What type of insulin should I ask for?


I’ve skimmed the responses, but have not read in detail. I will simply share my own thoughts based upon my own experience. I was diagnosed with LADA at age 46. My A1C was 9.8 and my fasting BG was 260. I needed no basal for the first 18 months and my insulin to carb ratio was 1 unit of insulin for about 25 carbs. Seven years later, I take 8 units basal by pump and my insulin to carb ratio averages 1 unit for 10 carbs. However, I continue to be very insulin sensitive and one unit can drop my BG 100 points over the course of a few hours. If my BG were reacting to my body’s own insulin production the way yours is, trying to take exogenous insulin would be a complete nightmare. Your own body is currently regulating your BG. If you inject insulin, I think you would likely end up feeding the insulin – i.e., you’d have to keep eating carbs to keep your blood sugar from tanking.

That being said, I’m not a doctor, I don’t have your medical records, etc., so these are just my thoughts.


I was worried about taking insulin only because so far I can get down except that one meal. Dropping by 100 would be scary for me but I had considered it since my endo told me to use it to protect my beta cells especially if I decided to eat a very high carb meal. I did get an appointment with my old CDE for an hour in two weeks so I am going to talk to her about it as well.


I wish I’d had an endo or Internal Med specialist like yours earlier in my diabetes. I was misdiagnosed as T2 20 years ago. Six of the nine years before starting insulin, I was taking oral meds that juiced my pancreas to produce more insulin. Metformin worked fairly well for the first 3 years.

I’m not giving medical advice. I’m under the impression that starting insulin early to preserve beta cell function isn’t proven, even though it makes sense. So different medical providers may have differing opinions on the LADA question and how to use insulin to preserve beta cells. I will tell you that I would have preferred to protect beta cells with hopes that might have allowed my body to regulate blood glucose longer.

If you are LADA, going extreme low carb (Bernstein type) to avoid insulin doesn’t make sense to me long term. LADA is likely to progress over time and you will likely end up taking insulin anyway.


I am not the Bernstein type diet right now - I do eat white bread, beans, fruit, etc. I usually do have a salad for one meal a day but that’s also to help me lose weight right now (since I am about 2 months out from being pregnant). I can do about 35-45 grams of carb and peak at around 120 at one hour (I know Bernstein would say too high though). So part of me was wondering should I push to eat more carbs to take insulin or do I take insulin to make it stay closer to the 100 range at peak (which seems too risky for me personally right now). I was also questioning if I should ask for basal when my fastings were higher like mid 80’s to 90s but the last 2 weeks they are in the high 60’s/low 70’s so that doesn’t seem appropriate anymore.


@Ashley30 If what you are doing eating wise is sustainable for you, I’d personally just keep doing this. You’ve received excellent responses to your numerous posts in this thread.

Eating more carbs just so you can justify using insulin is pure madness.


This is a totally normal post prandial level.

Source www.diabetesselfmanagement.com/blog/what-is-a-normal-blood-sugar-level/amp/


Oh yes for now I don’t plan on taking insulin until I have my secondary endo consult. With my original post I wasn’t sure if taking the insulin was the key or keeping my levels low enough to prevent damage (without making my life hell). So based on all the great responses I am just going to keep my diet and wait for my secondary consult and my meeting with my GDM CDE. If that endo also suggests starting insulin now then I know what to do.


Haha yea if I keep a 35-45g meal - I don’t really eat more than that for now since I don’t like seeing highs for 60-70g meals (I can’t imagine eating a bowl of pasta anymore).

I am still not planning on taking insulin yet - if I need it/will help with beta cell preservation I will do it but not yet! Going to go meet with a CDE/secondary endo consult before I do anything besides keep up the diet and try to get my BMI under 23. I am very curious for my new A1C though in two weeks.


There’s an easy way to see if your exceed the normal levels… eat a bunch more carbs, have a big chocolate Costco muffin or something, or go to one of those sushi restaurants that have the conveyor belt… those are awesome then measure at 2 hours and see if you’re over the normal postprandial limits.

I’m confident based on your descriptions here that your A1C will not be elevated to any clinically significant extent.


I have debated doing the Swedish fish exercise with 12 Swedish fish and testing but I am too afraid to do it! Maybe I will try it out and see how high I go and if I come back down.

Oh I actually think my A1C will be lower (or I hope so) since my last one for the first month after pregnancy I ate whatever - white rice, cupcakes, donuts, etc. just curious to see if it changed at all based on change in diet. Also my fasting are a lot lower now than before (not sure if more sleep or if losing a lot of the baby weight).


Don’t get caught up in the exact a1c number… it’s either normal or elevated for practical purposes. Slight differences within normal ranges aren’t particularly meaningful

Try the Swedish fish thing… I’m confident you’ll survive it. I’ll give you $10 if you’re above 140 at 2 hours, and if you’re not, it means your blood sugars are normal. So it’s a win-win for you.


I may try next week - have to do some bloodwork early next week so after that maybe I will try and see what happens!


Sounds like you have a good handle on things. You might ask your endo for specifics on the blood glucose objective for taking insulin and how that preserves beta-cells. And in spite of what I was told not long after starting with insulin, zero is a legitimate dose.