Hi and welcome from me too.
If you followed a low carb way of eating before diagnosis and you are comfortable continuing with that and it works for you in other ways, then it is just a question of learning how to use your insulin to make it work for you again and no, you should not have to go out for a trek after every meal, but learning how to dose for it and when to reduce the dose to account for intended exercise (many people here cut their calculated bolus by 50% before exercise, as oppose to doing compulsory exercise each time you eat to bring levels down.
I follow a low carb way of eating but I just jab more insulin after my meal to deal with any protein release which usually starts to happen about 2 hours after a meal. It means more injections but I actually find it easier to manage rather than harder as most people suggest, particularly now we have CGM like Libre, because I just keep an eye on my levels after a meal and if they start to drift upwards I inject a bit more insulin. Generally, I inject some before the meal for the few carbs I eat and then some 2-3 hours later when the protein starts to take effect. I don't weight or calculate carbs or protein, I just guestimate what I will need and being low carb, I can't be more than half a unit out.
Question.... Do you have a half unit pen for your NovoRapid? And a half unit pen for your Lantus for that matter? With small doses, having the ability to fine tune is really important.
I too wonder if your Lantus may be covering some of your protein release. Equally, you may just be walking the protein release off or a combination of both.
The key with being an insulin dependent diabatic is to learn to make your insulin work for you and not be frightened of it. You have to factor in a lot of things as there are something like 42 factors which impact your insulin needs and whilst food and exercise and medication are the 3 big hitters, there are lots of other factors like hormones and ambient temperature and illness and stress and sleep etc. which play a part, sometimes quite significantly.... hormones particularly can make things challenging.
Something else to consider is the insulin that you are using. Different insulins have different profiles and so one particular insulin might suit you better than another or even taking it at a different time can make a difference.
For instance, your Lantus..... When do you take it? Lantus generally lasts just under 24 hours and has a peak of activity about 5 hours after injecting. It can be injected as a single dose or split into 2 doses to achieve the best coverage for an individual and the time you take those doses can be relevant and the doses don't have to be an even split. I take Levemir which is similar but specifically designed to be split into two doses and is generally considered to be the most flexible basal. I can change my doses on a day by day basis to help manage the days when I do more or less exercise or more specifically the nights after I do more exercise as that is when I have problems with hypos. I need a lot of Levemir in the morning at 18-24 units but just a small amount in the evening of up to 5 units but often none at all. Being able to adjust my basal according to what experience tells me I need is extremely important for me and I abolutely love Levemir for this. Other basal insulins like Tresiba are very, very long acting (about 36 hours) and give a very flat profile with each dose every day topping up the previous dose. This works well for people who have a more uniform basal insulin requirement (ie about the same day and night) and not much variability. If you are female, then Tresiba may make things more challenging at different times of the month too as it needs about 3 days for any changes to become effective.
Bolus insulins also have different profiles although a little less variation. I started on NovoRapid, but changed to Fiasp which has a faster action but shorter duration. The changeover wasn't easy and it took e 2 x 3 month trials to learn how to make it work for me but it was worth the change. Another member recently changed to Lyumjev (another faster acting insulin) after many many years of using Humalog. The change was forced because she could not obtain Humalog and she was really unhappy and worried about changing, but she finds the Lyumjev absolutely wonderful and her diabetes management has improved enormously just from that one change and she has many many years of experience. So these things can all make a significant difference.
I learned about all this stuff here on the forum, so I am pleased that you have come here as I am confident that you can pick up some really useful info too, but diabetes is very individual and carefully experimenting on yourself is the key to good diabetes management and learning how to use your insulin or try new insulins to suit your lifestyle and tastes and routine. It takes time and trial and in some cases error, but worth it when things start to become more manageable.
You mention that you take a long time to recover from hypos when you have them. Are you relying on a CGM like Libre or are you finger pricking to check your recovery? Libre will typically take much longer to show your levels coming back up after a hypo which is why we are advised to finger prick 15 mins after taking a hypo treatment to check recovery. Also, what are you using to treat hypos? Hopefully fast acting carbs, but are you aware that solid hypo treatments like jelly babies or glucose tabs are best chewed really well as the glucose absorbs quicker through the cells inside your mouth than in your stomach, plus your mouth is closer to your brain, and if you are taking hypo treatments after a meal, if you swallow it quickly, it can sit on top of the food that is digesting and delay it further, so chewing really well and giving it the chance to absorb through your mouth is a better option, but don't rely on a sensor to assess recovery and don't rely on how you feel to assess recovery. I find that hypos themselves are not difficult to deal with but the adrenaline release if I go too low, gives me horrid shakes and sweating and heart pounding even when my BG has come back up, so if went by my CGM or the way I felt I would almost certainly overtreat hypos every time, whereas doing a finger prick test will help you to manage it much better.
Also, what do you have your low alarm set at? Most of us have it set above 4 to give us the opportunity to prevent hypos. Mine is 4.5, but there are many people here who set it higher at 5 or even 5.6. Again it is important to find what works for you as an individual. I tried higher but had more hypos because I ignored it and it didn't go off again once I was below that level. On a low carb diet using Fiasp, my high alarm is set at 9.2 and that generally gives me time to prevent going above 10. This level would likely not work for anyone on a normal diet, where they might be tempted to inject more insulin when the alarm went off, but for me, it usually tells me that the protein is releasing and I need to hit it with some more Fiasp.
The key thing with diabetes is to only change one thing at once and leave it for a few days to see how that change works out. If it is better, then adopt it, if worse, go back to the drawing board and try something else and make small changes and look for trends in the direction you want to go.
Also wanted to mention that timing of bolus insulin is as important as the dose. If you are using insulin and then significantly spiking after meals, the chances are that you didn't take your insulin far enough ahead of the meal. Slowly increasing the prebolus timing by a few minutes each day will help the spike to come down and you need to find the timing that works well for you, for that time of day and in some cases that meal. I needed as much as 75 mins before eating breakfast with Novo(not so)Rapid to prevent me spiking up to 15mmols every morning even on a low carb diet, but only 20-30 mins at other times of the day. I should say that 75 mins is really extreme and most people would hypo in that time scale, but you have to slowly and carefully experiment to find the timing that works for you.
Just wondering if you are seeing rises after meals and then panicking and heading out for a walk to bring them back down and then of course hypoing because you didn't factor in the exercise, when just adjusting when you inject the insulin would sort the problem, with no need for the walk, but if you wanted to walk then you would also need to reduce the bolus.
This may all seem incredibly complicated especially when you are newly diagnosed, but slowly you can learn these different tricks and techniques to enable you to use your insulin to mostly balance things. We all get it wrong from time to time though so hypos still happen occasionally and sometimes we get a whopper of a spike, but you learn to accept that is part of the challenge.
I remember the time I went to the cinema after a meal with my friend a few years ago. I ate low carb and bolussed accordingly, but sitting in the cinema afterwards and watching a very intense movie which caused me to be very anxious resulted in my levels shooting up to 17mmols.and needing masses of insulin corrections to bring it down. (Combination of not bolussing far enough in advance for the meal, sitting very still afterwards and the stress caused by the film being very tense)
AS regards your diagnosis, I think it is most likely Type 1 rather than Type 3 because your antibody tests were positive and you have other autoimmune conditions and perhaps triggered by the trauma of the surgery or perhaps the steroids put your beta cells under pressure and that triggered your immune system to attack them. Knowing which antibody tests were done may help resolve it in your own mind, but either way, the important thing is to learn how to make your insulin work for you rather than adapting your lifestyle to reduce your need for it. You may not always be in a position to walk afterwards, so you really need to find strategies with your insulin which manage it, just like your pancreas did before it lost that ability.
