Feeling Optimistic: First Follow Up Since LADA Diagnosis

I should say that I haven’t posted much on here, but I have read a great deal and learned a tremendous amount about LADA from all of you. So thanks for sharing all of your experience.
Five months in and I’m just getting used to this.

I had my first follow up appointment with my Endo, since being diagnosed with LADA about five months ago. I was so nervous that I was up half the night. My A1C dropped from 11.3 to 5.2 in five months! Obviously, my pancreas is still providing some support. But the initial combo of Lantus/Metformin/Amaryl seems to have worked pretty well in rapidly bringing down my numbers without having too many overwhelming things to learn.

That said, I’ll be dropping the SU and switching to Novolog for meal time coverage. Thanks for pointing me to look into the SU drugs, @Brian_BSC, @David_dns, and @Melitta. I think it was good for me to have an easier regimen for a few months that got my numbers in shape. I think I’m mentally prepared now to start learning the nuances of MDI, whereas jumping into it from the start might have frustrated me. (And my 3.5 year old son can watch and start asking me thousands of questions! He’s going to be fascinated by the whole process.)

A couple of quick questions: I have Think Like a Pancreas and Walsh’s Using Insulin which I plan to consult for working on my MDI regimen, are there other other resources that I should consult. It seems like there is plenty to keep me busy with these two books. The endo gave me some fairly vague orders. I’ve already read the basics in the books; I think he basically trusts that I will figure this out on my own.

One other thing that surprised me. I test about six times a day (more with strenuous exercise, illness, etc.) My meter had my EAG at 120, so I was expecting an AIC of around 5.8 or more, as most of what I’ve read seems to imply that actual A1C levels are slightly higher than meter averages.

I am currently using a VerioFlex. I test with control solution occasionally and it is within range. Does anyone have experience with this particular model of meter just reading high? Or is this kind of variation from meter to blood test (0.6) typically normal?



Testing 6 or 8 or even 10 times a day doesn’t give a completely clear picture of what your blood sugars are during the day. Even if you get up once per night to test, there are several hours on both side of that test where you really aren’t sure where you are. And you probably test somewhat on a schedule and are missing multiple-hour segments of information throughout the day. That said, your 5.2 A1C is awesome. Next time you go in for bloodwork, test with your Verio and compare it when the results come back.

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Congratulations on getting your A1c down so quickly. Sure, your pancreas “helped,” but you did all the hard work!

In terms of books to read - while there are many good books out there, the two you have are the best to get you on the right track with MDI. Between those and the wonderful community here for support, you will learn the basics and much more.

The reason your meter’s calculated average differs from your actual A1c is, first, as @Michelle43 said, because the meter numbers are only momentary snapshots, but your blood glucose (BG) goes up and down throughout the day and night - most of those changes are not captured by 6 – or even 12 - blood checks a day. In addition, the value given by your A1c is very dependent on your individual physiology, People’s red blood cells don’t all lat exactly three months - some live longer, some shorter. So A1c represents approximately a 3-month average, but for some people, it’s only 2-months, some longer. FInally, people have found that the last few weeks before the A1c is drawn tend to have more impact on the value than what happened at the beginning of the period; your BG was headed toward better control, so the lower numbers were “better represented” in the blood tested.

Keep up the good work, and feel free to ask for help/support or anything else around here!

Congratulations, that’s an A1C of a human with a functioning pancreas! So far my A1C’s have been a little higher than my meter and app estimates. You’ll get the hang of MDI pretty quickly, I imagine you will not need very large doses if you are doing so well on Lantus + oral meds?