Less carbs, more insulin?

Food Nutrition
#1

Has anybody had this problem?
I am getting 25% of my calories from carbs and around 60% from fat, the rest from protein. i know i am not in ketosis and my body probably still prefers sugar over fat. But the thing that i do not understand is every time i reduce my carb intake by a little bit i become more insulin resistant. For two years i had to take 1 unit of insulin for 5g of carbs, and now ,when i am eating less carbs and more fat, i have to take 1 unit of insulin for 3.5g of carbs? I am actualy taking the same amount of fast acting insulin as before.
I have two explanations for this. Proteins are converting to glucose, but than i still dont understand why do i need the same amount of insulin as before, i am guessing it would be at least a little less than before.
The other idea is that my body, which is using more fat now, does not need al this glucose any more and the only way the cell can reject taking glucose is to become more insulin resistant.

Just tell me what do you think about it. Why are my insulin requirements almost the same as before?

I am going to visit a nutritionist specialised for LCHF diet next weak and after that i will cut my calories from carbs to 10%.

#2

I'm afraid that I don't understand why your insulin requirements hqaven't dropped significantly.
My T1 husband has multiple complications, so I persuaded him to try reducung his carbs [no use asking dieticians about this in England, they think it's dangerous"] Anyway his insulin requirement has just about halved. He's lost some weight, which is good and the deterioration in his kidneys has been halted. Plus his A1c is now within target [7%]. In fact he's much fitter. he still eats some bread, potatoes and rice, which I generally don't. I'm a genetic T2 using 2 x 500mg Metformin per day 10 years after diagnosis. Many T2s need insulin within 5 years especially if they follow NHS dietary advice!
Hana

#3

So sorry for the frustration, Lovre.

I've was diagnosed with Type 1 in 2008, and finding the right formula of how to eat and the right insulin type/amount for my body involved a lot of trial and error.

My husband eventually made an insulin calculator for me (I'm horrible at math) using the information in Dr. Bernstein's new diabetes diet book that calculates how much insulin I'm supposed to take based on the carbs and protein that I plan to eat. I just recently read that 10% of fat turns into glucose, so I might have him figure the fat into the calculation.

How did you find a LCHF nutritionist??? I'm so jealous. I just did online searches and now follow the advice of PROFESSOR JOHN YUDKIN (http://www.second-opinions.co.uk/fat-not-protein.html#.UWg4q7UjxNk) which is: Ten to fifteen percent of calories from Carbs, Twenty to thirty percent of calories from Protein, Sixty to seventy percent of calories from Fats. I'm 5'5 and about 120 lbs, and I eat 8.25 percent carbs, 16.75 percent protein, and 75 percent fat. I use Livestrong's Daily Plate to plan/track what I eat. This is what works for me, and I hope you find what works for you very soon!

#4

pilgrim, I did pretty much exactly the same as you did -- I created a bolus calculator based on Bernstein. Only difference is that, being a programmer, I was able to do it myself. At any rate, that's what I did and I use it every day to determine my insulin dose.

And yes, I reached this point after lots and lots of trial and error. Practically speaking, I don't think there is any other way. Each person's physiology is so distinct and individual that the only way to know what works for you (not the person next to you, but you) is to try things and keep notes until you find the formula that fits you.

We have an acronym for it -- YDMV (Your Diabetes May Vary).

#5

So, yeah, insulin requirement, on the one hand, is dependent on Total Available Glucose from carbs and gluconeogenesis from protein. When you drop carbs to Bernstein levels, that's a significant decrease in the requirements for insulin to cover your TAG. There's also the law of small numbers that says that smaller insulin boluses from less TAG act much more predictably than larger doses from more TAG.

Hopefully you've had these positive outcomes.

On the other hand, IC ratio is a separate consideration. Lot's of things also affect IC ratio, such as lean body mass, and activity level, and insulin resistance.

Have you changed anything else besides your TAG and fat intake?

Fat does have a pretty well known habit of slowing glucose absorbtion so that correctly calculating your TAG still results in a big spike, except that the spike occurs much later than usual (the "Pizza Effect").

Is your increased IC ratio based on high BGs occurring later than usual?

There is also this discussion in the general forum:

https://forum.tudiabetes.org/topics/dietary-fat-can-affect-glucose-and-insulin-needs-of-type-1s

Not to suggest that fat is bad for you, but I know that no matter how accurately I calculate my TAG based on my own IC ratio, and no matter how many extended boluses I program into my pump I always have to give myself more insulin to cover a high fat meal than a lower fat meal, all else being equal.

If fat is responsible for increasing my IC ratio, independent of TAG, so be it. Doesn't have to change my diet in anyway, just the way I calculate my insulin dose. As long as my carb and fat content are to my satisfaction, and my insulin dosing, overall, is satisfactory. Ultimately, it's all about BG control.

#6

Boy, this is SUCH a moving target. I know that for many people fat makes a big difference in the speed of absorption. For me, the effect is very minimal. Go figure.

FHS makes a lot of good valid points. I would just add to the list one more variable that affects the I:C ratio for many people: time of day. Just to keep things from ever getting too simple . . . LOL

#7

well I live on the Mediterranean. In a small country called CROATIA, of only 4 milion people. There is only this one nutritionist in the country that promotes this diet. she has been in every bigger city in the last year promoting LCHF diet.
have you had any problems when you started LCHF and did you do it gradually or ?

#8

Pilgrim
I too have read and admired Yudkin. I read some of his stuff when it first came out in the 1970s. The worst thing that happened to understanding nutrition was when Ancel Keys's so called "Seven Countries Study" [which is VERY BAD SCIENCE] came after Yudkin and half the western world espoused it. Ok it was a massive undertaking to go thrrough huge amounts of data without ccomputers,[ Keys was a statistician NOT a NUTRITIONIST!] but how many people are aware that he studied 22 countries and just abandonned the data that didn't fit his theories? On the other hand Yudkin was a clinician who did his own research and published honestly.
YUDKIN'S books are pretty hard to find nowadays, but I recommend "Pure, White and Deadly"
Hana

#9

Lovre
I've been LCHF for about 8 years. I started by gradually decreasing carbs.
Hana

#10

thank you on your suggestions. You have actually helped me a lot. I have thought about insulin requirement and Total Available Glucose (TAG)that FHS mentioned and after reading professor Yudkin article i had a eureka moment. It is the proteins. I am not actually geting 60% of my calories from fat as i thought, i am still a full sugar burner. Insulin requirements stayed the same becouse glucose in the blood stayed the same as before. the only difference is that now i am getting 30% of that glucose from proteine. i have done the math, it fits perfectly. my IC ratio never really changed. that means that my body isnt really using all that fat and that explains why my caloric intake is bigger than before. part of calories from fat just end up in the bathroom. Last time i was eating this little carbs my insulin requirement went down just as I expected, but i felt ill because I was using glycogen and everything that goes with that but after few days i stoped my experiment and never strated using fat.
this time my body handled sugar scarcity differently, THE PROTEINS!

#11

I have to tell you, I have found that I need to bolus even if I am eating like "zero" carb. And yes, protein can convert to glucose. Dr. B has suggested that 35-40% of protein converts to glucose. But the real thing is that eating volumes of food distends the gut and generates a hormone response and a blood sugar rise. Dr. B explains this as his "Chinese Restaurant Effect." I could pour olive oil on iceberg lettuce and eat it and my blood sugar would rise as though I ate like 10g of carbs.

So I bolus to "target." I adjust, counting half my protein as equivalent carbs and bolusing a couple units "just cause." And the point is to be back within 10-20 mg/dl of my fasting blood sugar in 2 hrs and not suffer any hypos.