The symptoms of MODY would be the same as the symptoms of T1D, but maybe you’d use a little less insulin, and you can get a genetic test to rule it out. The difference is that many people with MODY can control their blood sugar without insulin but with pills instead, although they typically would be diagnosed when younger.
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The basal seems reasonable and has been working for me. If I’m LADA, would oral meds be a bad idea? My Endo wanted me to consider the possibility of taking repaglinide, the generic version of Prandin.
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I don’t know much about oral meds… I personally wouldn’t be thrilled for myself about any of them unless they were offered in addition to insulin and a good explanation was offered about their possible benefits
I also don’t know much of anything about how diabetes presents differently in various ethnic groups, although I know there is a lot of discussion about that amongst hc providers… all those things may be going into the discussions
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[quote=“Sam, post:23, topic:10459”]
much about oral meds… I personally wouldn’t be thrilled for myself about any of them unless they were offered in addition to insulin and a good explanation was offered about their possible benefits
I think if my pancreas produced no insulin, I would not think that there would be any benefit or convenience of taking oral meds. If my pancreas can produce insulin- maybe it needs a push…I don’t know.
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True. Your body requires insulin to survive, so if you don’t make it you must take it to live.
I’m an insulin-only guy. I don’t make it at all anymore, so I just take it. But the oral medicines do various things. Some kinds reduce insulin resistance, which some folks believe is helpful to some type 1s. Other medicines flog the exhausted pancreas into squirting out a bit more insulin. Another class of medicines causes the kidneys to leak blood glucose into the urine. There’s another kind that slows down the digestion of carbohydrates after eating. The choice of therapy and the reasons for those particular choices may be a good topic for discussion with your medical professional. You can get an introduction via articles such as Diabetes treatment: Medications for type 2 diabetes - Mayo Clinic
Medicines have side-effects, which is why the doctor doesn’t have you just take all of them. There are trade-offs that need evaluation by someone well qualified to do that.
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Thank you! The doctor and I had a brief talk about some of the above drugs. He didn’t seem to like the side effects of Acarbose, the one that slows down the digestion of carbohydrates. it produces gas because basically the carbohydrates are fermented in the colon, similar to beans producing gas. I don’t like the idea of Invokana - sugar in the urine. it was described as pee out the sugar in the urine. I have read about lots of UTI. Imagine, all the sugar in the urine. He is leaning towards Repaglinide, the generic version of Prandin, and has given me a prescription to try it. I completely understand your description above of “flog the exhausted pancreas into squirting out a bit more insulin.” I don’t know…it’s not easy. There are some people who have used Repaglinide for awhile and seem to be ok with it, on Facebook groups.
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Is this like Symlin? From what I understand, that can be helpful at lowering BG spikes but it’s a very finicky drug to dose – you have to take it at the right time, and some people feel pretty nauseated by it.
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Because I’ve been down the same road, and been equally frustrated when less than stellar doctors couldn’t comprehend the dynamic… so I dug into it and learned what I could
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I’m not familiar with Symlin, and just read about it in wikipedia. Repaglinide behaves more like sulfonylureas; although, repaglinide has a shorter duration of action than some of the sulfonylureas. Therefore, repaglinide needs to be taken at every meal.
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oh I’m sorry i misread it as Pramlintide! You’re right! If you have some residual beta cell function though and i fact have LADA, I would worry that a sulfonylurea might hasten the demise of those beta cells by putting extra stress on them. I’m not sure though whether that’s the case with Repaglinide.
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Do you mean basal??
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Yeah… that’s what I meant to say, and I was going based on memory on tiny phone screen so that actually may not be correct might be estimated tdd with half and half split
But not to get off in the weeds, what I mean to convey is that significant c pep levels, minimal basal needs, and disproportionately large bolus requirements are quite characteristic of LADA and that can linger in that state for quite a long time or even forever
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Yes, I think it is TDD, but as you said, that formula is just a starting place!! For those whose schedule is erratic or includes lots of activity/exercise, it probably wouldn’t be very applicable, at least it isn’t for me!
Yep, I understand your meaning re: c pep levels and totally agree with you!! No D is easy! 
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Wow, I weigh… far, far more than 85 lbs, and I take 18u Tresiba. I do take metformin ER though. I think before I went on metformin, I was maybe at 23u? That formula would be very off for me, and I’m close to my 30 year T1 anniversary, so presumably I don’t make any insulin.
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Yeah… I corrected myself to say that number would be the estimated TDD… with half being basal
I’d also WAG that as a 30 year t1 your bolus levels probably aren’t disproportionately much higher than your basal?
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Ok, for TDD that makes more sense.
I think for me it varies a lot re the ratio. When I’m eating low to moderate carb, I’m probably close to 50/50. When I eat higher carb (which I only do when my food sensitivities leave me few options), I may end up taking more bolus. Still probably not to level you’re talking about here with LADA though.
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My blood sugar at the time the blood was drawn for c peptide
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The lab test said that my BG was 75 at the time the blood draw was made for the c peptide…
So my BG seems not high. What may be inferred, if anything?
BTW -
What are the c peptide numbers for-
A. Type 1
B.
Glucose normal non diabetics.
C.
Type 2
Maybe there is no answer to the above question.
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I’m not an expert but what I would infer from it is that you have normal fasting blood sugar levels with a normal c peptide level while taking very little insulin overnight… so I’d say that means you’re capable of producing, in the absence of food— “almost” enough insulin. The observation that you take disproportionately large doses of insulin with food makes me think that you’re not capable of increasing that amount of insulin production on demand whatsoever
Normal lab ranges are just that— normal… they’re not broken down into specific categories for specific ailments generally
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Ah…!
How much basal does a type 1 use?
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