Woohoo, finally got on insulin

I haven't been posting much lately, mostly due to being busy. I was also really discouraged. For the last year I had another one of those doctors who told me to exercise more and eat less. Hmm, 25 miles of running per week isn't really exercise is it? I recently got new insurance not to mention moved so I found a new doctor. For the first time, I have an internist who actually knows what LADA is and despite not having GAD antibodies she still believes I am T1. She actually paid attention to the fact that my insulin levels are on the very low side of normal.

She put me on Lantus and took me off the glimeperide. I'm still trying to find the right dosage for the Lantus but feel much better without the glimeperide. I feel like I will finally get my BG under control. That was a great Christmas present.

Congratulations! Do get Using Insulin by John Walsh if you don't already have it and feel free to ask questions. It takes awhile to get it all going smoothly and there's a lot to figure out so hang in their through the learning curve!

Zoe's right. The most important element in your success using insulin will be your knowledge. Insulin is potent, effective, and demands respect. I hope you feel a lot better. No mealtime insulin?

Zoe, Thanks for the book idea.

Terry, Doctor just did Lantus for now. She is sending me to the endo and a diabetes educator also.

I have been diabetic for about 15 years and have struggled the whole time to keep my BG down. No matter what I ate or how much I exercised I had problems. I only had one doctor who would listen to me. The rest told me that I just didn't eat right or exercise enough. That included eating 25 grams of carbs per day and running 30 miles per week. I still had doctors tell me that I didn't do enough and if I would just do more they would be able to take me off all the drugs. I have been on glimeperide for about 3 years now.I have been battling morning hypos and afternoon highs

I have actually been on insulin before, when I was pregnant. Much tougher then with the old insulins.

I'm glad you finally found a doctor who could help you. I think many of us have struggled with getting a proper diagnosis. I pushed for years to get the proper tests and move to insulin. I finally got the antibody tests, all negative. And my previous endo ("He who shall not be named") always told me I had diabetes because I was overweight and refused my requests for insulin. I eventually fired him and started insulin (gosh was that really 4 years ago?).

I had prepared for insulin for quite some time, as Terry suggests insulin demands respect. I bought "Using Insulin" by Walsh as Zoe suggests as well as "Think Like a Pancreas" and had read extensively. I still walk around with the label "Type 2" but it appears that my insulin production has declined markedly, my last c-peptide was 0.4 ng/dl which qualifies me for a pump. My current endo ("She who will gladly be named") now calls me "Ideopathic Type 1" sometimes called Type 1b. This category includes a type of diabetes called Ketosis Prone Type 2 where insulin waxes and wanes, but also includes other "undiagnosable" types.

I still wear the label Type 2 because Type 2 truly means diabetes of unknown cause. And that is what I have. However for my own sake I may need to hide behind my endo's classification of me as a Type 1 in order to get access to medical care such as an insulin pump or CGM as access is distinctly biased against Type 2s.

I have also been preparing for years. I read "Think Like a Pancreas" a few years ago. I have done lots of reading.

Other doctors have told me that I am not obese enough to be on insulin. I will take the T1 label since it gets me on insulin. I actually think this is rather common with Asians. I have some older relatives who are fairly thin who also are on insulin.

I meant to ask when you first posted 2 days ago, if your previous doctor was so, uh ... what's a good, respectful euphemism for idiotic? ... and refused to actually diagnose you properly, why did it take so long to visit another?

Not intended as criticism, just curious. I probably would have just accepted that I was T2 as I was told back around 1980 if my sister hadn't insisted that I see a doctor she scheduled an appointment with.

He scheduled a glucose tolerance (do they still do those?). The difference was that for this test my BG & the amount of insulin in my blood were both measured. When the results came back I recall being told I was producing only about 1/2 the insulin a non-diabetic would.

I might still have the graph from that test laying around somewhere. I really should try to find it and scan & upload it. ;-)

-irrational john
T1 LADA since roughly 1980
first pump: Minimed 507

Due to lots of moving (I actually lived in 3 states in 2013) I have changed doctor's often. Also, even in the same office I had a few different doctors due to having them move or other things. In the last 8 years when I started suspecting that I wasn't a T2 I've probably had 12 or so doctors. Out of them, this is only the second one who actually realized that I wasn't very typical for a T2. When I was diagnosed 15 years ago, I had never heard of LADA and apparently neither had the doctor's. Even now, some don't seem to really know what it is.

Anyway, this last batch of doctors I was with for about 6 months while I was temporarily living in one city. I knew I was moving out of that city so didn't bother to find another doctor. Now we are settled, bought a house, got a regular type of job and will probably stay here for a while.

I have learned over the years that doctor's have a tendency to brush of their patients (I worked in a hospital and have found many doctors kind of have an attitude that they are smarter than the rest of us). They look at my chart and some other smart person said I was T2 so I must be. Nothing I say will change that.

I find many doctors will stubbornly kling to their ideas. In high school, one of my daughters was super atheletic and was extremely muscular. She weighed a lot for her height and so her BMI was high. She had no extra body fat, it was solid muscle. The doctor took one look at her weight and lectured her on eating properly and maybe getting off the couch to walk a little. My daughter tried to explain that she worked out about 4 hours a day but the doctor said her BMI was high so she was fat.

I sort of have a love/hate relationship with docs.

I have learned over the years that doctor's have a tendency to brush of their patients (I worked in a hospital and have found many doctors kind of have an attitude that they are smarter than the rest of us). They look at my chart and some other smart person said I was T2 so I must be. Nothing I say will change that.

I believe the problem arises because doctors often are smarter than the rest of us. It either is or at least should be one of the requirements to do that job. They are also extremely well educated and, in general, highly competent.

And all that can make them really, really stupid. Dumb is bad enough when it's just ordinary dumb. But it can be ... well, really bad when you've got an otherwise intelligent idiot. It can be really hard to talk them out of their stupid because they can think of lots of very clever ways to dumb themselves down. <sigh />

I suppose what got me thinking along these lines was this NPR interview with Dr Jerome Groopman:
Groopman: The Doctor's In, But Is He Listening? MARCH 16, 2007

I think you might find it interesting. I would also suggest you read the except (preface) from his book. It describes a case which might resonate with you. A woman, "Anne Dodge", was misdiagnosed again & again & again & frickin' again until she finally met a doctor who asked what every doctor should ask himself: "What else could it be? What could I be missing? Where could I be going wrong?"

Goodman was plugging his book at that time so he also did an interview on the program "Fresh Air". Here's the link to it as well mostly because I'm OCD: 'How Doctors Think' interview on Fresh Air

-irrational John
T1 LADA since ~1980, first pump: Minimed 507 (late 1990s), currently: Minimed 723 + CGM (2013)

That's great, welcome to the insulin club! There are so many Type 2's who would benefit from insulin, glad to hear that more and more docs are willing to take the plunge with their patients. Make sure to see the endo at least 2x per year, ideally 3-4 times especially until things are stabilized. You'll get the dosage figured out, just trial and error. What a great way to start the new year!

I'm cramming for a huge exam. I take the first test in about a week and the second at the end of Feb. Then I'll have a little time to do some reading of my own until I start prepping for another certification. It is apparently the year of certifications for me. Thanks for the links.



Out of curiosity, what type of certification(s) are you working on?

BTW & FWIW, your site "PROFILE" still says you have "Type 2 diabetes". It just seemed as though that might matter to you. ;-)

-irrational John
T1 LADA since ~1980, first pump: Minimed 507 (late 1990s), currently: Minimed 723 + CGM (2013)

Sound like my case too. Thin Asian male (33 years old) with Diabetes. I also bought "think like a pancreas" from everyone's advice here and I'm preparing myself mentally to assume I will need insulin in the future, but am working to see if the LCHF will work for me.
Good luck with the insulin. I think it makes more sense to use fasting acting insulin before meals with your lantus because controlling the postprandials will be important.

Certified Management Accountant. After 20 years of being an accountant I went back to school and officially became one. Now I have two tests to be certified. Then later in the year I plan on taking the SPHR which is a Human Resources certification. I'll be 50 at the end of 2015 and will probably, maybe? stop getting letter after my name.

Thanks, I'll go change my profile. It really doesn't matter so much except that the doctors always treated me like more exercise and eating different would help me.

My daughter has spent a lot of time studying my health issues and she said there is something she calls "Asian" diabetes. It is generally diagnosed as T2 but really is our own special disease. I was your age when I was diagnosed. I walked several miles a day, worked my ranch hauling feed, fixing fences etc. and did an hour of high impact aerobics every morning. I ate lots of fruits and whole grains but they were very healthy foods.

Don't feel bad if you end up on more drugs or insulin. It isn't a failure on your part. The reality is, we just have organ failure. I figure any way to stop the rot is good. I win if nothing fails or gets amputated.

Congrats! Awesome!