Ghost lows

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1

So, I'm still doing well with low carb / tight control. Reading still stable, and no longer interested in eating carbs at all. I'm gradually lowering my before bed BG target. Now 140-150, along with my night time basal now .775u / hr.

My basal during the day .85u / hr holds my BG almost completely steady. However, in a couple instances, I've mysteriously dropped 20-40pts. This morning, I went to bed ~140. Woke up 62. Took a glucose tab 4g fast carb. Carb ratio of 8 is pretty accurate, so should've brought me to about 90? 30 minutes later, still only 68. After coffee + 1tsp milk, finally stabilized at 77. This is all without having exercised for over 3 days.

I've always suspected that there were other factors at play, making my BG unstable. Now that I have eliminated most of the variables, it somewhat confirms my suspicion. After all this time, do my islets still wake up and kick once in a while? Am I MODY or something? Seems very unlikely. Who knows?

2

Also, I'm finding that on this low carb diet, my urine is sometimes negative for sugar with positive ketones. Is this to be expected?

3

This is Avery good question and I was hoping you would have some answers! I have the same problems sometimes but I know that my pancreas does not produce any insulin anymore because I’ve had the test done where it can show how much it works and it shows not at all… Id you show some ketones it means that you have had some highs lately and are residual most likely

4

*if

5

Or actually now that I’m thinking about your ketones and I just retread your second post. I wonder if you are not eating enough carbs? Remember the Atkins diet that was out
. They warned people that they could get ketones with to low of a carb diet. It could mean that you are burning muscle for energy which is dangerous. I’m just thinking out loud. If you google ketones you will learn more about where they come from, course they don’t come from just diabetics! I hope this helps but I’m just writing as I’m thinking…let me know what you find out cause I’m Curious!

6

I think the ketones w/ lc diet is not necessarily bad, as long as your BG is ok? If I had .85U and dropped from 140---> 62, I'd try cutting back a bit, maybe even to .80U to see what happens? It might smooth things out. Once it's smooth, I'd maybe aim a bit lower at bedtime and run 80-80 all night?

7

I've been eating very low carb, about 30-45g / day intentionally, and essentially living off ketones. I believe that these ketones are coming from fat, not muscle. At least that's what I'm hoping. Other than the one issue with an injection site, my BG's have been stable. Around 100, so there's no chance I've been in ketoacidosis. I've alway thought of ketones in urine as trouble. Maybe it's normal in this case, though. I'd like to hear from others that have been on restricted carb diets. Seems like many of us, here.

8

I was taking .80 / hr when I dropped 140 --> 62. .85 is during the day. I lowered night time to .775. I'll see how it works. I woke up a few nights ago in the middle of the night, and corrected for a 175. So it seems to swing both ways. Mostly down, though. When I was a kid, I went into insulin shot at night many times, so I have a habit of going to bed high. I'd love to run 80-80 but it'll take some work. Night time has always been a problem for me. I'm also an insomniac. Thanks for all the input.

9

Googling around, the whole ketosis thing seems to be a pretty polarizing issue. I feel fine, though, so I'll just keep doing what I'm doing.

10

discussed here previously

https://forum.tudiabetes.org/topics/ketosis-confusion?commentId=583967%3AComment%3A806267

11

Ketosis is different from ketoacidosis? Some of the challenge can be figuring out if lows are from "leftover" bolus insulin vs. "overabundant" basal insulin. Junior has some later classes so we've had some 8:30-9:00 dinners for a while and, generally, there seems to be some delay/ slowing of everything at or after bedtime? Sorry I don't have a more useful observation but food for thought or thought for food?

12

It’s all very interesting and I hoe you figure it out and it’s actually making me wonder about my own situation. Lately I’ve been waking up low in the morning. I always used to have problems with the dawn phenomenon. Funny how things are always changing. Also, how did you learn to eat such low carb. I keep trying but not succeeding!

13

To my understanding, ketoacidosis occurs when the body is deprived of insulin and so it burns fatty acid for energy, which it can't use. The blood becomes acidic, and goes into a death spiral. Ketosis is when the body does have insulin, but is deprived of carbohydrates, so burns and metabolizes the same fatty acids at an elevated rate, for energy. It is normal during exercise. This is the goal of a lot of low carb diets and caveman diets. Some say that it is damaging. I hope not. Ketogenesis is the normal metabolism of fats, which wouldn't show up on a urine test.

Still trying to figure out the night time lows. Honestly, I haven't been 100% scientific about it. Probably doesn't help that I work nights, sometimes. went to bed @140. Woke up 126 on .775u basal. So I'm moving in the right direction. not long ago, I was on 2.5u / hr at night.

14

re: low carb

Again, mostly Dr. Bernstein's recommendations. Cutting down never really worked for me. I had to quit cold turkey. Got rid of all bread, rice, pasta, beans, fruits, root vegetables, milk etc. Went to the grocery store. Got a whole bunch of Wasa crisp breads. I eat about 2-3 / day. I was really hungry and had intense spaghetti / pizza cravings the first 3-4 days. I cheated a couple times and my BG spiked a lot, even though I bolused. When I'm hungry, I'll eat a spoonful of greek yougart, piece of cheese or some crackers. I'm a pretty good cook, so it's actually been a fun challenge to figure out meals. If I'm out, I just avoid any starch and I eat slower. It's much easier now that my body is used to it. I need less food to feel satisfied. My BG is steady. I have noticed that my posture is better, and I think my vision is a little clearer. I don't crave carbs anymore at all. The other day, I needed to eat half of a small cookie to push up my BG before a meeting. I had to force myself to do it.

15

can you give me an idea of what you DO eat? im actually at the library right now and maybe ill look at bernsteins book again. i looked at it before and it looks a little bit to intense for me. actually if you go on dlife you can find a video of my doctor. dr wolpert and dr. bernstein having a debate. so i know my doc does not support his theories but i would like to learn how to eat lower carb. i seem to eat 40 - 80 carbs per meal.

16

I saw that video before. I am not a patient of Dr Bernstein. I have never met him. Just read his books. I've never had an endo with T1. They tell me my BG should be lower and tell me to take more insulin. If I get low, eat a sandwich. It just doesn't work well, in my experience. I've basically arrived at this method, through the process of elimination. Until a couple weeks ago, I ate at least as many carbs as you.

Right now, I'm almost eating exactly what I ate before - starchy food.

here's some sample meals. I'm usually cooking for 3. I'll also give my son noodles, bread, bananna, etc.

For Breakfast, usually a 3 egg omlette with red peppers. sometimes seaweed or cheese. Usually coffee with 1tsp heavy cream, which I also use for sauces. Sometimes 1 or 1/2 wasa cracker with cream cheese.

For lunch maybe a stir fry. Sausage with hot peppers, okra, scallions, bamboo shoots. If I don't feel like eating meat, substitute tofu or fake soy meat. I'll serve the stir fry on a lettuce leaf or tortilla made of soy flour. Maybe ramen with shiratake noodles.

For dinner I like fish. Maybe a whole porgie steamed in wine and soy sauce with a little lemon juice, fresh basil. Grilled salmon steaks. Roast chicken w/ salad, vinegar dressing is good.

My wife or I will snag whatever looks good at the store, and figure out something to do with it. I like eggplant a lot, too. I drink a lot of water and seltzer. Occasionally a dry white wine or beer. If I eat out, I'll get a burger or gyro and just not eat the bun or fries. Any kind of sandwich without the bread is pretty good. I enjoy salad sometimes, too. Also, mustard instead of ketchup. Or mayo, but I make it myself. For side dishes, pickles or sourkraut or shredded steamed cabbage are good. I eat a couple small snacks during the day, too. My body is getting used to eating a much smaller volume. Drinking water helps.