New diabetic 1.5 lada

Type 1 and LADA
1

Hello friends,

I am 39 years of age and got diagnosed with type 2 in 2007, now recently my blood sugar has been going up since june 2011, so i decided to ask my family doctor to see an Endocrinologist. I also noticed that i was losing weight. I was 200lbs right before getting diabetes, now i am 162 lbs and 5'11.

When i saw the endo, she said that i might have lada 1.5 because i am very thin and i am taking more insulin, bolus:18 units and basal:18 units
She also removed metformin, glyburide and crestor out of my prescription and kept Fluvoxamine for mild anxiety and Synthroid for my hypothyroidism which began in 2004.
My HA1C% is 11

My Blood sugar spikes a lot faster now, right after a meal and i get blurry vision and dizziness at times. The worst feeling i got so far was last saturday when i went to a dinner with friends and i had 2 pints of beer before my meal. I don't know if my sugar was high or low but i felt very dizzy and i had trouble maintaining the conversation, was like a feeling of confusion and then started to feel tremors in my chest.

Since i did not have my glucometer with me, i had a few slices of bread to see if that helped, but not much. i called 911 and told them the situation and an ambulance arrived shortly to measure my vital signs and blood sugar.
i was at 11.7 mmol/L

I have to go for a c peptide test in june and blood tests to see if this new insulin and diet will work or not.
so far i have not been able to bring it down below 10 mmol/L
I am worried.
Am i damaging my kidneys and other organs?

I also am trying to go back to school to learn web programming and on monday i had to leave the class because i was feeling weird, almost like a panick attack, was right after lunch, felt like my sugar was high and my face was very warm. I also felt dizzy from reading the text on my screen. Should i just forget about programming, is it a too stressful job for someone with diabetes? I been hearing about jobs that cause stress and can make your sugar go up a lot too.

As you can see, i have a lot of questions and little answers,I feel like i have no luck in life and this disease was the cherry on top of the sunday.

Links Added by the TuDiabetes Administration

LADA Group

Stories of Misdiagnosis

Top !0 Tips for the Newly Diagnosed

Medical Misdiagnosis of Insulin Deficient Diabetes

Positive Autoantibodies Indicate Type 1 Diabetes

Manny's Video on LADA

2

Thanks Zoe,

i will try that,i will also try the glass of wine test tonight, see if i go high or low after a glass.

yeah i called the clinic and spoke with a dr. there about the dosage he said to only adjust the lantus for now, take 1 or 2 units more tonight and see how my sugar is tomorrow morning, but never adjust 2 types of insulin at same time.

i will post here tomorrow to say how it went.
have a great week end all

3

That's good advice, and many people say the basal needs to be right before you can accurately set the bolus. Just keep writing things down and the patterns will emerge. Yes, let us know how the new lantus dose works!

4

it's 3:30 am just got back from friend's place, had 3 glasses of chivas regal scotch and had some chinese food, rice schrimps, beef and brocoli, just checked my BG, 17.1 mmol.
i guess the rice made my BG go up, but i did not feel sick, and i know 2 or 3 hours from now it will drop.

just took a dose of lantus 20units, i will see tomorrow when i wake up if it worked.

goodnight...

5

10:23 am, 7 hours later, just checked BG, it's at 15.7 mmol,
was i suppose to take a fast acting 6u dose when i had my meal at 2 am?

What do you do when you have a 4th meal of the day, even if it's 2 am, do you take a 4th shot of fast acting, like if it was dinner or we must not go over 3 daily shots?

6

Yes you should bolus for the carbs you consume whenever you eat. You just have to remember when you took your last shot, the insulin on board and test to see where your numbers are at before injecting. If you wake high, like you did, you need to take a correction bolus.

7

I agree with drsoosie; you need to bolus for food you eat; it doesn't matter how many times a day you eat. Not "6 units" but whatever your I:C ratio suggests. That's part of why I recommended you get into the habit of thinking I:C ratio rather than a set dose per day. Your basal dose (Lantus) is not designed to cover your carbs, but merely to give you background insulin for the whole day. It's not good for you to have blood sugars over 300, even if you don't feel bad and even if it comes down in a few hours.

The only problem, though is that it's not safe to go to bed with fast acting insulin active, because you could go low during the night. So you shouldn't eat less than 4 hours before you intend to go to sleep.

8

Thanks drsoosie and Zoe, that is amazing advice, i did not know that at all.

The reason why i did not take the shot at 2 am was because i had alcohol and i thought it would bring my BG down and if i added a 6u bolus, risked bringing down more. But now since i did the test, now i know that alcohol doesn't always bring the BG down.

So yeah was kinda tricky because i had alcohol first and then the meal. But thanks to you guys now i know i have to take a bolus if i eat even if it's at 2 am.

I was curious, i been having a bit of blurry vision, will that eventually come back to normal when my BG goes down below 10 mmol/l ?

9

Yes, the blurry vision will correct when your blood sugars come down to normal. And btw 10 (180) is not normal, it's still high. Normal is below 140.

10

something weird happened tonight, i tested myself before going out, right after dinner and i was at 9.1 mmol

Then i drive to my friend's place downtown and tested myself again in my car and i was at 15 mmol, and i did not eat between both tests. I had pasta with meatballs and homemade tomato sauce, about a 2 cup portion for dinner.

now tested again after i just got home, 12.6
i don't get it, why am i going up and down like a rollercoaster?

11

No, this makes sense, DW. When you tested "right after dinner" the food had not had a chance to affect your blood sugar. Later it went up and then later still started to come back down. 2 C of pasta, unfortunately is a lot of pasta for someone with D. I know you were bolusing a set dose. I hate to sound like a broken record, but you need to determine and use your correct I:C ratio - a meal like that will take more insulin.

12

First, get Using Insulin, like Zoe suggested. You might be able to check it out from your local library, but Walsh does a great job explaining carb ratios. It is kind of like a user manual, though, so I used post-it tabs when I read it a few years ago. I have been type 1 since 1984, and I learned quite a bit.

Second, DO NOT eat chinese food, pizza, or Thanksgiving dinner when you are trying to figure our your carb ratios. Those random amounts of carbs, protein, and fat will do crazy wicked things to you blood sugar, and you will just get frustrated. I make my own chinese food, like broccoli beef or stir fry. That way I know the carbs and fat that goes into it.

Third, yes, an A1c of 11 causes nerve and organ damage (that includes eyes). Low blood sugar, though, damages your brain and can cause seizures. You need to get your doc to diagnose you type 1 so you can get more strips and carry your meter with you. Since your A1c is so high, you need to gradually try to lower it. Do not try to do it all at once. If you drop from A1c of 11 to A1c of 7, that will be a shock to your system and will just frustrate you. Some Dr's would say it is really hard on yoru system to correct that fast.

Fourth, set reasonable goals. Using Insulin sugests you set goals and try to attack one goal at a time. Figure out what you need to do and make a list. Only tackle one thing at a time. My list went something like the following (yours will be different):

1. Check blood sugar 7 times a day (I was checking 4x/day)
2. Walk 2 miles at lunch every day.
3. Have good blood sugar levels before bed.
4. Have good waking blood sugar levels.
5. Determine carb ratios (different carb ratio at different times of day).
6. Determine basal doses.

This is a huge and overwhelming list. If you try to do everything at once, you will proobably fail, and then get discouraged. Master one task at a time. Don't start one until you get competent at the last one. Assume one task will take you a week. If it takes you 2, 3, or 4 weeks, that is okay. Each step you take will improve your A1c and should prevent lows.

13

Thanks baby tee, i will slowly work on all these tips you gave me.

14

I am having some spikes after lunch, and this is bothering me because i am in class trying to learn web programming and i get these spikes and make me somewhat confused, hard to stay focused, they usually last an hour after i ate.

I am taking 20 lantus at bedtime and 6u at breakfast, 6u lunch and 6u dinner for a total of 18 novolin fast acting.

For some reason i am almost always over 10 mmol after lunch.
I also feel hungry right before lunch and a few hours after lunch too.
What kind of snacks can i have that will satisfy my hunger and not raise my BG, so i don't have to inject every time i have a snack.

15

You might have higher insulin needs at lunch, DW, or perhaps eat more carbs. That's why set doses don't work as well as trial and error figured I:C ratios.

Snacks that don't raise BG much are nuts, cheese, cold cuts, nut butter and vegies.

16

I feel like my body is playing yoyo, i took a nap after dinner, woke up and i was in a hypo, 4.4 mmol.

not enough carbs in my dinner probably, i had fish and some ratatouille and took the usual insulin dose of 6u. I guess i have to adjust my dose according to what i eat? or adjust what i eat according to my insulin dose?
What's the best method?

17

eat more carbs for lunch? won't that raise my BG even more?

18

Yes, yes, DW, you need to adjust your dose according to what you eat! That is the purpose of the I:C ratio. Rather than a set dose of 6 units, no matter what you are eating, you need to figure out your I:C ratio, then you can eat what you prefer and adjust your insulin for the food you eat.

4.4 (79) is not a hypo but a fine blood sugar.

19

No, I wasn't suggesting you eat more carbs, DW. I was just saying the reason you are high after lunch might be either that you need more insulin at lunch or that you ate more carbs.

Our insulin needs are different at different times of day. My I:C ratios, for example are 1:5, 1:10 and 1:19. By knowing my I:C ratio for each meal I can eat a low carb meal or a higher carb meal and take the right amount of insulin. For example, my usual weekday breakfast is 20 carbs so I take 4 units of insulin. For lunch today I ate 27 carbs so my dose was 2.70. For dinner just now I ate 40 carbs so my dose was 2.65.

20

Thanks Zoe, i will try to learn how to master this I:C ratio and better control it because right now i am either too high or too low, but i am doing much better than 2 weeks ago when my BG was almost 15 mmol any time of the day.

it's been 2 days that i am reaching better readings.
apointment with Endo is coming up on april 12th, so i have 10 days to better control my BG.