Total daily doses for T1s LADAs and 3cs?

[SweetGuy]

@SweetGuy
Have you done anything to modify your diet as that will have an enormous impact on the amount of insulin you need. Eating less carbohydrates will mean that you need less insulin and will also help with your insulin resistance. If you add in some daily exercise like a brisk walk, that will also help to reduce your insulin needs. Some Type 2s have managed to come off insulin by following a low carb (keto style) diet and it is quite an enjoyable way to eat once you get the hang of it and you rarely feel hungry which makes sticking to it so much easier.
I have to say, I hate injecting my morning Levemir (long acting insulin) because 16 units seems like such a huge amount and sometimes it blebs. I can't imagine what it must be like to have to inject more than twice that! I usually only need 2 meals a day and they are normally less than 5 units each, sometimes just 1 or 2 if I have no real carbs or I have had a very active day.

Thanks for that Rebrascora. Yes I do have repeated goes with the food but I keep falling off the wagon. I am now doing 5 injects a day as I have to split both the morning and evening insulin doses into two instalments. So it's a double treat lol. Luckily never had any bleeding so far.

 

[rebrascora]

Thanks for that Rebrascora. Yes I do have repeated goes with the food but I keep falling off the wagon. I am now doing 5 injects a day as I have to split both the morning and evening insulin doses into two instalments. So it's a double treat lol. Luckily never had any bleeding so far.

The key is to get straight back on the wagon again. If you can stay on the wagon more than you are off eventually staying on will become easier.
I found it really helped to have plenty of low carb snacks for when I was feeling weak willed. Then I would allow myself to binge on the low carb snacks, so whilst not ideal, it kept my BG more stable. There were rather more packets of pork scratchings and chunks of cheese and salami sticks and jars of peanut butter with bars of dark (70%+) chocolate and boiled eggs with mayonnaise consumed than I would have like but it kept me from totally losing control. Once you start hitting the carbs, you get cravings for them for a couple of days afterwards, so it is like starting from scratch again but it you can stick to low carb snacks when you fall off the wagon then you don't get the cravings and getting back on board is so much easier and eventually it is not difficult to stay on the wagon. That has been my experience anyway.
Most people make the mistake of not eating enough fat when they cut the carbs, but fat stops the hunger pangs and provides slow release energy without the BG spikes and it is hard to feel badly done to when you start the day with a coffee made with double cream and end it with a chunk of cheese and a small glass of red wine, both of which are low carb.

 

[Becka]

Liraglutide is probably better known as Victoza.

Glutides are GLP-1 agonists. Because they are quite a new class of medication they are still under patent so are not yet available as generics. This is why they are known by their brand name, inn this case Victoza, but it is also known as Saxenda in other parts of the world.

It also means they are still expensive, so are normally only prescribed when needed in combination with other medications, usually Metformin and a sulfonylurea, often after other medications have failed, and often only with severely overweight patients because they help with weight management. If not overweight and other medications have failed then insulin would usually be preferred. But the exact prescribing will vary by local policies and budgets.

GLP-1 agonists are also known as incretin mimetics as they simulate the effects of that hormone on the body. GLP-1 is an incretin, which are hormones released when you eat. It has the combined effect of stimulating the pancreas into releasing more insulin, the liver into reducing the release of glucogen, and suppressing appetite so you feel full. So essentially it increases the effect of the body's normal response.

In addition to appetite suppression, the medications also leads to some weight loss though the reason is unknown. But Metformin was first discovered a century ago and it still is not known exactly how that works either.

If you can get down to a normal weight than that should be one less injection as you should no longer need to take Victoza. And being a healthy weight should also reduce your insulin requirement too.

 

[Hatton VR6]

Hi, daily dose depends on activity. On a week day I usually have 18 units of Novorapid & 6 of lantus. At the weekend with the dog getting a 4 mile walk after breakfast and salad for lunch and digging garden etc I can drop the Novorapid to 10 to 12 units with a low carb diet.

 

[Schrodinger]

Just looked back at my diary (MySugar) seems I vary from and can inject 19 - 20 most days or up to 30+ when things go a bit wrong, longterm insulin remains at 18.5 and has done for months.

 

[trophywench]

Highish carb day yesterday (spag for tea!) so I had the usual 10.9u basal and also 9.5u bolus - 30g CHO for lunch and 60g for evening meal. Over the last 10 years since getting my first pump originally, basal has reduced from 16-18u down to just under 11u.

Before that time, it was always said that pumping you'd expect to reduce basal by about 30% and so the clinic would usually start you off on at least 25% less.

Bolus is much the same - I still very very rarely eat more than 100g carb in a single day.