[foxl]

Okay, it appears to be up to me ... I do not want to start insulin yet, not with fastings in the 80's and 90's and rarely, peaks over 120 ...

But, when DID you start, as a LADA or whatever, using insulin to preserve your beta cells? What criterion or criteria did you or your MD use?

[jtausch]

When I was in the hospital the had a endo see me and he put me on insulin because of my foot and because my insulin was at greater the 160 said insulin for better control. I agree it gave a lot better control

[butterflykisses]

By the time I was properly diagnosed I was already on insulin. Had I known from the beginning I would have asked to start bolusing with meals when my BG's started growing after meals. In the beginning my fasting BGs were okay, after breakfast I would rise, maybe come down a bit by lunch. Then came lunch, you get the picture. I think some mealtime insulin would have preserved beta cell function for a while...but then who really knows for sure?

[retired60]

My a1c's were running 7.2 to 7.4%. I asked the doctor to put me on insulin. With a little insulin it is very easy to control as you can see by my a1c's.

[foxl]

I find what the endo-on-call did to be less than appropriate and think even the new Endo is not too impressed and he was a partner ... he had me on insulin for 2 days in hosp, but sent me home on oral meds, not even knowing how I would tolerate them. No beta cell rest there! I probably could be on a minuscule basal or just bolus and do okay now ...

[luckharm]

My A1c was 8.9 and my fasting BS was 180 to 250 when I started on 10 units of Latus 1 time per day. This was only a few days ago and already my numbers are improving. My fasting Bg this morning was 124. I wish I had done this sooner instead of denying myself carbs for months just to keep under 200.

[foxl]

Originally Posted by luckharm

My A1c was 8.9 and my fasting BS was 180 to 250 when I started on 10 units of Latus 1 time per day. This was only a few days ago and already my numbers are improving. My fasting Bg this morning was 124. I wish I had done this sooner instead of denying myself carbs for months just to keep under 200.

OMG that is high! Was it because you were insulin-phobic, or ... ?

[Subby]

Originally Posted by foxl

OMG that is high!

Is this a respectful and tactful tone when discussing someone elses possibly tricky situation? I don't think I'd want anyone using that tone with my trends whatever was going on.

[foxl]

Sorry Subby, I did not mean it impolitely, I do not know Luckcharm nor she me, so I guess it did sound rude.

I just know I would have been freaking out, way before hitting that point.

As someone who was at 447 at DX, I did not mean she was using poor judgment or was on the verge of dying or anything! I just know I would have been upset. And I am asking for info so I can base my decision (since it appears to be MINE, not my Endo's) to go onto insulin on others' experiences, and worrying about not being there yet ... so yeah that sounded high to me - maybe as in wow your nubers are high, but also as in, well if your MD let you go that high, I have a ways to go.

[Subby]

No worries - and no need to apologise or explain. I just know, when you've been struggling with difficult BGs for some time whether you are doing the right things or not, that such throwaway lines (usually not meaning anything too judgemental - but you never know) can be very negative sounding, a real kick in the guts. Not always, but sometimes.

[zoelula]

I had been stable on oral meds for a bit more than a year (misdiagnosed as Type 2) when my numbers started a slow but steady climb (last September) I waited perhaps longer than I should have to go to the doctor (December) and say, ok, this is no longer working. Then my doctor wanted to try one more oral med first (again thinking Type 2) then started me on bolus only at too high of a dose so I was hypo by mealtime and still very high postprandial. I would have to look at my old notebooks to remember what happened when. I think by the time I went to the doctor and said we have to change something my fastings were around 140, and my post prandials were in the 200s. Right before the time I actually got on the right regimen (diagnosed myself as LADA) my postprandials were spiking into the 300s and even 400s a couple times. But like I said I waited too long.

But remember, Linda, I was not controlling my carb intake AT ALL in those days (only not eating sugar). Besides being more recently diagnosed than me (I just had my two year anniversary), I wonder how your numbers would look if you were eating without any consideration of carbs?

[foxl]

Originally Posted by zoelula

But remember, Linda, I was not controlling my carb intake AT ALL in those days (only not eating sugar). Besides being more recently diagnosed than me (I just had my two year anniversary), I wonder how your numbers would look if you were eating without any consideration of carbs?

I tried to argue that with Endo ... she said she wanted me on 40 g carb per meal, in part b/c I told her when I "tested" with that my peak BG was around 120. I told her I thought I would exhaust my insulin reserves more rapidly at 40 g per meal and that 120 would then not be the case!

AND she wants me to lose 10 - 20 more lb ... how would TAHT work?

I definitely think low-carbing is keeping me from being prescribed insulin ... but, is that a BAD thing? I think not. And I do not really want to prove myself right by eating higher carb and gaining weight, in order to do it! Or going DKA again ... another possibility.

[dbc]

Originally Posted by foxl

But, when DID you start, as a LADA or whatever, using insulin to preserve your beta cells? What criterion or criteria did you or your MD use?

When the A1c drifted up to 6.5% after being down at 6% on diet, exercise and metformin for about a year. Doctor's criteria was the 6.5% threshold on an upward trend.

We had discussed starting insulin before, when the A1c was around 6.3% (on a VERY restrictive low carb eating plan). At that time he wasn't in favour because of possible/probable hypo issues. We also didn't know each other well enough at that time, and I suspect he had me labelled as a 'normal' patient who would not apply himself properly to managing things and would therefore be likely to experience hypos. He now knows otherwise and largely agrees with everything I suggest

[tealas]

Originally Posted by foxl

I definitely think low-carbing is keeping me from being prescribed insulin ... but, is that a BAD thing? I think not. And I do not really want to prove myself right by eating higher carb and gaining weight, in order to do it! Or going DKA again ... another possibility.

Just a suggestion, along with low-carbing you may want to explore ratio of raw to cooked foods in your diet.

I've been on Humalog for about 5 years, and was starting to feel like I could not control the post-meal spikes and was unhappy with this. I tried Byetta which controlled the spikes but I had horrible GI problems from it. Then I stumbled into doing more raw foods (I aim for about 75% - mostly salads and green smoothies or veggie soups made in a VitaMix). I was really surprised to see that I could eat 2 fruit exchanges in a green smoothie, (but blended with two large handfuls of spinach or chard and 1-2 tbls chia seeds), and see my blood sugars go down to 78! For me at least there is something very restorative about getting more raw greens. If you search on YouTube they have some documentary films about a 30 day raw diet challenge for diabetics and how it helped many (mostly Type 2, but some Type 1's) to lower their levels of medications.

FYI - I'm not personally in favor of the 100% raw vegan approach all at once. Natalia Rose has a great book (avail on Amazon) about stages of incorporating raw foods into ones diet, "Raw Food Detox Diet: The Five-Step Plan for Vibrant Health and Maximum Weight Loss." This book has excellent reviews on the Amazon site - the reviews alone gave me a good bit of information about the benefits and potential pitfalls of shifting to a diet with more raw foods. You can get most of the benefits of raw foods just by shifting 2 out of 3 meals raw, and then having good quality cooked poultry/fish/meat OR starch and veggies. Rose is big on food combining - and I think it is very important for detoxification, which I think as diabetics we are always needing (due to oxidative stress).

[foxl]

Originally Posted by tealas

Just a suggestion, along with low-carbing you may want to explore ratio of raw to cooked foods in your diet.

I've been on Humalog for about 5 years, and was starting to feel like I could not control the post-meal spikes and was unhappy with this. I tried Byetta which controlled the spikes but I had horrible GI problems from it. Then I stumbled into doing more raw foods (I aim for about 75% - mostly salads and green smoothies or veggie soups made in a VitaMix). I was really surprised to see that I could eat 2 fruit exchanges in a green smoothie, (but blended with two large handfuls of spinach or chard and 1-2 tbls chia seeds), and see my blood sugars go down to 78! For me at least there is something very restorative about getting more raw greens. If you search on YouTube they have some documentary films about a 30 day raw diet challenge for diabetics and how it helped many (mostly Type 2, but some Type 1's) to lower their levels of medications.

FYI - I'm not personally in favor of the 100% raw vegan approach all at once. Natalia Rose has a great book (avail on Amazon) about stages of incorporating raw foods into ones diet, "Raw Food Detox Diet: The Five-Step Plan for Vibrant Health and Maximum Weight Loss." This book has excellent reviews on the Amazon site - the reviews alone gave me a good bit of information about the benefits and potential pitfalls of shifting to a diet with more raw foods. You can get most of the benefits of raw foods just by shifting 2 out of 3 meals raw, and then having good quality cooked poultry/fish/meat OR starch and veggies. Rose is big on food combining - and I think it is very important for detoxification, which I think as diabetics we are always needing (due to oxidative stress).

tealas, I am an ovo-lacto vegetarian. And I have a family of 3 kids, and work fulltime. Sorry but until I see something evidence-based in favor of it, I am not going to further complicate my diet and meal-planning.