So I’m clearly a LADA, since T1 started at ~35 years old (early this year). I do still have some endogenous insulin production, which is noticeable in my low Tresiba dosage (11 units daily).
Still, I have to diligently bolus for carbs, or I can easily spike well beyond 150. And, well, I did that, in addition to carb reduction, regular exercise (cardio on stationary bike + resistance training at the gym).
Time in range these last 3 months was 99% … with 1% below because of exercise related BG adjustments. And labs results are: HbA1C 4.9% !!!
I was also worried a bit about the increased fat and protein consumption, but the Albumin/Creatinine ratio is great (2.1 mg/g , threshold is 30), LDL is at 62, HDL at 52, triglycerides at 39!
So my BG control really is awesome now. Thanks to the exercise, the Humalog works crazy fast. I have very modest spikes these days, and in fact sometimes have to split the injections because the Humalog acts TOO fast.
Which brings me to pumps: In the past I was considering pumps, because the BG control is much more fine grained with them. Basal adjustments are quick and easy, you have more options regarding bolusing (for example, spread over a certain time, often called “square wave”), only one insertion every 3 days etc.
But, I am concerned about the downsides: Pump failures, stuff sticking on your skin, costs. In particular, with this HbA1c, I have become skeptical about the cost/benefit ratio. I also currently have no dawn phenomenon, only a modest “waking-up” phenomenon (on some days, the BG rises by 10-20 mg/dL after waking up; dawn phenomenon happens even in your sleep, at a certain time in the morning).
The pumps covered by health care here are the Ypsomed Ypsopump, the Omnipod, the Medtronic 640G, and the Accu-Check Insight. I avoid Medtronic like the plague, given the bad things I’ve heard about them. As for the rest, eventual compatibility with looping systems is a must have for me, since in my opinion, it truly unlocks the potential of pumps. This rules out the Ypsopump and the Insight, leaving only the Omnipod (AndroidAPS support is WIP, and cooperation with Tidepool seems to be ongoing).
However, I keep hearing about frequent pod failures. And, I am concerned about such a large area covered with an adhesive. I don’t want to provoke skin reactions that may eventually not only make Omnipod use impossible, but CGM use as well.