Thank you so much, Annabella for your words of wisdom (as usual). Maybe that's what I'm supposed to learn from D: acceptance of the inexplicable. I will now recite the Serenity Prayer (a good one to live by!).
Give up? Nah! I had a life-long friend who died 2 years ago after 20 years of a chronic debilitating illness: she could barely walk, often needed oxygen and was in pain most of the time. But she never complained and I was happy to have shared her 60th birthday in Costa Rica the year before she died. Tami makes Type 1 look like a walk in the park. So what if I obsess about numbers, parcel out food like the food stamp police and stick things in my tummy and hips! I feel fine and the pine trees in the woods around my house have a new coat of snow!
No, you were, Shawnmarie, thanks. It's just hard to think of "honeymooning" at five years. I feel like I've been doing this forever, though I know five years isn't long compared to some who've had Type 1 for decades!
Zoe, thanks so much for asking this. I never thought of allergies as being a contributing factor to BGs, but I guess if the body is fighting something it's inevitable.
I think that has been recognized for quite awhile. But there is still a big difference between the very small amount of insulin Type 1's make over time (and its negligible effect on management) and the initial "honeymoon phase" where insulin needs may lower very dramatically for a period of time after diagnosis. I also don't think the term "honeymoon" is too applicable for LADA though it is used. The difference is that for LADA, slower onset (slower death of beta cells) is part of the etiology of our Type 1 to such an extent that we are often misdiagnosed as Type 2 because we can manage on oral meds for months even years. Melitta was reminding me of that fact since she knows I'm LADA.
Hi Zoe and Shawnmarie. I hope I'm not arguing but may I point out that earlier in this thread, I mentioned that after almost 20 years, I produce enough insulin in the afternoon to affect my management of diabetes. I thought this was true years ago; then at an appointment my excellent endo pointed it out by looking at my long term records.
Just saw the Dr. Faustman--Manny video, and while I don't expect a miracle for myself, this much I know: after almost 20 years, I still make insulin.
No, I didn't think it was news, and a couple people said they didn't either but I didn't read the whole thing, maybe she is applying the information in new ways.
I think it's great that you're learning so much and you don't even sound overwhelmed! When I figured out my correct diagnosis I also learned a lot in a short period of time, because I had to but it was pretty overwhelming. I remember one day after the only endo I've ever seen had said to take 1-3 units of insulin before my meals. I mentioned this on the board and Gerri wrote back all about carbs and ratios and I remembered staring at her words and they all just ran together without making sense and I recognized the signs of mental and emotional overload so I turned off my computer and went downstairs to watch tv. The next day I was able to read her post, learn from it and go on to implement it.
Melitta is a lot more widely read in adult onset (rapid and latent) than I am so perhaps the word "honeymoon" is used, but I still don't feel it applies to LADA.
No, I don't see it as arguing at all, Trudy, since, yes, you did just point that out! Just another thing showing that we are all different! Does your endo feel the amount of insulin you produce 20 years in is more than typical? Do you actually know your c-peptide?
Zoe, my endo pointed this fact out a couple of years ago, but we didn't talk about it further. About my c-peptide, I just squeaked by to get my pump about 10 years ago, but I don't remember the number -- .2? My insurance wouldn't pay for another test now, but I would be interested in knowing. Hmmm.
Wow, Trudy, that's very little and that was 10 years ago! Just a question, since I (and others) find we have different basal needs at different times of day (From Noon to 2PM I'm .325 where the rest of my day and night varies from .375 up to .500), how do you know it's due to more insulin made at that time? Maybe all of us who have variations in basal needs have them because of small variations in endogenous insulin production? I thought it was just a normal variation.
I just checked Pumping Insulin but all he just says "Most pumpers are on three or more rates a day. Variable basals work better for those who have DP or whose insulin sensitivity varies due to changes in activity, stress, or other variables during the day."
I never really thought about why it varied, I just saw it did and adjusted. Now I want a new c-peptide! Too bad I don't still live in Guatemala - there I would just walk into any lab, pay about $16, ask for any test and come back to get the results in a couple days!
Hi Zoe. The thing is, my pump settings haven't changed during those hours over all these years. I wear the pump part-time, and I'm constantly tweaking the other hours due to the time of year. My pump setting is 0.2 from 11.00 AM until 4:00 PM. The only reason it's not set lower is that I found my insulin clogged! If I shop or hike or do much moving around during those hours, I have to constantly snack to avoid going low. Of course, it's still an educated guess that I'm making insulin during those hours, but it sure fits.
I doubt that it is due to changes in endogenous insulin production, I think it is just that the body needs different amounts of insulin to function at different times of the day or the cicadian (spelling? I couldn't spell in English & now in American it is even worse!) rhythms, not just DP.
If you read the literature, the researchers seem to consider c-peptide levels of 0.2 or above to be significant (in that it correlates with lower A1c, lower insulin requirement, lower after-meal blood sugars, etc.). So, a result of 0.2 for Trudy is significant in the world of Type 1, and your 0.38 and especially 0.7 would be, even if it's decreased since then. If you look at studies like the Joslin 50-year studies that said that over 67% of Type 1s had some insulin production after 50 years, "insulin production" was considered to be a c-peptide of 0.03 or above. Only about 2.6% (if I remember correctly) of those studied had results of 0.2 or above, and all of them were adult-onset Type 1s. This level seemed to have at least some impact on their control, such as lower after-meal blood sugars, according to the researchers.
In all the literature I've read nearly all those diagnosed as adults (even as regular Type 1 and not LADA) produce some insulin for many years (even over a decade) after their diagnosis and starting insulin. Even adolescents often have some insulin production for a few years after they are diagnosed. It's really only the younger kids (diagnosed before puberty) who have very low or undetectable levels of c-peptide after a year or two.
I actually find the whole topic of c-peptide and residual insulin production really fascinating (hence why I've done some reading up around the subject)! I have never had mine measured but would love to get it done just out of curiosity. I doubt any doctor would do it, though, and I myself doubt I would have a detectable c-peptide level, but you never know!
I wonder where I'm at with that, as I was dx'ed at 16, sort of in the middle, and don't have any family HX, before or since, although the current generation concerns me? Perhaps I'm cheating with "home grown"?
I once was on vacation in Mexico and decided to extend my trip. I called my work and lied (true confession) about being sick. I called from a phone with a view of the blue/green Caribbean in the Yucatan. It was so hard to keep that view out of my voice!
Hi Zoe. You've had a rough week! I hope things settle down for you very soon.
About allergies--pollens are important, but so are molds. I have a host of allergies that get better in the winter, but don't go away completely because, where I live, even if it's too cold for the pollens, it's plenty damp enough for molds to flourish. And then there's dustmites. You said you feel most allergic when you wake up in the morning. Maybe you could buy a new pillow and see if that makes a difference. Dustmites are almost impossible to get rid of but you won't find them in new bedding.
Allergies are auto-immune related and so I guess it's also possible that you've just become more sensitive to various allergens. These auto-immune conditions seem to reinforce each other, working in concert to keep us off-balance!
