Thanks all! Met with Endo yesterday. Adjusting meal time insulin ratios for 2 weeks. After one day, it’s been a marked improved. I mean, I had a ‘real’ meal and my numbers were normal.
First time I was heard (out of 3 post-hospitalization appts) about how their dosing ratios were wrong for me. Felt confident having this conversation after reading about other people’s experiences here.
Challenged their diagnosis when they said their old formula was working because my numbers were “good”. (Yes, they are ‘good’ because I’m doing crazy eating patterns and exercise to stay with their insulin ‘rationing’.)
Once they saw my CGM records with all the ‘micro-meals’ (4g, 10g, 3g), I think they finally realized an adjustment was needed.
Hi, all! I’d like to apologize for the length and if the language isn’t quite right–
The TLDR version is: can folks help me understand my carb sensitivity and ratios so I can discuss adjusting my prescribed insulin amounts with my Endo?
Ty Mohe001 for the post-prandial language
I take 15 units of basal (Tresiba) by pen at night
I am currently “allocated” 15 units of bolus (Humalog); 5 units per meal. None for snacks, which they say at 8g carbs, I do not need to insulin for.
I have been trying to do LCHF which ends up being LC and high protein. I want to eat more carbs–vegetables and fruits, without running out of insulin. With the kidney injuries from my DKA, I am on no/low salt (1000mg) and try for low protein, but go over a daily amount.
I prepare all my own food. Everything is weighed. To the best of my ability, I believe I’m accurately recording the carb counts.
My “post-prandial” is 25 mg with 0 carbs and no insulin (egg and cheese). No exercise.
Post-pranial is 70 mg on 14g carbs and no insulin (slice of Dave’s bread) and no insulin. No exercise. (I don’t drop down until I bolus for my next meal.)
Would I say this is 1 carb = 5mg?
My post-prandial is 34 mg on same 14g carbs, with 3 units of insulin. ( I go up and then down, and then stay about 34 above my starting BG).
Would I say this is 1 carb = 3mg?
My post-prandial is 36 mg on 41g carb (same bread, egg, cheese combos with apple added), with 3 units of insulin and 75 minutes of exercise (87mg to 123mg after 2 hours).
Would I say this is 1 carb = .875mg?
Long version here:
I’m 55, new to my LADA diagnosis after, like many, being misdiagnosed with T2. I had a near-death experience with DKA in Sept '20 (with a 21 day hospital visit and almost losing kidney functions plus neuropathy) where I still wasn’t diagnosed for LADA until after being discharged–and essentially told in a very off-hand manner.
That’s the background very briefly–lots to unload.
I fought for a CGM after being told I didn’t qualify for one (because they still had me as a T2).
I’ve had to fight for insulin prescriptions to be filled ‘early’ as they didn’t account for the priming they instructed me to do and I’ve insulin-rationed to make up for the gaps.
The ‘diabetes educator’ lied and wrote their own narrative based on their own bias – they saw someone with an overweight BMI with T2 and made lots of triggering assumptions about food and exercise. Everything I said I *didn’*t eat – they wrote I did. For women with lifelong complicated food histories, you understand how triggering this can be. (I’ve been an ethical vegan/vegetarian by choice for other 30+ years, however have been eating meat (which I hate to do) for the LCHF diet to get my daily meal carbs down.)
I’ve tried to follow my endos’ instructions, but feel my follow-up care is lacking and not focused. Combined with how poorly the hospital controlled my BG, is there any surprise that I have low trust?
Greatly appreciate any insights folks could share --!