Migrated from type 2 to type 1.5 (LADA)

[Trader]

Hello everyone

I’m a newbie to this platform and have recently been migrated from type to to type 1.5.

I am 56, male, 68kg, 179 (5’10”) athletic, cyclist and gym goer.

In Jan 2019 during a medical check the nurse noticed my reading was a little high and confirmed I was pre-type 2.

She offered me metformin, however as an athlete with disciplined eating and exercise habits I advised that I will manage it by diet. The goal was to reverse it. 😎

All was going perfect until, sept 2020 (18 months) with fasting readings 5 - 7.5mmol. My weekly testing started going up... 9, 13, 18, 20! My weight was also rapidly dropping from 72 to 68kg.

Obviously, alarm bells were ringing loudly. My wife sent me packing to the nurse ‍⚕️

She prescribed a GAD antibody test and results confirmed my reading was very high, 2000. Pancreas not doing the full job!

After a catch up with nurse and doctor I have been prescribed 6 units of insulin just before bed.

The insulin results are going in the right direction so far. My daily fasting readings have been 11.8, 14.8 (after pizza night), 4.3, 4.1 (hypos), 13.3, 8.3, 14.4, 10.4

It’s early days, however I want to optimise my diet and insulin use. My goal is to get back to 72kg as that is my ideal weight and continue my normal exercise routines.

I’m curious if there are any nutrition plans available for people with LADA? Been searching the internet and amazon with very little joy.

Thanks for reading this.

 

[Inka]

Hi @Trader 🙂 I’m glad you now have the correct diagnosis. Far too many adults are misdiagnosed as Type 2 when they’re actually Type 1.

It sounds like you’ve only been put on a basal/long-acting insulin. If it was me, I’d ask about a proper basal/bolus routine where you have your basal/long-acting insulin and also a bolus/fast-acting insulin for meals. That meal-time insulin gives you a lot more flexibility and allows you to calculate the right dose for what you’re about to eat, thus keeping your blood sugar in range better and meaning you can eat a normal diet as required.

Your aim is to ‘be your own pancreas’ and to do that you need to learn how to carb count and adjust your own mealtime insulin. That’s not as hard as it sounds.

Then you’ll gradually put the weight back on and feel more yourself. I doubt the basal only will allow you to do that, hence why I say get the bolus insulin too as other Type 1s have. Even if you only need small doses it will help a lot. They make half unit pens.

 

[SB2015]

Welcome to the forum @Trader , from another late starter (diagnosed at 53)

I would echo what @Inka has said about going on to the basal (background) / Bolus (quickacting) regime. The background insulin will deal with the glucose your body dribbles out to keep you ticking over, the Bolus/quick acting deals with the glucose that come from any carbs that you eat. This will give you the flexibility to adjust your mealtime doses to match whatever you choose to eat.

There are a variety of education courses online about calculating carbs and making adjustments. It is worth asking your Practice and if necessary ask for a referral to the specialist team at your local hospital.

With LADA your beta cells are gradually being destroyed by antibodies, so your body will have less and less insulin available from your pancreas and you will have to take over. This is why you went into crisis losing so much weight (I lost a stone and a half in a week at diagnosis) as, in the absence of insulin, your body needed some energy from somewhere and started to use your fat stores. The weight reduction should stop once you have enough insulin.

Glad you have found the forum. I have learnt so much from others on here.
Fire away with any questions that you have. Nothing is considered silly on here.

 

[everydayupsanddowns]

Welcome to the forum @Trader

I agree with @Inka

It’s great that your team are on the ball enough to have diagnosed LADA, but really you should be being treated in a T1 style now (LADA is a variant of T1) with basal:bolus even if your doses are small.

The more you can support your flagging pancreas the better, you don’t want your last remaining beta cells to burn themselves out struggling to cope with your meals 🙂

In terms of an eating plan, T1 or LADA is very flexible. Any healthy balanced diet can be accommodated with the correct insulin doses and dose timings.

A book like ‘Think Like A Pancreas’ might be really helpful

Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin-Completely Revised and Updated: Amazon.co.uk: Scheiner, Gary: 8601419445929: Books

Buy Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin-Completely Revised and Updated 2 by Scheiner, Gary (ISBN: 8601419445929) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders.

www.amazon.co.uk

Former admin and experienced runner @Northerner often recommended the Diabetic Athlete's Handbook too as very useful for explaining how to deal with various types of exercise and explaining the physical processes very well.

 

[Trader]

Hi @Trader 🙂 I’m glad you now have the correct diagnosis. Far too many adults are misdiagnosed as Type 2 when they’re actually Type 1.

It sounds like you’ve only been put on a basal/long-acting insulin. If it was me, I’d ask about a proper basal/bolus routine where you have your basal/long-acting insulin and also a bolus/fast-acting insulin for meals. That meal-time insulin gives you a lot more flexibility and allows you to calculate the right dose for what you’re about to eat, thus keeping your blood sugar in range better and meaning you can eat a normal diet as required.

Your aim is to ‘be your own pancreas’ and to do that you need to learn how to carb count and adjust your own mealtime insulin. That’s not as hard as it sounds.

Then you’ll gradually put the weight back on and feel more yourself. I doubt the basal only will allow you to do that, hence why I say get the bolus insulin too as other Type 1s have. Even if you only need small doses it will help a lot. They make half unit pens.

Thanks @Inka
This is all quite new for me, so I appreciate the insights.

I have a call with the nurse next week, so I will ask her about the bolus. Sounds like a good option for me.

 

[Trader]

Welcome to the forum @Trader , from another late starter (diagnosed at 53)

I would echo what @Inka has said about going on to the basal (background) / Bolus (quickacting) regime. The background insulin will deal with the glucose your body dribbles out to keep you ticking over, the Bolus/quick acting deals with the glucose that come from any carbs that you eat. This will give you the flexibility to adjust your mealtime doses to match whatever you choose to eat.

There are a variety of education courses online about calculating carbs and making adjustments. It is worth asking your Practice and if necessary ask for a referral to the specialist team at your local hospital.

With LADA your beta cells are gradually being destroyed by antibodies, so your body will have less and less insulin available from your pancreas and you will have to take over. This is why you went into crisis losing so much weight (I lost a stone and a half in a week at diagnosis) as, in the absence of insulin, your body needed some energy from somewhere and started to use your fat stores. The weight reduction should stop once you have enough insulin.

Glad you have found the forum. I have learnt so much from others on here.
Fire away with any questions that you have. Nothing is considered silly on here.

Hi @SB2015
Thank you the great insights. It’s great to get understanding on the background insulin and foreground insulin and the roles they play.

Sounds like it’s worth checking about the carbs and adjustments during my call next week. I now she is keen to get an idea of how much insulin my pancreas is actually producing before making many changes.

Great to meet you on this very useful forum. Thanks a lot.

 

[Trader]

Welcome to the forum @Trader

I agree with @Inka

It’s great that your team are on the ball enough to have diagnosed LADA, but really you should be being treated in a T1 style now (LADA is a variant of T1) with basal:bolus even if your doses are small.

The more you can support your flagging pancreas the better, you don’t want your last remaining beta cells to burn themselves out struggling to cope with your meals 🙂

In terms of an eating plan, T1 or LADA is very flexible. Any healthy balanced diet can be accommodated with the correct insulin doses and dose timings.

A book like ‘Think Like A Pancreas’ might be really helpful

Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin-Completely Revised and Updated: Amazon.co.uk: Scheiner, Gary: 8601419445929: Books

Buy Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin-Completely Revised and Updated 2 by Scheiner, Gary (ISBN: 8601419445929) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders.

www.amazon.co.uk

Former admin and experienced runner @Northerner often recommended the Diabetic Athlete's Handbook too as very useful for explaining how to deal with various types of exercise and explaining the physical processes very well.

Wow @everydayupsanddowns so many great insights from the forum already... it feels like Christmas!

Will definitely be discussing with my nurse and try save the pancreas.

Thanks for the book recommendations, i’ll Be checking them out too.

 

[everydayupsanddowns]

Will definitely be discussing with my nurse and try save the pancreas.

Glad to hear the forum has been giving helpful ideas. I’m pretty sure all of our pancreases are mangled beyond repair by the time we get a T1 / LADA diagnosis, but I think there is trial evidence to suggest that more support and better BG management in the first years after diagnosis can be helpful in the long term.

I’m not 100% sure if it’s linked, but I know that the Joslin centre in the US has ‘medalists’ with 50, 60, 70 and more years of T1 under there belts that are still producing small amounts of their own insulin. And I seem to remember that those that do generally have an easier time of things diabetes-wise. My guess would be that it kinda ‘smooths off the edges’.

 

[trophywench]

... and the Joslin Center used to pay all the overheads to host them and their other halves from all over the US every few years and whilst the lucky ones with D were undergoing barrages of tests with the Centre, the other halves were ferried about and royally (wrong word being USA but you get the picture) entertained at attractions in and around Boston, shows at theatres or heaven knows what, all being fed and watered too. Nobody was expected to foot a bill themselves for anything or provide any of their own transport.

We had a regular contributor to DSF (Richard) diagnosed when he was 4, and well into his late 70s when he stopped posting to UK groups. He was one who didn't produce any at all himself.

Extremely interesting to anyone interested though, so I'm grateful to him for being so truthful and informative,