woes of pill usage in LADA (rant)

[Ohana]

Ok.

Here's the thing.

My days are SO FREAKIN varied that my prescription to take 1 prandin (insulin stimulant) pill at every eating session (I may have fractured my foot a couple of weeks ago, so forgive me for not getting up to check the mg dose) sometimes works, but rarely anymore. The 2 pill dose I used to take with only >50 carbs I now take all the time regardless of carbs, and SOME days it isn't enough, and other days like today, I hit the 50's without realizing it two hours after lunch. ARRGGGHHH.

If it is SO varied that I can eat the same thing 2 days and get 98 two hour PP one day and
171 two hour PP the next.....

WHAT IS THE POINT??????????:mad:

[lorilei]

sorry ohana..thus is the fun life of the lada-er..my advice is don' t give it a real long time before you track all your numbers and call your doctor

[Ategeler]

I get so confused when I hear LADA people talk about taking insulin stimulants. I thought that injecting insulin was better since there isn't enough insulin to begin with. That way you don't make your pancreas work any harder than it has to.

My doctor didn't want me to take pills but I know that a lot of people do. Did you doctor explain why a pill is better?

Not judging in anyway! Just curious. Learning more and more all the time...

[mortis505]

Sorry to hear about the rough patch Ohana. Hopefully you can get things worked out soon. Do you want to go on insulin, or are you trying to keep control with just pills for now?

[Therese]

Hi Ohana
I'm new to the forum so forgive me if i don't know much about where you are at. How come they have'nt diagnosed your type yet? With LADA the aim of going on insulin in the early stages is to rest your Beta cells thus not allowing them to work as hard therefore they can produce insulin for a much longer period of time. With it you retain C-peptide which your body needs. Can't remember why though but thats the general concensus that I know of. Can anyone remember why we need the c-peptide?
Good luck
Therese

[lorilei]

yes therese..there is a whole thread on this i think...cpeptide seems to correlate to improved vascular issues, less complications and some other potential benefits...plus the option of having a pancreas that has some function should be able to help in an emergency situation, to some degree, compared to some one with no function at all...these days it is beleived that most type 1's have some residual function left even if it is minute...

[lorilei]

here is the info lifted from a previous post of mine..

Re; c peptide: "perturbations in this networking of functional and structural proteins translate into a variety of structural abnormalities such as axonal degeneration, degradation of physiologic compartmentalizing barrier systems, impaired regeneration and aberrations in C-fiber integrity. These abnormalities will eventually translate into both positive symptoms such as pain, a common and debilitating symptom in diabetic subjects, and negative symptoms such as loss of sensation, erectile dysfunction and impaired cardiac function.

Clinical investigations have demonstrated that C-peptide has beneficial effects on blood flow in several capillary beds in skin, muscle and forearm [3, 11-13, 15, 16]. It has beneficial effects on glomerular filtration rates and micro-albuminuria in patients with incipient nephropathy [7]. In the retina it protects against vascular permeability. In diabetic neuropathy it improves sensory nerve conduction velocity, thermal and vibratory perceptions as well as heart rate variability [18]. These effects were achieved in addition to the effects provided by tight hyperglycemic control. They suggest that optimal hyperglycemic control with insulin alone is not sufficient to optimize the protection against microvascular complications. "

Per the website forwarded by Xmenace..
Will C-Peptide Substitution Make a Difference in Combating Complications in Insulin-Deficient Diabetes?

Hmm...more food for thought...

[BlueSky]

.... it is SO varied that I can eat the same thing 2 days and get 98 two hour PP one day and
171 two hour PP the next....
It sounds like the ability of the beta cells to produce extra insulin changes from one day to the next. This is not unusual with LADA, and is one of the reasons why injecting the required extra insulin works better. Injecting at meal times means that the beta cells are rested, and because they are able to provide a more consistent supply of insulin, blood glucose is more stable.

[Ohana]

Hey everyone. First, thanks for letting me rant.

I understand the principle of pills vs shots. I guess I got spoiled because I used insulin first thing and it worked very well even at super low doses.

I am not sure WHY we switched other than 2 very simple reasons
1) With having negative antibodies so far, there IS a chance the pills could have worked wonders and that would lead to further clues as to a type diagnosis, if they didn't work that would also indicate type...

***(although I haven't figured out what the advantage is of making an overworked type 2 pancreas produce more insulin with pills vs. injecting insulin- anyone know?)*** and

2) if pills did work for me I would then have the required info to choose which method I liked better.

I am going back to the Dr. in 2 weeks. I am going to keep up with the Prandin till then, but when I go back assuming things are still not working well, I am going to politely insist on returning to the Humalog that is happily waiting in my fridge!

I am really tired, So sorry if this post doesn't make sense in the morning! Night :)

[mortis505]

I might also consider asking the doctor for a new C-peptide level, If its decreased, then this would indicate less insulin production.

[soso]

correct me if I am wrong, but I thought Prandin was a drug which delayed the metabolism of carbs until they were further down the intestinal tract, thereby reducing the amount of glucose which reaches the bloodstream (or just slowing it down?) as far as I know it does not stimulate the pancreas... (like sulfanylureas) This is why Prandin has an unfortunate side effect of excessive gas production..
My take and experience of LADA, is that the pancreas builds up a bit of insulin production, then we push things a bit and all our 'nest egg' is spent.. meaning we have a good day bg wise.. then the next day we do the same thing and there is no emergency fund anymore and we can't produce enough insulin to deal with the meal we seemed to cope with well the day before.. My good days are often followed by a crappy day till I catch on and readjust..
C-pep is also thought to provide some protection from Colon cancer..I am sure they are going to discover it is indispensable and start giving it as a supplement—so I am going to hang on to any I have as long as possible!

[lilituc]

correct me if I am wrong, but I thought Prandin was a drug which delayed the metabolism of carbs until they were further down the intestinal tract, thereby reducing the amount of glucose which reaches the bloodstream (or just slowing it down?) as far as I know it does not stimulate the pancreas... (like sulfanylureas) This is why Prandin has an unfortunate side effect of excessive gas production..


No, you are thinking of a different drug - acarbose. Prandin does stimulate insulin production. I was on a similar drug - Starlix, and I was never able to get good control. I had to eat 60g of carbs at meals or my bg would go high at 1-2 hours, but at 3 hours I would have these prolonged lows that were difficult to treat.

[soso]

Ahh..thanks ... I looked it up and acarbose is distributed as Prandase in Canada..I remember my doc giving me a sample of it, but I never tried it as the very idea scared me...

[Ohana]

My take and experience of LADA, is that the pancreas builds up a bit of insulin production, then we push things a bit and all our 'nest egg' is spent.. meaning we have a good day bg wise.. then the next day we do the same thing and there is no emergency fund anymore and we can't produce enough insulin to deal with the meal we seemed to cope with well the day before.. My good days are often followed by a crappy day till I catch on and readjust..

I have started to notice this as well. If I have very good control diet wise, I can be bad diet wise for a day or so with no real consequences... however if I am consistently bad on diet, my BS readings are just as bad. Glad to hear from another!