High bg's with low carb diet and exercise

MegaMinx, I have noticed my bg rises in the morning too but esp with caffeine-I have heard thre may be a correlation but not sure. I think you are right about needing more insulin when you reduce carbs and eat more protein and fat. I have been experimenting with TAG today and so far it seems to be working well…but we will see. Whenever I think I’ve got it right something changes! I would definitely like to get the cgms because I think that would really be enlightening! Thanks for your suggestions!! :slight_smile:

I do believe that protein contributes to blood sugar rise, I count half of the protein grams as carbs. Bernstein also recommends this. Also, morning is always a hard time for me. And once you low carb and your insulin levels drop, you can have situations where your liver dumps blood sugar (low insulin and rising glucagon starts gluconeogenesis). So something like exercise in the morning can be a real problem. It sets up the conditions for major Darn Phenomenon even if you start out low. Dr. Bernstein recommends against exercise in the morning for exactly this reason. I actually have to bolus for my weight training, otherwise my blood sugar rises.

YDMV ( Your diabetes may vary) is the name of the game,Katie.I totally agree!! I forgot ,in my post telling you to read Pumping Insulin. that you ARE A CDE. Sorry if I was "preaching to the choir".It is great that you have both the first-hand experience and the credentials to help others. Way to go!!!

God bless,
Brunetta

Re your "trusting the pump" comments, what I learned from from the MM pump, even w/o the CGM is that if I ate really regularly which I do during the week as much because my job is nutso and I'm really just eating for fuel, the pump reports, splitting it up between at meal BG and post meal bg gives me a notion of the accuracy of my bolus settings w/ the post meal numbers and the basal settings w/ the pre-meal numbers. If they aren't coming out where I want them to be for like 3 days, I'll make adjustments until the BG is where I want it. It may oversimplify it a bit and, well, weekends can be crazy but it has gotten me to an ok spot and allowed me to pursue some of my other interests.

That is very interesting! I wondered since I had dropped my carbs considerably if perhaps my liver was releasing stored glucose in my blood. I am so glad for tudiabetes because no one has ever told me protein contributes to bg rise. When I told my old endo about having high’s in the morning without eating any carbs he assumed I had a bad site or air in the tubing…uhm everyday? I think not dr! I bought Dr. Berstein’s book recently and am looking forward to reading it. I noticed when I was exercising in the morning regularly I wouldalways have higher bg afterwards but my dr didn’t buy it. This really explains a lot. Thanks for your help! I was exercising in the afternoons only but recently started doing more in the mornings because it’s just getting so darn hot! Thanks again for your help!

Ok that makes sense. I’ll download it in a couple days and see if I can’t make heads or tails of it. Thanks for your advice. I really should be downloading more often and going through the reports.

TAG? Finally I’ve got SWAG figured out today and here’s another one.

Second all the above advice. 50% bolus for protein has been working well for me. I've done away with dual / square wave. Apidra seems to peak in 1-2 hour lower my BG for 4.5 - 5 hrs. Seems to cover protein nicely if I take it all at once.

I've been eating quinoa instead of rice for several years. It's healthy, doses true and tastes great.

I don't always TAG, but if I'm eating a significant amount of protein and/or fat, I find it helps the later spikes (like your 4 hr pp one) a lot. For some reason if I have no carbs with a protein/fat, I spike more, and sooner. I've found combo boluses great for those meals, though it did take me quite a bit of trial and error to figure out what timing/% works for me.

If you eat that few carbs per day, you're going to need to keep track of the protein content of your foods, because your body will be converting proteins to carbohydrates. You're also going to need more insulin per carb.