

[mikeyB]

140? Don’t recognise that. Only know figures in mmol/litre. Whatever, the figures you knew you should be after a meal are the same as T2, LADA, T1, 3c, or normal human being. 140 or less is fine.

Incidentally, LADA is just a descriptive term, T1 is the diagnostic term for what you have. ‘LADA’ is just a fancy excuse for not getting the diagnosis right in the first place, but a reasonable shorthand for how you got here🙂

 

[MikeyBikey]

Are you in the US billyblue? The BG you quoted was superceded in the UK decades ago. In new money 140 equates to ~7, which is fine.

A friend was diagnosed Type II because of age despite being slim. He struggled for months on increasing doses of Metformin before the diagnosis was changed to Type 1.5. On insulin now and absolutely fine.

 

[billyblue]

y

Are you in the US billyblue? The BG you quoted was superseded in the UK decades ago. In new money 140 equates to ~7, which is fine.

A friend was diagnosed with Type II because of age despite being slim. He struggled for months on increasing doses of Metformin before the diagnosis was changed to Type 1.5. On insulin now and absolutely fine.

Hi @MikeyBikey,
Yes in the US, I mean 140 mg/dL (7.8 mmol/L) sorry for that.
I was 86 KG (fit and muscles built guy since I am a fitness instructor) in 2016 when my Dr discovered I have type 2 diabetes, started losing weight since till I was stable at 75kg for 3 years.
This year for about 4 months I did a detox (liver and others...) and stopped eating meat & 0 carbs trying to see how my sugar levels will be, my weight went down to 67kg, looked healthier but my sugar levels were always high, I was on metformin pills since 2016 till My NEW DR did the entire antibodies blood tests and all, he found out that I have LADA, Now I am on insulin since last month, levels are fine and started gaining weight, gained almost 4kg since last month and apparently I look happier 🙂 well that's what my friends are telling me,
Should I blame my first DR who didn't do his job properly and ask for the right blood tests? i think Drs should always ask for specific blood tests to determine right diabetes in order to subscribe the right medications

 

[mikeyB]

Couldn’t agree more, @billyblue, having experienced the same thing, along with quite a few folk on the forum.

 

[MikeyBikey]

y


Hi @MikeyBikey,
Yes in the US, I mean 140 mg/dL (7.8 mmol/L) sorry for that.
I was 86 KG (fit and muscles built guy since I am a fitness instructor) in 2016 when my Dr discovered I have type 2 diabetes, started losing weight since till I was stable at 75kg for 3 years.
This year for about 4 months I did a detox (liver and others...) and stopped eating meat & 0 carbs trying to see how my sugar levels will be, my weight went down to 67kg, looked healthier but my sugar levels were always high, I was on metformin pills since 2016 till My NEW DR did the entire antibodies blood tests and all, he found out that I have LADA, Now I am on insulin since last month, levels are fine and started gaining weight, gained almost 4kg since last month and apparently I look happier 🙂 well that's what my friends are telling me,
Should I blame my first DR who didn't do his job properly and ask for the right blood tests? i think Drs should always ask for specific blood tests to determine right diabetes in order to subscribe the right medications

It is a tricky one as for some reason most GPs and many consultants do not seem aware of it. If someone is not obese and middle aged then I feel Type 1.5 should be checked for. Approximately 10 - 20% diagnosed Type II are not but there has to be a fundamental change in approach. I would write politely to the doctor that made the wrong diagnosis. It is not helped by internet trolls posting things like "LADA is a convenient label for Type IIs who cannot stick to their diet". There are some some total idiots out there! Sounds like you are doing good!