Hi JustLookin,
How is this going for you? I’ve been eating <200 cals per meal and just told to go to low carb with 20 grams per day max and < 100 cals per meal. I’m worried what it will do to my insulin requirements and how to handle the lows that may happen ( I mean one Gluco Tab is my allotment for the day 
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Hi. So far going great. Big reduction in insulin doses. I just switched to tresiba and blood sugars are very stable mostly in 80s and 90s. On a typical day I don’t need bolus insulin for meals though I do correct if I find I’m over 100. I have not had any lows below 70. I haven’t, had anything measured higher than 120. 6 weeks in and I’ve lost 5 kg so far. I can almost forget i have diabetes. Very liberating!
From the literature they say when ones brain is running mostly on ketones lows will be felt less because the brain still has fuel.
Take away message for me is that both basal and bolus insulin requirements will change. Expect both to drop. Therefore monitor closely and adjust.
You may also need to consider that any dextrose used for blood sugar adjustment is not counted in your 20g of carbs. As you get into this way of eating your frequency of lows and need to correct these should drop.
Less than 100 calories per meal? I’m not aware of those kinds of restrictions ever being useful outside of certain kinds of seizure disorders. Even then, those are usually administered in liquid form in a hospital. Are you eating more than 10 meals a day? It is generally acknowledged in most medical practices that calorie restriction under 1,000 kcal per day is dangerous territory.
Hi David,
I’m getting ready for gastroparesis surgery and for a month prior to the month after I’m on 500 cals. Then low carb the rest of my life…I would walk on glass to get rid of the nausea…I was wondering how others are doing this and what impacts, especially to my insulin regime which I am gathering I will have to re-learn
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Ok, that makes perfect sense! Sorry to hear about those troubles, and wish you the best! Just stay strong… 500 calories is a brutal deficit to deal with emotionally and physically.
Although I’m not insulin dependent (yet…docs think I’m likely early LADA), I do follow a very low-carb diet, and my (endogenous) insulin levels are quite low. I know it’s not a one-to-one match, so not sure how useful my experience could be to you, but the three biggest issues I’ve had with low-carb are pretty straightforward and simple:
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I digest fats very poorly, and can only eat so much protein. This makes it hard to get enough calories in a day (then again, I need about 2,300-2,500 to not lose weight).
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I have enough endogenous insulin production left, but very low BG levels because I don’t eat many carbs: this means exercise is a serious threat for me to going true low (below 60 mg/dL). It sounds ridiculous from someone not injecting insulin, but at least in that circumstance I take gels and other quick carbs and my testing kit when going for runs/hikes/biking since I’ll pretty reliably drop too low. Fortunately, I don’t have overnight lows since I don’t use bolus or basal at this point.
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I have to take a ton of supplements (magnesium, potassium, Vitamin D, ALA, multivitamin, a strong probiotic, a strong omega-3 fish oil, etc.) due to not getting basic requirements from the carb portion of a “normal” diet. Vitamins and minerals can be surprisingly hard to come by in a low-carb diet. I eat way more salt than I like, because I can’t hold on to electrolytes. I drink a ridiculous amount of water… and I don’t eat homemade bread, pastries, rice, potatoes, sweet potatoes, turnips…fruits, non-green veggies, …, the list goes on, ad infinitum. What it really comes down to is I don’t like eating low-carb. However, it’s the only treatment option I have at the moment that works (along with exercise and metformin to short-circuit liver dumps).
So, I feel for you! I have often thought that when (if) I’m on exogenous insulin therapy, I’ll be able to enjoy “normal” food again. Then again, I feel like a low-carb diet is a small price to pay to keep my health for as long as possible. And as much as I don’t like it, it is working for me.
Stick with it anon, some of your cravings could be gut health related. There is a growing body of research that shows our gut health is driving much more of our health than we ever imagined.
If you aren’t familiar humans a are very large symbiote or host to tons of bacteria that help us digest food into absorbable molecules. The modern diet has skewed the balance of this gut “microbiome” and cravings are a huge symptom.
I can tell you I don’t crave those things anymore but it has been a slow 2 year elimination for me. I used to binge on carbs, I could be good and healthy for a while but stress ate refined carb garbage with the best of them.
You could try a $50-100 gamble on some high quality probiotics & inulin (a food that feeds a healthy ballance of bacteria). I am not affiliated but am a customer and had good luck with Mercola.com products after trying several others.
Feel free to message me if you want to go deeper down this rabbit hole…
I am 6 mos into the lower carb lifestyle (30 - 50 grams) and while my HBA1C has tumbled to 5.4 I find my BG runs lower overall (in the 80’s) I don’t get those fast low BG events anymore. I do test pretty frequently just in case. Hope this helps 
@David49, do you take enteric coated fish oil pills or regular fish oil pills? I’m just curious if there is any difference between the two. I’ve been taking the Costco Kirkland brand fish oil pills.
And yeah, I know what you mean when you said: I don’t like eating low-carb.
Nope, I go straight to the source and take fish oil in a teaspoon 
YUMMY! But you get a lot more bang for you buck that way (i.e., highest Omega-3s you can absorb), plus it reminds me of my youth, when my paternal grandmother would torture us every evening with cod liver oil…
Cool. Are you presently taking cod liver oil? or liquid fish oil? Where do you buy it, and which brand do you use? The Nature Made Fish Oil softgels Label states: Contains Fish (Anchovvy, Sardines, Mackerel)
This is the one I’ve been using. It’s not cod-liver oil, but is from cod I believe. Doesn’t taste too bad, given the lemon flavor.
Nordic Naturals is a pretty solid supplement company. I use their D3 pills as well.
Thanks.
I picked up a bottle. Looking forward to using it!
I can understand that some people have said that the gel caps are easier when travellig.
I agree with TIA. I eat under 40 or 50. I decided to bolus my carbs to what my body can handle instead of being bolusing insulin. I don’t like the idea of being reliant on Big Pharma/Insulin and all its trappings. You know if you were lactose intolerant you would avoid milk, not take some drug that let you have it’s evil way with you…
We as diabetics have a carb intolerance so why not treat it for what it is?
As for Low Carb it has been a gradual evolution for me over the last year and a half. I am in my mid 40’s and did an elimination diet called The Plan, that helped clean up my otherwise healthy diet. Then I transitioned to the Zone diet once I was diagnosed, but that was high maintenance and expensive because of all the veggies I would consume. Now I am happily living on the Ketogenic program for the last two months.
I will be getting my blood drawn tomorrow for a lipid panel. That will be the true test of the Keto. I know from my own monitoring it has kept my BG in check very well. I rarely go above 120 these days. Usually it happens if I over consume protein. I’ll try to check back in once those results come back… Wish me luck
Kevin
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Latest results for cholesterol on keto diet. Dr happy with all except HDL. Don’t know what to do for that. Dr didn’t understand ketogenic diet and seriously raised his eyebrows when i told him my macro targets 80:15:5 fat:protein:carb. Then he said he knows me well enough to know that I do these things with research and monitoring.
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I believe that eating your way into higher HDL is quite hard, but… Omega 3 supplements, fatty fish, olive oil, canola oil, flax seeds, and other such omega-3 rich foods can help raise it. It seems to be largely hereditary: mine is also lower than I’d like it to be, and stubborn as hell. Even though I eat all the “right” things, my HDL number is pretty well stuck.
I just realized, looking at your results. Your HDL is right where it should be, but your LDL is “too high.” That number is also controlled strongly by genetics, and eating seems to have very little effect on it for most people. The one thing you can do to lower LDL is to exercise and lose weight. It might not bring it down a lot, but it will change it to some extent.
Working on the losing weight with keto eating, and am increasing exercise. Will be interesting to see if it decreases ldl / increases Hdl.
I had thought that ldl below 100 was considered ‘good’.
How is an LDL of 96 too high? I mean, I get that there are the absurdly low standards for diabetics now, which seem like they would require almost all of us to be on statins and are based in limited research, but under 100 seems pretty good, and the LDL:HDL ratio is good, so… hard for me to see what’s not working, good job! My LDL hovers in the 100-115 range, but as someone with high (65-75) HDL and low triglycerides, I’m ok with that, and my current endo seems to be as well.
Yeah, I think I even misread that. Why did your doctor have a problem with your lipid profile at all? It seems like everything is in the reference range. Good job!
So scratch what I said about bringing them up or down. Looks like yours are great.