Hi,
I'm aged 40 and was diagnosed LADA-diabetic in July 2012, and here's my history:
To begin with, I do have a history of autoimmune disease, as I have Crohn's disease since I was 14 (this diagnosis was preceeded by a heavy attack of chicken pox, by the way).
After only one year of "standard" medical treatment of Crohn's, I only went to alternative practitioners and got along very well with this. In August 2011, my practitioner persuaded me to do an extended blood test, and there, my HbA1c was at 6.4, which neither of us had expected.
End of 2011, I went to see diabetologist (= an internist focussing on diabetes) and she just took another HbA1c (5.8), but no further testing, and asked me to protocol my BG for a week or two, which I did in January. After meals, I reached some values in the 160s-180s, but only because I tried out whencould I find the highest level of BG. If I had done what she told me (measuring 2 hours after meals), BG would have been back to normal already and I'd still be without diagnosis and treatment.
After this, she classified me as type 2 diabetic, but put me on no meds, told me I just should keep an eye on my BG. Perhaps my bad luck was, that I answered to one of her questions that I had gained 5 kgs weight during the past year due to stress at work, which made me 62 kgs at 1.66m instead of 57kgs).
This experience made me look for another doctor and found a more sensible one who took more time to listen to me and drew conclusions from my having Crohn's disease. She did an antibody test and the outcome was that I'm positive on GAD-antibodies (in July 2012).
This doctor strongly advised me to start with insulin very soon, as there was evidence from studies that would help beta cell function to last for a longer time. So in September 2012, I started with NovoRapid as bolus and no basal insulin (my fasting BG was 100-105 autumm-winter, and now is usually in its 90s).
Until now, my bolus doses are very low, my I:C ratio is around 1unit:30 grams. When I ride my bike to work (20 min), it's no insulin for breakfast, and no insulin either, when I'm planning to do sports the same day.
I had to find out about this all by myself, as the "diabetes counselor" working with my doctor says, as LADA-diabetics mostly have an intact glycogen/glucaon cycle, I could test out my dosis without the risk of hypos. She told me to increase by 0.5 unit if I went over 150 after meals. That's how I experienced some hypos where I measured values in the 50s down to the mid 30s, once even as low as 28 mg/dl, just after having an accelerated 10 min walk to catch my bus in the morning last winter...
So that's why I returned to I:C ratios around 1:30.
Next thing I tried was injection 15-20 mins before meals. This works fairly well, especially if I'm planning to eat faster-acting carbohydrates. This was a suggestion of my doctor's, and it's based on the fact, that the graph of the insulin effect curve becomes steeper, as more units are injected. So, with my few units (for my regular meals, it's 1.5-2.5 units), the curve is not very steep and the maximum effect of insuline only reached after ca. 1.5 hrs. Therefore: please be careful to imitate this if you are on higher doses!!
Im focusing on my after-meal values, as this currently is the only time when my BG goes too high: it goes up to the 170s until 200s when I try without insulin, sometimes even with insulin, if its effect comes too slow for my digestion. This is also where I see that probably my rest function might be currently decreasing: two years ago, my BG went back to normal values faster and more reliable after meals. Now, for the last 2 or 3 months or so, it stays higher for up to 3 hours after meals.
