For those of you with LADA who did not go on insulin right away, when and how did your doctor decide to put you on insulin? My a1c is still good (5.8) but my mealtime spikes have been higher than previous but still random enough to confuse me. I had my highest recorded post meal spoke of 17 last week but still sometimes go low (3.5-4) overnight. I don’t see my endo for another 5 months.
Can you talk to endo sooner? I think with big spikes it is time for insulin.
Yeah, 17 (300+ mg/dl) is a heckuca spike. The main thing is how long you’re up there, but if it’s long enough, like 4 hours, thats a DKA risk. A1c isn’t really all that helpful about this, because it’s just an average over time and you only get it tested every 3 months or so. I’m assuming if you’re not on insulin you also don’t have a CGM, but what you need is to have data to work with. Test lots so you can get a sense of how long the spike takes to subside and make notes so you can talk to your Dr intelligently about it. If it looks like you’re spending hours above 200 after eating, he/she may be able to start you with an injector pen of Novolog and some kind of sliding-scale advice about correction doses for this stuff.
Also: in the meanwhile, you should probably just dial back the carbs. In the bad old days that was step one—the list of forbiddens! Once you’re adjusting to taking insulin and carb counting that eases off, but for now your system is telling you you can’t handle the stuff you used to eat the way you did before.
That one spike to 17 was after cake, not after a typical meal. I usually eat low carb (20-30/ meal) but what used to spike me to 10 now gets me to 12 or 13. I do periodically use a libre and did recently which is why I’m considering my next step. I can probably get all my post meal spikes to 12 or less. But I will also almost certainly lose weight and I’m a healthy weight now. I think my endo said previously that frequent spikes of 15 (270) would be when we’d consider insulin but probably only with meals. Basal May be problematic for me. Although I have bad dawn phenomenon, I also go low in the middle of the night. So just wondering when other people decided it was time for mealtime insulin? Did anyone else start insulin with normal a1c?
If you’re spiking to even 10 after meals it sounds like you need insulin. 15 is very high, I’m not sure why it would be ideal to go that high after every meal before starting insulin.
Your high sugars will cause your pancreas to over react and then you go low. I was going hypo a lot just before I was diagnosed, but I didn’t know what it was. This roller coaster effect is dangerous. I think some mealtime insulin could help you. As long as you have some insulin in your system you won’t go into dka but it’s still bad for you and puts more stress on your remaining islet cells.