Carb intolerance

I feel very weird. If I keep my carbs at 25 or less per day, I can control my diabetes. I know, because I did it for 2 years and was completely off insulin. I can’t (or won"t!) live that way. So, I’m trying to strike a balance. I’m trying a pump for the first time - I hope this works. Any suggestions?

I see you are Type 2, diagnosed 12 years ago, which is a pretty average amount of time for when Type 2’s need insulin. I don’t mean this as a put-down but only an observation: I see that your last A1C was 9.3. I don’t know if it just started going up recently, but with an A1C that high your strict 25 carbs a day is really not controlling your diabetes. So yep, it seems like it’s what you need to do, and don’t view it as a “failure” but just the normal progression of the disease. Many Type 2’s avoid insulin as long and hard as they can, but then are relieved when they go on it and their life gets much easier. Have you been able to get the pump yet?

A few suggestions on pumping.

  1. Read John Walsh’s “Pumping Insulin”. It’s everything you wanted to know about pumping and didn’t know to ask.
  2. Develop strong carb counting skills. A pump gives you the ability to fine tune every dose but you can’t do that unless you get the carb count right.
  3. Work on getting your basals down as soon as possible. Basal insulin provides a back ground which allows you to stay steady without eating. Without getting the basals more or less right nothing is going to work.
  4. Keep logs - good logs. Looking at logs helps you see patterns and correct problems.

Good luck,


I think I mislead - I low carbed a few years ago and got the A1C to 6.2 without meds, but I had to limit my carbs too much. I just got a pump (am actually waiting for training) and am tracking everything carefully. I do better with insulin, but still struggle with getting it balanced and hate doing the shots, hence my MDs pump recommendation. thanks for youe reply!

Thanks for your recommendations. I find the whole basal thing confusing. I’m awaiting training on my pump and hope I’ll get a good explanation on this.

I agree! First read the book. Things will make a lot more sense when you go for the training. I am just about to finish the book and I feel very good about going on the pump for the first time. I feel that I understand the terminology used in working with the pump much better and what to expect.
I also use several apps to help me keep logs and my carbs. They are RunKeeper Pro for my walking, Carb Diet for carb counting and Glucose Buddy to keep up with my readings.

Sorry about my misunderstanding, soga, so currently you are no longer eating low carb…there’s a lot of ranges of how much carbs we eat between “low” and “high” but you’e having a lot of trouble controlling your blood sugar on MDI’s? Some doctors won’t prescribe pumps for their patients unless they are already doing well on blood sugar management. Ironically, some won’t prescribe them if the person is doing “too well” (doesn’t appear to need the pump). I think both prohibitions are silly but do think there are basic skills that can be learned on MDI that also apply to the pump. It’s not a panacea and if you don’t have those basic skills it doesn’t help the control much. Some of those skills include carb counting, record keeping, dosing, ISF for correcting, I:C ratios, etc. If you are not super proficient on those yet you might want to review some of those things as you work with the pump. I agree with the others that Pumping Insulin is a must have book. If you don’t have it, Using Insulin, also by John Walsh is good for those basics.

Congratulations on your pump! I’ve only been on mine (the Ping) for 7 months but couldn’t imagine being without it!

The simple explanation is that your basal insulin is designed to keep your blood sugar fairly steady (within 30 points +/-) over a long period of time. During a basal test you eat a low fat, reasonable protein meal and then begin to test every hour or so starting with hour 4. If your blood sugar goes up or down by more than 30 points you adjust your basal. Trainers usually go over this in a lot of detail. Be sure to ask questions if you are unsure of something.


There may be a happy medium between 25 carbs a day and a pump. However, if the pump is the best way for you, go for it.

For those still looking for that happy medium, this technique may be worth considering: Test, Review, Adjust

I don’t understand what you mean, Alan by “happy medium”. I’m assuming you are saying that 25 carbs a day is an extreme dietary restriction. Do you consider a pump an extreme as well? How so? (just curious)

I have T1 too but a huge benefit of the pump for me was logging more accurately and more thoroughly. The “test every 2 hours” was sort of what I was doing but I wasn’t totally keeping track of it the same way, I’d miss swathes of time that would drop out of the record but would still be there. With the pump chugging away, it became much easier for me to see patterns and attack anomalies before they got out of hand. I am sort of extreme though so perhaps it didn’t faze me as much? I have around 130-150G of carbs most days which is also sort of “stuck in the middle” between the very low carb afficianados and the “food pyramid”. I am pretty conservative with carbs during the day during the week but splurge evenings and weekends. For me that seems to work nicely…

I was commenting on the original post:

I feel very weird. If I keep my carbs at 25 or less per day, I can control my diabetes. I know, because I did it for 2 years and was completely off insulin. I can't (or won"t!) live that way. So, I'm trying to strike a balance. I'm trying a pump for the first time - I hope this works. Any suggestions?

sogamusicman said " I'm trying to strike a balance." In that context, for blood glucose control I do consider a pump as an extreme if the other extreme is 25gms carb a day. There are a lot of other dietary and medication options apart from extreme low carbs before I would think a pump is appropriate.

I suggested a possible way to try to find that balance point. But that's just my opinion. No-one has to agree and sogamusicman is fully entitled to do exactly as he or she wishes.

Cheers, Alan, T2, Australia
Everything in Moderation - Except laughter