Lada

[JueB]

I was diagnosed type 2 just under 4 years now after having Covid. Hba1c 118.
I was put on metformin and linoglipton and within 8 months got my hba1c down to around 50 of which it stayed there for a couple of years . It then started to rise over the months and I was suffering weight loss , was then diagnosed as Lada just before Xmas .
I was put on toujeo once a day and to continue with metformin x4 a day .
I have got my fasting levels down to inbetween 5 and 8 from 12 to 15 but after eating they rise to around 15/18 but over time go back down to as low as 4 .
I had a review with the nurse and she seemed surprised and said that I must still be producing insulin for the levels to go back down that low.
Is this normal with Lada ? Was wondering if I’m a type 2 after all !

 

[Robin]

I had a review with the nurse and she seemed surprised and said that I must still be producing insulin for the levels to go back down that low.
Is this normal with Lada ? Was wondering if I’m a type 2 after all !

One of two things could be happening here. Either you ar still in your 'honeymoon period' and are still producing a bit of insulin of your own..not enough, obviously to cope with a meal, but if it’s trickling out, it could be bringing your levels down slowly. The other thing is that your Toujeo dose might be stepping in and helping, especially if, as you say, you come down very gradually. Toujeo is meant to be set at a dose to keep your levels steady in the absence of food, but if you are taking a bit more than that, your levels will gradually fall as the Toujeo mops up any spare glucose.

 

[Inka]

I’m Type 1 @JueB and when I was first diagnosed, I struggled to accept it. I experimented with not taking my insulin and eating a normal breakfast. My blood sugar went up to 13+ but by lunch time had come down to 3.8. I still had Type 1. This was soon after diagnosis and I was still producing some insulin.

Toujeo is a basal/background insulin. It’s not supposed to deal with meals. You might well be better off reducing the Toujeo and adding small amounts of bolus insulin where needed.

 

[helli]

Yes, this it normal for LADA to be producing some of your own insulin.
LADA is Type 1 which is an autoimmune condition. As an adult, it takes some time for all the insulin producing cells to finally die off. For 8 years after my diagnosis, my injected insulin dose slowly rose before it stabilised. I am pretty confident this is because I was producing less and less of my own insulin over that period...but still producing some.
However, you are injecting Toujeo and, I assume, not adjusting your dose. So, it is possible that this is more than covering your needs. For example, I need less insulin when I exercise or drink alcohol. And that is without considering the insulin for my meals.

 

[Inka]

@JueB Toujeo is an ‘unusual’ insulin to be started on. It’s usually used for insulin resistance. So maybe that’s having an effect too?