Regulating Insulin dosing

Newly changed from type 2 to LADA,,Changes in medications esp insulins, Lots of highs and lows trying to play with insulin with md on dosing..right now levemir 20-25units @ night with epidra 7-10 units with meals three times a day..trying to figure out when to lower or hold insulin with increased exercise, decreased appetite etc...Is this going to be easier as i understand how my body reacts??? thanks How to find support groups locally??

Hi Rose. I'm glad you were correctly diagnosed as LADA; so many of us were initially misdiagnosed Type 2 due just to age! Yes, things will get easier over time, but what I would suggest is you get the book Using Insulin by John Walsh. That will help you understand how to set up your Insulin to Carb ratios. But to quickly explain it: The best way to dose for meals is to know how many carbs you can cover with one unit of insulin, called an I:C ratio and many of us have different ones for different meals. One way to do it is to start with 1:15. So if you are eating 30 carbs you take 2 units. If you are always high two hours later from that I:C, than try changing it to 1:13, etc until you get the ratios that keep you in range more often than not.

We are all different, but your Levemir of 20-25 units and Apidra of 7-10 units sound pretty high for a Type 1. If you are having a lot of lows you might want to slowly reduce those. Does your endo work with many Type 1's?

For support groups I recommend contacting either your local hospital (though they often have only type 2 groups) or the JDRF in the nearest big city which are more likely to have Type 1 activities. My JDRF didn't have a support group for adults so they backed me in starting one (a Type 1 Women's Group which is amazing!) There is nothing like meeting others who truly understand!

Hi Rose,
Hang in there! I also went from T2 to LADA and in the beginning I was on a lot of insulin too. It will most likely gradually go down over time as your body adjusts. It did with me until I was hardly taking any, but then I started needing more as my honeymoon period decreased. I have noticed over the last year and half that I've been on insulin that I have had less and less lows and less up and down swings in general. I think a large part of that is me just learning how to manage my diabetes. It's so hard sometimes!
I hope you find a good group. Sometime I want to do a JDRF walk or 5k or something just so I can see large groups of people just like me! I get so tired of people staring at my pump or me checking my bs. We are all too polite and PC in this day and age. I wish they would just ask so I can happily share the fact that I have diabetes. I guess I'm too shy to change conversation topic with, "Oh. I've noticed you starting at the general vicinity of my crotch/hips area for a large part of our conversation. No I'm not stuck in the 90's with a pager. It's an insulin pump." But that just feels impolite. :)

It will take a lot of adjusting until your honeymoon period is over, but in the meantime you will be learning what works and what doesn't,what foods affect you the most and least, I was fortunate to go on a pump about a year after I was diagnosed LADA, which is much easier than shots--and more acceptable in public. Of course, just when you have things figured out, you diabetes goes and changes, but that's how the beast works. My support group is thru my hospital, and includes T1s and T2s, which I prefer. I'm not keen on separating the 2, I've heard way too many nasty comments from T1s about T2s. Both have similar problems, and when I start feeling sorry for myself, I think about some of the T2 stories, which sound more like horror stories to me.

Thanks to all,,Will get the book Using Insulin.

You may also may want to check out Dr Edelman's book, sold on the TCOYD website-its a great reference book, also Think Like Pancreas.

Hi Rose: I put together a blog on my top ten tips for the newly diagnosed adult-onset Type 1 (LADA is Type 1 diabetes, just a slower onset) that you might find useful. And yes, the insulin dosing does get MUCH easier as you do a lot of testing and see how your body responds. As Zoe suggests, "Using Insulin" is a great book. Several other books that may be useful are "Think Like a Pancreas" and Ginger Vieira's "Your Diabetes Science Experiment." Best of luck to you!