Off meds and testing bg like crazy

[Rekarb]

I was recently dx'd about 2 months ago and was initially given Avandamet by my GP. The endo I was referred to says that I'm LAD. This sucks but it's just one more thing to deal with as far as I'm concerned.
What really irked me about this process was not being able to examine my baseline functioning BG before I went on medications for the rest of my life. The endo said I needed to make decisions but I asked him on what basis? I've got a science background and starting any project without understanding the underlying functions of a system that you plan to change sounds crazy. He wrote out a script for strips so that I could test myself till I fainted from blood loss.
I built a database for my testing, went off all meds and then methodically tested my BG under as many conditions as I could think of.
I've been my own lab rat for a month and it ain't been fun. Still, I found some valuable stuff about how I function. I did low carbs to no carbs and found very little difference. Above 40 g of carbs, however, and my BG took off. I tolerate carbs much better late in the day and no matter how low the BG was before I went to bed it was always higher in the mornings.
Exercise, for me, was the big key. I was able to bring my readings down between 110 and 160 with exercise but the exercise time had to be hard and at least 60 mins. The problem with low carb and hard exercise is that it hurt like heck because I never seemed to have enough energy or I would take too many carbs and the BG would fire up passed 300. There is such a fine line there and I never could find it. My belief is that the meds make that line much easier to find and I'm going back on the meds tomorrow and will be testing against this baseline.
Has anybody done anything like this? How do you manage carbs and hard exercise. What's the relationship of adrenalin and BG? Am I crazy to find all this so interesting?

Mike - the mad scientist

[owlyn]

Oh Mike, Mike, Mike...

You failed to take into consideration the phases of the moon, the square root of the Julian Day, and the price of tea in China. What I am trying to tell you is that all this basal testing is all very well and good, and it is definitely needed and useful, but you are setting yourself up for a big disappointment. The problem is that managing diabetes is as much voodoo as it is a science. The body is not a machine and will not react the same way to your input variables each time. The body has its own variables that you will never be able to control, so get used to something not working "this time" that worked 1000 times before.

Good luck to you.

[sumi]

Hi Mike,
the wise old owlyn has spoken. I think most people on this forum have done at least some experimenting. We all seem to have different carb limits, and differing exercise regimes. I find a 20-60 minute walk really help my bg levels, but when I exercise more intensely, my levels go up. Many can eat extra carbs just before or after exercise. From what I understand, those with LADA have a particularly tough time as your pancreas tends to 'sputter'. Therefore as well as, the myriad of other variables, you have the added bonus of sometimes on, sometimes off insulin production. Your great attitude and curious nature will be a huge help to you as you figure out what works for you. Just remember, what works today may not work tomorrow.

[Subby]

I was recently dx'd about 2 months ago and was initially given Avandamet by my GP. The endo I was referred to says that I'm LAD. This sucks but it's just one more thing to deal with as far as I'm concerned.
What really irked me about this process was not being able to examine my baseline functioning BG before I went on medications for the rest of my life. The endo said I needed to make decisions but I asked him on what basis? I've got a science background and starting any project without understanding the underlying functions of a system that you plan to change sounds crazy. He wrote out a script for strips so that I could test myself till I fainted from blood loss.
I built a database for my testing, went off all meds and then methodically tested my BG under as many conditions as I could think of.
I've been my own lab rat for a month and it ain't been fun. Still, I found some valuable stuff about how I function. I did low carbs to no carbs and found very little difference. Above 40 g of carbs, however, and my BG took off. I tolerate carbs much better late in the day and no matter how low the BG was before I went to bed it was always higher in the mornings.
Exercise, for me, was the big key. I was able to bring my readings down between 110 and 160 with exercise but the exercise time had to be hard and at least 60 mins. The problem with low carb and hard exercise is that it hurt like heck because I never seemed to have enough energy or I would take too many carbs and the BG would fire up passed 300. There is such a fine line there and I never could find it. My belief is that the meds make that line much easier to find and I'm going back on the meds tomorrow and will be testing against this baseline.
Has anybody done anything like this? How do you manage carbs and hard exercise. What's the relationship of adrenalin and BG? Am I crazy to find all this so interesting?

Mike - the mad scientist

You'll see all these things and probably a change of things, as you go on medication. If you go on a relatively flat long acting insulin like Lantus (or a pump) you'll have the same dynamics to deal with, just lessened to some degree.

As a LADA, (if you are) you suffer from a deficiency in insulin. Thus, unlike type 2 (who suffers from insulin resistance and often an overabundance of insulin) you probably need something to replace that insulin - such as injecting insulin - or to cut down on your body's energy production, such as metformin.

Just wanted to check that you're wised in to that. You're in a completely different ballpark to being type 2! You need to be very aware of what "meds" are going to help and why, and insulin may well be a good thing to be introduced either now or soon. I'm not prescribing it, I'm just mentioning this because you have mentioned LADA as "just one more thing". No - it changes your situation quite dramatically, moreso in the future.

[foxl]

Welcome Mike.

I too have LADA. And my most recent A1c was 5.8, but if I can persuade my Endo (whom I have not yet met) to prescribe basal insulin in a very low dose, I want it ASAP. It helps you save your beta cells.

I have a biology and both laboratory and library biomedical background, and I absolutely agree, this stuff is fascinating! I found thyroid biology interesting, first, but then I actually worked in thyroid research long ago!

[Rekarb]

This is like chasing a phantom and the variance is wild. I'm 56 and this is just one more thing to deal with, trust me, I've dealt with a lot worse. Life involves problems, some more solvable then others. I'm not foolish enough to expect a good clean curve for my data. It never happens. What I do expect is that I will understand how the MAJOR variables interact and what range I can expect the outcomes to be in.
My endo suggested going straight to insulin but I had to see a basis to make that decision. I'm thinking that this might not be such a bad idea. I'll be meeting with the docs soon and will go over the data with them.
One thing that I'm sure of is the need for some type of antioxidant to deal with the free radicals from the interaction of BG and hard exercise. I'm hurting like **** right now from all the working out while doing low carbs. In the past, this was handled by fruits but I can't take too much of that without blowing up the BG. Probably try some vitamin supplements.

Mike - the mad scientist

[Subby]

I find high BGs have a generally toxic effect on me. I don't know the science enough to comment off the top of my head, but everything is likely to hurt, I am likely to have headaches, aches, pains, tiredness, with higher than normal BGs. And lows, they can physically ruin me. I personally can't win unless I maintain control.

So, whatever you choose medication wise to help you in your quest for the best BGs, good luck with it, I will bet you will feel a lot better when you are normalised. Get that goal in your mind and go for it! Good luck.

[dbaratta]

This is like chasing a phantom and the variance is wild. I'm 56 and this is just one more thing to deal with, trust me, I've dealt with a lot worse. Life involves problems, some more solvable then others. I'm not foolish enough to expect a good clean curve for my data. It never happens. What I do expect is that I will understand how the MAJOR variables interact and what range I can expect the outcomes to be in.
My endo suggested going straight to insulin but I had to see a basis to make that decision. I'm thinking that this might not be such a bad idea. I'll be meeting with the docs soon and will go over the data with them.
One thing that I'm sure of is the need for some type of antioxidant to deal with the free radicals from the interaction of BG and hard exercise. I'm hurting like **** right now from all the working out while doing low carbs. In the past, this was handled by fruits but I can't take too much of that without blowing up the BG. Probably try some vitamin supplements.

Mike - the mad scientist
Mike, I am like you, I feel everything. High and lows, the lows are the worse because I feel drained for the rest of the day. I never feel good anymore. That is why I am going to try to cut back on the insulin and take the pills instead. What good is a longer life if you are not happy and feeling good. I will take quality of quanity anyday. :o)

[dbaratta]

Hi Mike,
the wise old owlyn has spoken. I think most people on this forum have done at least some experimenting. We all seem to have different carb limits, and differing exercise regimes. I find a 20-60 minute walk really help my bg levels, but when I exercise more intensely, my levels go up. Many can eat extra carbs just before or after exercise. From what I understand, those with LADA have a particularly tough time as your pancreas tends to 'sputter'. Therefore as well as, the myriad of other variables, you have the added bonus of sometimes on, sometimes off insulin production. Your great attitude and curious nature will be a huge help to you as you figure out what works for you. Just remember, what works today may not work tomorrow.
My BG goes up too when I exercise hard. I told my doc and he said he never heard of that before....ugh, I think I need a new doc.

[foxl]

My BG goes up too when I exercise hard. I told my doc and he said he never heard of that before....ugh, I think I need a new doc.


Not necessarily. Use the MD who is supportive of you and helps you manage your D -- not the one who knows the day to day stuff. Seriously.

[Rekarb]

Got my test results
GAD - 65 AB < 0.2
C - peptide 1.56
this mornings BG reading - 248
Basically all my tests came back NEGATIVE!
Still can't eat a slice of bread without carbo overload. This is so mystifying. Anybody else got these sort of goofy numbers?

Mike

[Rekarb]

Got my test results
GAD - 65 AB < 0.2
C - peptide 1.56
this mornings BG reading - 248
Basically all my tests came back NEGATIVE!
Still can't eat a slice of bread without carbo overload. This is so mystifying. Anybody else got these sort of goofy numbers?

Mike
I guess I'm going to have to resign from being a 1.5. I've got no antibodies so it appears that I'm a T1b. It was fun while it lasted. Maybe they can start a forum for "real goofy diabetes".

[matingara]

I guess I'm going to have to resign from being a 1.5. I've got no antibodies so it appears that I'm a T1b. It was fun while it lasted. Maybe they can start a forum for "real goofy diabetes".

do you have to classify yourself as a "type x"? who does it help? what does it mean?

have you thought about using insulin (along with your low carb diet) as part of your regimen?

:)

-- Joel.

[Rekarb]

Actually this particular classification is important. It means that there is a chance that it will go into remission. I think that knowing something about this classification would help some one sort out a great deal of confusion.
I am going to get on insulin as soon as I can sort this thing out with my endo. The key is getting him to accept this classification so he will be open to the treatments they suggest.

[networkguy]

Oh Mike, Mike, Mike...

You failed to take into consideration the phases of the moon, the square root of the Julian Day, and the price of tea in China. What I am trying to tell you is that all this basal testing is all very well and good, and it is definitely needed and useful, but you are setting yourself up for a big disappointment. The problem is that managing diabetes is as much voodoo as it is a science. The body is not a machine and will not react the same way to your input variables each time. The body has its own variables that you will never be able to control, so get used to something not working "this time" that worked 1000 times before.

Good luck to you.

LOL This made me laugh...

QFT!

[Subby]

Actually this particular classification is important. It means that there is a chance that it will go into remission. I think that knowing something about this classification would help some one sort out a great deal of confusion.
I am going to get on insulin as soon as I can sort this thing out with my endo. The key is getting him to accept this classification so he will be open to the treatments they suggest.

Nothing wrong in the slightest with trying to find out what mechanics are going on in your body, and type is certainly one avenue into that.

Out of interest, do LADAs definitely, positively, test positive for GAD antibodies every time? Maye they do - just posing the question.

Could you be type 2, or to put it another way to bypass typology, insulin resistant? Again, is a higher C-peptide completely inexorable in that scenario?

Here's another question connected to that: does the lack of weight you mention here or in your other thread, mean that insulin resistance is not possible? I thought I had heard both here and on the net, of people diagnosed type 2 quite fit and slender.

Many questions. I don't pretend they are useful, just the ones that come up for me. Good luck.

[foxl]

[QUOTE=Subby;477079]

Out of interest, do LADAs definitely, positively, test positive for GAD antibodies every time? Maye they do - just posing the question.

QUOTE]

no in fact, there are 3 distinct antibodies that can test positive in LADA -- ICAs (islet cell antibodies) and insulin in addition to GAd-65. And how many of these types you have can predict how quickly you end up insulin-dependent.

[Rekarb]

The endo says that a LADA doesn't always test positive of any antibodies.
A t2 is usually going to have a higher C-peptide than mine. He looked at all my crazy testing and saw that diet, exercise and pills were not going to get the job done, only insulin would. I think I'm going to put the rest of the stuff in another thread because it is weird!

[SB_Krista]

I guess I'm going to have to resign from being a 1.5. I've got no antibodies so it appears that I'm a T1b. It was fun while it lasted. Maybe they can start a forum for "real goofy diabetes".
Mike,

Did the Dr. only test for GAD-65 antibodies? My understanding is that there are several different kinds of autoimmune antibodies that can present in type 1.5s (LADA) and the presence of one or more is the basis for a type 1.5 diagnosis.

Also, with regards to exercise and the effect on blood sugar, longer duration and higher intensity can lead to the release of adrenalin which will cause your liver to dump glucose to keep your enegy levels up.

[Rekarb]

No, the endo checked for all the pertinent antibodies. Nada! Zip!
Yeah, I noted that the exercise initially brought up my bg but when it went down, it would go down to under 130 without medication. Shorter duration exercise hardly budged my bg.
I've got insulin in the fridge right now and I'm waiting to take a class on exactly how to use it.

[foxl]

Well, the good news is, your management should be the same, regardless of cause, at least.