Insulin for keto/low carb

Hi, Just curious about others’ experience with keto/low carb foods. For me I often still need a lot of insulin (relatively-speaking) to cover these. For example, I’ve had Healthy Life’s keto buns a few times now, which are each 1 carb, and yet I need a whole unit of insulin to cover it (normally my ratio is 8.5 carbs/unit). I’ve had similar experiences with other low carb foods needing proportionately more (sometimes a lot more) insulin. Any ideas why this might be so/similar experiences?

When low carbing I was eating 30 carbs daily, and I needed an average of 20 units of insulin daily. I did this for 11 years. For the last 5 yrs I have eaten around 270 carbs daily while eating a low fat plant based diet. I now take an average of 22 total units daily.

I am 5’ tall and weigh 105.

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I’ve found the many “keto treats” are in fact highly processed foods that use ingredients like almond flour to substitute for wheat flour. This substitution does cut down on total number of carbs but still are comprised of ingredients that can absorb quickly.

I avoid these foods except on the rare occasion when I want to engage in the shared fun of Christmas dinner or a birthday party. Every time I do that, however, it makes me wonder if it’s even worth it. And that brings me back to the sentiment that no food ever tastes as good as an in-range glucose level feels.

Keto bread, buns, chips, and baked treats made with alternate flours are just not worth it to me. They’re still highly processed and absorb into my metabolism too quickly and make glucose management more complicated.


That’s interesting, thank you!

So true. Thanks for your input!


I agree with @Terry4 about Keto low carb foods. I also find that net carbs (carbs minus fiber) is not a good guide for bolusing. I don’t bolus for just the net carbs but net plus 50% of the fiber. That seems to work well.

If the fiber was indissoluble, then it should not be an issue. But some fiber is soluble and can be digested. I really don’t know what they are putting on the nutrition labels.


Haha I think I must be good at extracting carbs from fibre too!

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I find that eating carbs with fat means I need a whole lot more insulin.
In another thread I mentioned tan experiment with a piece of dry toast vs a piece of toast with pure peanut butter.

It took nearly twice the insulin to metabolize the same carb content when needed with fat.

That being said , I don’t believe that those bread items that claim to be low carb are really that low carb.

When I want some processed carbs, I just eat regular bread, I just don’t eat much of it


Me too, we are blessed with overly efficient digestive systems. :woozy_face: :rofl:

Net carbs are super misleading in my experience, and they can sell them that way in part because the majority of their consumers do not ever realize that the products do in fact have much more of impact on blood sugars than the labels claim. For example net carbs assume things like sugar alcohols have no effects on blood sugar–in my experience, some sugar alcohols have considerable impact, less than regular sugar, but at least half of the grams of carbs need to be covered by insulin.


If this doesn’t give you good bolus control on low carb/ keto. Then nothing will. …If your I:C and basal is right., You can use your I:C for about 60% of the protein and 10% of the fats.

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Hi Marilyn, hope you are keeping well. Re what you have said, did you surmise that was because you were eating a lot more protein and it was the protein that was requiring the units, rather than carbs? And that presumably now your protein intake is relatively low (being plant based) that is why you are able to get away with much less insulin? Thanks!

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I am also vegan. It’s a myth that vegans have low protein diets (due to being vegan). Protein is abundant in many plant-based foods - legumes, nuts, seeds, tofu (a legume) and soy products (e.g. tempeh), seitan and vital wheat gluten products (concentrated plant protein), and protein-fortified foods (e.g. plant-based milks). It’s so easy to get enough, even a lot, of protein, even on a plant-based diet, as long as one’s diet is nutritious and sourced from a varity of foods. When I was keeping track when first being diagnosed as Type 1, I was easily getting 60 grams of protein/day on average without even trying to “eat a lot of protein”.

That being said, one question I do have is whether plant-based proteins affect blood sugar differently than animal proteins, b/c even though I eat a relative large proportion of protein vs. total calories, protein does not seem to affect my bolusing needs, unless I have a very low-carb meal w/ some seitan chicken (for ex.), but this may also be due to a high fiber-carb ratio in such meals as well (e.g. broccoli)…

On a high carb diet, the bolus for the protein is normally covered by the insulin for the carb ratio and perhaps a later correction. There would be better BG numbers if TAG was used, but most don’t even know of it. As you are finding, the protein bolus need, shows up when low carb.

I eat at least as much protein as I did when low carbing. My diet now consists of different kinds of beans, lentils, grains, a few nuts, and all kinds of vegetables and fruits. It is a misnomer that a vegetarian /vegan diet is low in protein. My blood now shows higher levels of protein than when I was eating eggs, dairy and meat.

I can eat around 270 grams of very healthy carbs because my diet consists of no more than 15% of fat. Fat causes insulin resistance.

I only rarely go off my way of eating. I did a bit during the holidays, but I don’t know if it was worth it. I really enjoy the food that I have been eating for the last 5 yrs. It is healthy for me, kind to animals, and good for the future of the earth.

It is very much like the Mediterranean diet and many who follow this way of eating live very long lives. It is considered by many to be the healthiest way to live.

I quit low carbing after 11 yrs, because I believe that the Bernstein diet helped lead me to suddenly needing heart stents almost 12 yrs ago. The diet made my LDL rise to unhealthy levels. I have arteriosclerosis and I am working hard to try and reduce the levels. My test results are improving on the low fat plant based diet.

I think that the Bernstein diet is ok for people with diabetes whose lipid levels remain stable. My HDL and Triglycerides levels were great, but my LDL just kept climbing.

During my last two years on the Bernstein diet, I would suddenly pass out and hit my head due to sudden low blood pressure. Although I have never needed to go to the ER because of diabetes, I did because of head injuries I also was getting debilitating migraines, which had nothing to do with passing out. Once off the diet my health improved substantially. I no longer pass out and I only rarely have a headache.

I also rarely eat processed food. I try to eat an organic very clean diet.

I also exercise after lunch and dinner which reduces my need for insulin.

If you want more information about the WOE I follow see the website Mastering Diabetes or buy the book by the same name.
If you wanted way less info, please forgive me.

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Yeah that seems to be what I’ve been discovering, and same w/ fiber perhaps too, or perhaps low carb itself also requires a relatively higher ratio (maybe your liver spits out glucose more when eating low carb? I don’t know). I don’t always eat low carb relative to total calories, but anyway yeah when I do that’s what I’ve been experiencing, so thanks for your input and for some validation! (Nuts is another example - except for cashews and pistachios, as long as I’m bolusing for other carbs, I can eat a fair amount of nuts w/out adding insulin for them, but if I just eat nuts themselves (peanuts, almonds, walnuts, pecans), I get that somewhat substantial rise in blood sugar.)

Hi @bkn480, I am vegetarian (vegan most of the time) and agree with what you are saying. My question was posed to Marilyn as I believe from reading her previous posts that her present diet is largely fruit and vegetables.

Really interesting, Marilyn - and there’s no such thing as too much information when it comes to this kind of thing :slightly_smiling_face:. I will check out the book.

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Thank you for that information. I am going to try that diet. My LDL is climbing too quickly on this keto diet.

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I would do some more reading. There are good and bad LDL, the sdLDL is the bad one.
The main markers are the trig to HDL ratio. You may have seen a fall in your fasting triglyceride on low carb.

This is a good video on blood tests. There are others.