Do you have LADA? Introduce yourself here!

I do think I need to have a talk with my endo…LADA seems to be really an oddball niche in the diabetic spectrum…

Hi Hunya. I have had my GAD65 done 4 times! The most recent test the antibodies were negative. I'm curious to try it again and see if it has stayed that way. I still have beta cell production and don't rely on insulin for meals, though I eat low carb plus gluten and dairy free! I do take a daily shot of levemir to maintain my weight because my insulin production is probably too low and I am naturally very thin to begin with and have no buffer.

One thing that I wanted to ask other LADAs is if they have noticed that the use of rapid insulin (novolog or apidra, etc) causes your beta cells to go on vacation. I've noticed that my blood sugars are worse in response to carbs after subsequent rapid insulin use. it takes a few meals for me to get back to good blood sugars if I've used rapid insulin for a meal. It makes me NOT want to go on rapid, because I feel like it's a slippery slope to insulin dependency.

That is really interesting AskHealthy. I was beginning to think the opposite. I prefer rapid acting insulin because it does not limit my exercise. I can take NovoRapid and four hours later it cannot cause a hypo, whereas Levemir adds a background confusion for 24 hours. The doctors all want me on basal insulin but it depresses me because I am afraid of becoming dependent on that. In reality all insulin feels to me like failure to maintain health. Each month #i go without insulin seems successful but I have been told I am 'playing for time'. Of course I am. The alternative is to be a pawn for pharmaceuticals companies - and there are enough health professionals to support them.

Don’t be concerned about becoming dependent on insulin, because it’s essential for everyone - even non diabetics. It’s just a question of maintaining an appropriate level, similar to keeping an appropriate level of oil in your car to keep it running smoothly. Even as a Type 1 diabetic, there are times when I need less insulin or more. It’s simply a matter of keeping the balance.

I'm always a bit perplexed by people who say they don't want to become "dependent" on insulin. I do respect, of course, people who try to live naturally in general and don't want to depend on unnatural substances or medications. But insulin is something our bodies produce naturally and we need it to live. For those of us with Type 1 D, our bodies do NOT produce insulin, or not enough for us to live. I'm one of those, so I'm dependent on exogynous insulin, the same as I'm dependent on air, water and food. No different.

Hummingbird, my T2 friend eats much better than I do, but ut

it makes no difference. She has many of the complications of diabetes, while I have none (knock on wood). I have an insulin pump, and have adjusted the basal rate, so most of my lows are caused by boluses and exercise. I am working with a cde, and we are trying cutting the basal rate by 30% when I walk my dog--I have lows if we walk more than a mile, so I would rather lower the basal rate (1 of 3 options), rather than eat a snack. So far it is working ok, except on those days when nothing works right. Less, and there's little chance of a hypo, more and I probably need to drop the basal longer.

Zoe...I too find that comment to be somewhat of an oxymoron, as when relating to someone with or WITHOUT diabetes the body is very much dependent on insulin.

Exogenous insulin is insulin from outside your body, not what your own body produces. Yes, everyone is dependent on insulin, but Type 1, and LADA will be dependent on insulin not produced by their bodies as what their bodies make decreases.

I think the point was that it's moot to be worried about being "dependent" on insulin, since we are all dependent on insulin, whether exogenous or endogenous - we need it to live.

If my body has stopped producing insulin, it presumably has its reasons. Maybe I am saved from old age.

I think finding out you have diabetes is depressing. When I was told I was T2, I was depressed because I knew I could have taken better care of myself! When I got correctly diagnosed as Type 1 LADA, I immediately started Insulin to preserve what little insulin I was producing. I am so glad because Right away I began to feel better, and after two years, I feel much, much better. Any chronic, life long illness can feel overwhelming. I am veery grateful for the tremendous access to knowledge we have and the great tools, pumps and monitors we have to keep us healthy, and they’re improving all the time! Please take a deep breathe, call a good friend, look at many options available to improve our health. Talk to your Endo or a good Nurse Practitioner! Having diabetes doesn’t mean you have to die, it means you have to do things a little differently, and when you do, you will feel better and see the opportunities out there! I will pray for you!

So, I know that I am dependent on insulin, as we all are, but I would prefer not to be dependent on exogenous insulin. I'm sure everyone can agree that the functioning pancreas is better at regulating blood sugars than we are with our novolog, apidra, etc. Type 1s, as much as they count and dose correctly, I've found there are inevitable highs and lows. In my own experience, I believe I am preserving my remaining beta cells with the levemir and no use of rapid insulin. This is more convenient for me as well. I don't have the inconvenience of dosing, carrying around the insulin, or taking numerous shots all day long. All I'm saying is that it appears that when I use rapid insulin, my remaining beta cells take a vacation and subsequent meals are harder for my body to handle. I'd rather just eat low carb and maintain normal blood sugars without exogenous rapid insulin. I feel like if I start using the rapid regularly, it's bye bye to my very fortunate situation where I don't need to rely on it.

Hunya -- maybe you should reduce your basal insulin on days that you think you are going to be exercising a lot? If that's every day, then maybe you just need to either reduce it a bit or make sure you eat a snack before working out?

I’m not sure there is any hard evidence that suggests the introduction of outside insulin actually diminishes your pancreas’s ability to produce its own insulin. What we do know is that not having enough insulin as a Type 1 diabetic is a bad thing, and that exercise and diet can delay the onset of Type 2 diabetes. I tend to rely on what we already know about this disease and how we treat it, while keeping an eye on the research that looks at alternative treatments and insights into the disease. I mean, who would have thought two years ago, for example, that a small and gradual introduction of peanuts to a person hyper-allergic to peanuts would be a possible therapy? It’s all very exciting and I’m almost certain new technologies and approaches for the management and treatment of diabetes is just around the corner. So my advice is to try to remain optimistic and do the best you can with what we already know.

Thank you for your understanding, AskHealthy. It is difficult being neither a straightforward type 1 or 2, partly because in my experience, health professionals react as though the patient is denying the condition when in fact that patient is really trying to work out the precise problem in order to treat it in the most appropriate manner.

When I refer to insulin dependent, I am doing so in the normal manner of health professionals, who refer to insulin dependent diabetes. I would not call somebody oxygen dependent just because they are.

When I was told I had over 2000 GAD antibodies on a scale of 0-25 I went onto a dose of 14 units of Levemir and stayed on basal insulin for 11 months, seeing it as less of a failure than bolus injections. I cannot help but see diabetes as a failure of the organism to react appropriately to food.

I am not saying bolus insulin is any different from basal in terms of influencing the immune system. If it works for you, keep going. I normally feel better the less I have to think about energy. What I do believe is that our bodies are expert adapters to new conditions. I used to enjoy eating bread, but when I learnt I had type 1 diabetes I stopped eating processed carbohydrates and bread is one of the worst culprits because ‘healthcare’ professionals encourage people to eat packaged food with numbers on the labels, when in fact natural foods are better. As I find products give me prolonged hypers, I have evicted them from my shopping list and rapidly lose interest in them.

When I began cycling, my blood sugars went down and my doctor asked me to reduce my dose of Levemir. Within a week I needed no insulin. My next HbA1c was 33 and she said that had gone down too fast (from 54) and could I get it back to 40, so I did. Don’t ask me how; it was coincidence – I may have taken a bit less exercise, or it could have been because my friend came to stay and we went out for a load of meals. It was because of him that I asked to be prescribed bolus insulin, but in practice I was able to eat as much as I liked and my blood sugar was still going down.

Then in November it shot up and I began taking just the bolus. I am not really happy with any kind of medicine and would like to wean myself off insulin. That is my ultimate objective.

Hopefully by the time I really need insulin, the methods of treating diabetes will have created a method of inhaling it. In the meantime, it gives me a good opportunity to get fit and as healthy as a non-competitive athlete can be.

It really comes down to doing whatever works best for your unique situation. Keep up the good work, healthy eating and active lifestyle!

Where can I read more about the "honeymoon" period? and high BG toxicity to the pancreas? For the past 1+ month, my BG has been mostly in the 80-140 range. (Previously, it was much higher 100 to 250) I find that my current insulin needs are less insulin, both basal and bolus. Is that common? My I:C ratio is now higher. It was suggested at 1:15 previously. Currently it's in the range of 1: 22.

I am not sure of a good source of info about the honeymoon period. Of course, the honeymoon in T1D is the period of time after diagnosis in which remnant (not destroyed) beta cells still produce some endogenous insulin. The honeymoon can be prolonged by intensive insulin therapy, avoiding spikes. I suspect that some of the newly diagnosed LADAs today can keep their honeymoons going indefinitely with all the great tools we have now (pumps, CGMs). When I was in my honeymoon, my I:C ration was 1:30.

What is meant by intensive insulin therapy? are there other types of insulin therapy?

Intensive insulin therapy just means 3 or more injections per day to match carb intake. When I was on MDI, I did at least 5 injections per day. The more closely you can match your carb intake and maintain steady BGs (avoiding peaks and valleys), the less stress you put on your remnant beta cells.