I usually drink bullet proof coffee for breakfast, snack on meat sticks and hard cheese, lunch is usually a salad with protein either fish or seafood, dinner is more of the same. The carbs come from the different veggies. Before bed I always splurge and have a spoonful of peanut butter and a glass of unsweetened coconut almond milk.
Hi, had a questionā¦Been trying low carb w/more fat to help my sugars b/c when I used to take my insulin (even w./out correction), sometimes itād drop VERY fast right after I ate, like 20 pts. a min. So I tried to lessen the carbs a lot and eat mostly protein/fat. Now, even when I eat mainly protein/fat and no carbs at a meal, (to take less insulin -sort of like Bernsteinās law above), take a correction dose, my BS still doesnāt go down like it should. I even took a correction before bed last night, no food and BS didnāt budge much. Just heard that if you eat fat (nuts, meats , cheese?) it can cause insulin resistance. Anyone experience this? I canāt get them down with carbs OR without! -_-
I mean anyone have insulin resistance w/the low carb high fat diet, or even if you eat no carbs? AND erratic-ness w/ insulin, where almost same food/ins will bring 2 very different results? Iām afraid to eat anything.
I have a couple of thoughts about why this might be happening. It could be because your insulin resistance is higher. Have you experienced an increasing need for insulin over time? My insulin resistance appeared as I slowly increased my total daily dose from about 40 units per day to 80 units per day over a period of a few years. I donāt know if youāre type I or II. Insulin resistance is common for type II and can also appear in type I. Iām a type I diabetic. My switch to lower carb eating turned out to be the main tactic I used to reduce my insulin resistance.
The other thought I have is that your basal insulin may not be matched well to your basal needs. Are you on multiple daily injections, MDI? Or are you on a pump? There are protocols to help you fine tune your basal insulin. The basic idea of your basal insulin is for your blood glucose levels to remain relatively flat in between meals and overnight. If your basal insulin is insufficient, then your meal insulin works at a disadvantage. It must backfill for the basal shortfall first and then it fails to adequately metabolize your meal, leading to high post meal blood glucose.
most definitely as @Terry4 said, do a miss a meal full basal check and get that right first, or you just chase your tail
with low carb, you may need to do delayed bolus, TAG total available glucose, for up to 50% of protein, [Fats 10% but a lot donāt bother.] if you are crashing after meals,then going high.
āpizza effectā also comes in to play.
if you are basing it on this, I will provide the full facts that show a different light if you want to have a discussionā¦I have seen the fat and resistance being promoted on a UK forum by a notable anti-LCHF, it is cherry picked, and the actual needed increase of insulin will mostly be covered with TAG total available glucose.
Iām not insulin resistant, but my insulin-carb ratio does change some depending on the hour of the day. So, yes - the same meal will give me different results if I eat it for lunch or dinner. Forget breakfast; carbs seem very hard for me to correct in the morning.
Before I get carried away, can you share a sample meal and the results it gives you? What is ālow carbā for you? And how unpredictable is āerraticā? Has this been happening for quite a while, or is this a change?
Hi thanks for your reply.
I possibly could need more insulin, b/c I had been taking so much less due to crashes after I ate. I asked about insulin resistance to my new dr. She said I could be having some. While I have put on about 8-10lbs, I am still w/in limits I guess. I noticed and asked if fatty foods (even eaten w/no carbsā¦nuts, cheese, red meat etc?) could cause resistance and she said yes. Though I was told to split dose if a fatty meal (w/or w/out carbs) b/c fat AND/OR protein slows digestion of carbs? So she said if I took full dose at once, it could crashā¦This was confusing to me, as Iāve noticed it has done that too in past. Iāve seen it crash (not go low cuz Iāve caught it, but go down real fast) with fatty foods and carbs, and low fat and carbs at a meal. So if it causes resistance (the insulin not working as well) BUT it can also cause crashes/lows b/c of the slowed digestion of carbs (and insulin doesnāt slow down), WHICH is it? That could explain the varied results?
What is considered āhigh fatā, how many grams per meal?
Then I heard not to focus so much on fattening foods b/c they can be low carb and shouldnāt impact BS too muchā¦It is becoming too much to obsess over every little bite of food wondering if my insulin will work or not at all
Hi there,
Iāve heard the ratio can change during the day. Why is this? Iāve had meals with no carbs or very low (<15g) and taken a correction dose and BS still wonāt come down that much. (It comes down most if I take a correction and eat no food at all). So say I had a salad, like yesterday, I tried to make it low fat dressing etc. and the carbs in that were about 10g Iād say (from things other than starch- a few berries, veggies, dressing and chicken- and I was told not to cover non-starch things unless it exceeded 5-7g) but when I eat non starch things as a snack with no insulin, sometimes bs goes up and sometimes it doesnātā¦Itās just hard to know when and why it will or wonāt go upā¦This has been happening for a while, 1-2 yrsā¦but also as long as Iāve had it, though I could get better sugars when I was younger as my insulin/food regimen and results were more predictable and I could more easily figure out why they were high or low. But yesterday even w/the salad and correction dose, bs stayed the same.
Sry for novel here, Iām just frustrated and concerned. Am new to this site to get insight from others. Thanks!
For me, gaining weight was an indicator of overall insulin resistance. When my insulin seemed to have little effect on my meals and corrections. Itās like all the old rules no longer applied. You need to up your game. I found that no doctor had the answer for me. I went through three endos in five years trying to fix this problem. It wasnāt until I learned some more about diabetes and insulin dosing in places like this that I overcame this problem.
Youāre dealing with a problem with many moving parts: basal insulin, insulin to carb ratios, insulin correction factor, duration of insulin action to just name a few. Itās too complicated to take on all at once without ending up chasing your tail.
I suggest that you start with testing your basal insulin. Have you ever done that? It involves some limited fasting and frequent blood sugar checks. Gray Scheinerās Integrated Diabetes Services has a basal testing protocol that I have found useful. It may take a week or two to get this right, but itās fundamental to good control.
Have your read any books about using insulin? Scheinerās Think Like a Pancreas and Walshās Using insulin are two great resources. Diabetes is a disease that usually responds favorably to knowledge, motivation, and a good attitude.
Unfortunately, there is no one magic bullet that will conquer this problem. Many of us have been in your situation and have figured out how to climb out of it. Itās a little different for every person but personal experimentation, so that you learn how insulin works in your body, is the key. Doctors donāt have the answer. Itās like Dorothyās quest to find the wizard to help her return home. In the end she realized she had the power all along. Donāt sell short the personal power you already have!
Good luck! This is not a simple solution. Your hard work and determination can fix it, however, over time.
Why does my I:C ratio vary during the day? I never looked up the papers on it, but it seems to me that hormones naturally vary during the day; Iām sure that whatever governs insulin resistance is part and parcel of that ecosystem. And to add to the confusion, in my case I was LADA and had a gradually declining pancreas, which some days worked better than others. So my own body was sending in variable amounts of insulin, which made adding external insulin a little tricky. But the reason I mention this is to note that my body today reacts differently to food and insulin than it did ten years ago, or even last year.
I used to think to myself that Iād figure it all out once and Iād be set for life. Not really. Theā¦ the settings move around gradually, and I try to note when Iām giving myself a different bolus than Iām accustomed to because thatās a sign that things have drifted enough that I ought to compensate.
@Terry4 has some really good advice! I like all of his recommendations, and especially agree that your basal settings might be up for renewal If thereās one thing Iād like to leave with you, itās that you and I are the absolute front line, and that our actions make a real difference. That means that for once, weāre in charge of our own destiny!
Well, once we factor in the natural biological variability. But the great news is that I can adjust all of the levers. I may not be able to get 80.0 BG readings, but I can get to within 85 or 90, and thatās way better than the 300 I was at when diagnosed. I donāt need to be perfect; better is working out quite nicely.
What about using this for kids? Iāve heard the body needs carbs to grow.
Hi!
I understand youāre on a ketogenic dietā¦ Just keep in mind that excess protein turns into carbohydratesā¦ Maybe youre not eating enough fats to compensate the low energy of your bodyā¦
Just a thoughtā¦
I would do one thing at a time. Step 1
is getting your basal right. When that is done by the miss a meal testing. Then you move on to step 2
Hi Terry4 and everyone,
Thanks for reply, no time now, will try to reply later! Have a good day.
Hi there, I am not on a pumpā¦Is the basal like Lantus or long acting insulinā¦What is the āmiss a meal testingāā¦Can you do this too to find a good correction factor with Humalogā¦I find the extra humalog I take for a correction works better if I donāt eat anythingā¦Drās said it should work with food (and combos of food- carbs/protein/fat at a meal) but I find it works just ok with no carbs (like a salad etc) then other times it works ok with carbs at a meal and other times no at all with carbsā¦Its so frustrating to see it working like a yo yo ā¦and Iām concerned theyāll up the dosages a lot, when maybe thats not what I need (perhaps a little more yes) since sometimes the insulin CAN work decently. I 'd like to not take always MORE, but do something that makes the insulin work BETTER. ā¦Perhaps any fatty food I eat causes insulin resistance as Iāve heard it can?? But this forum is saying high fat diets can be good for blood sugarsā¦How can something work so inconsistently o.Oā¦Sorry lotās of questions here, I just am at wits end
For basal long acting test
For corrections and general stuff
The site comes up as unsafe because itās certificate ran out. But it is safe
For lowcarb total available glucose
With low carb you may need to bolus for some of the protein and fats
https://healthonline.washington.edu/document/health_online/pdf/CarbCountingClassALL3_05.pdf
Just take it one thing at a time. Do your basal. The meals you do have 4 hours before the start. Should be a light meal. Salad no oil for example
All this should be done with medical help and supervision
Hi there,
Yes not sure if the weight gain is causing insulin resistance though could contributeā¦It seems like the old rules I learned long ago donāt apply to me anymore too. Just got a new Dr. affiliated w./the Joslin, hope it helps. ā¦Was recently in hospital for DKA and someone said yes itās like trying to hit 20 moving targets and when you hit one, it changes the next day or weekā¦It makes it impossible to keep up and I canāt keep up anymore or figure it outā¦but all the while still trying to do what I āshouldā and apply what the Dr said to do w./insulinā¦with futile results, though sometimes it has worked ok in the past. They told me in hospital to not change the scales too much (food insulin, correction factor and exercise) b/c then sugars could crash again and Iād be afraid to use the insulin right b.c crashing used to happen frequent enough which caused me to not use the insulin as I shouldāve to avoid crashingā¦So I lessened my carbs a lot in order to take less insulin, but still wasntā taking enough for my sugars, which prob led to dkaā¦Now to try to make up for all the weight I lost, I ate much more nuts, cheese etc (low carb as to not take insulin) which led to some weight gain.
Now, even if I donāt eat, in between meals itāll go up after 2-4 hrs, and other times itāll go down or stay the same, w/same food and insulin. Just the other day it went up 60 pts right before dinner and I hadnāt eaten since lunch. That makes it look like my pre meal sugars are much higher than they are (even though still not where they should be, at least it would be better than going up by itslef) ā¦and t hen them upping the dose to stop that when other times that might not happen. Had a friend in college who was diabetic n said same thing, taht you eat something and BS is up later, then you think oh i need more insulin for that food, take more next time and it goes down)ā¦Itās so hard and scary that if you donāt get it right, itās your body and life on the lineā¦I 'm not eating things I āshouldntāā¦even though Drās said long ago there isnāt anything you 'canāt ā eat, just take the insulin for itā¦well I try and it doesnt workā¦I eat only abot 15-20 g carbs per mealā¦they say donāt cover stuff like non starch (veggies, peanut butter, flavored meat, sugar free jelly -thatās 5g- etc) but I find that these things sometimes raise bs if I have as a snack)ā¦Then if I have a salad w/10-15 g worth of non-starch things, take a correction and a little for the salad, BS could go up or sometimes go down.
Am not on the pump, though at this point that might help w/the long lasting insulin since it is a continuous drip and wonāt wear off like Lantusā¦Then that might help the humalog work better for meals/correction by at least not going UP by itself w/no foodā¦But now Drās are being reluctant to put me on it , whereas before they wanted me to try it -_-
Will check out those books, thanks, though I am weary of thinking like a pancreas. I know it is a lot of work, more than full-timeā¦hard to think something can work for me when Iāve tried so much and nothingā¦but I know it can work from people like you! Thatās why I joined this siteā¦so thanks for your info! Any little bit helps One thing I miss a lot are sweetsā¦do you include them in your diet??
Some days itās really hard for me too. Then I remember that there are lots of people going through the same thing, and theyāre doing it - so I can too. And so can you. When I get jumbled up, I start back at the beginning, and address one thing at a time until Iām back on an even keel again.
If my blood sugar changes a lot without me eating or exercising, itās a sign that either my basal rate is wrong (amount/timing of Lantus in your case) or I have an infection. When my basal rate is correct, I can go all day without eating and my blood sugar floats within 10 points or so of where I started.
Start with measuring and setting your basal dose of Lantus. Once thatās better, you can address the boluses for meals and snacks.
Re-reading the situation you describe, I wonder if you are stacking insulin? That is, eat breakfast at 8, bolus for it. Eat a snack at 10, bolus for it. Eat lunch at 12, bolus for it. In my body, fast acting insulin lasts for about 4.5 hours. If I bolus at 8, that hasnāt worn off yet at 10, so if I bolus again at 10, Iām stacking one dose on top of another. And if I bolus again at 12, thatās 3 insulin doses all interacting with each other. I find that really hard to account for. Maybe as an experiment try skipping the snacks (and their boluses) and see if that helps tame the gluco-coaster (I first heard that expression here, and think it fits so well!)
My endocrinologist said I need to have at carb at each meal so I have something to bolus for. She said I should have 15 for breakfast and lunch and 30 for dinner. Is this true ?
You take insulin to metabolize nutrition that you eat to live and feel well. You donāt eat to give your insulin a purpose. That seems silly to me. The human body is adept at converting protein into glucose if too few carbs are available.
I think you should eat to sustain yourself and if that means carbs then you dose for it. To be fair, your endo suggests a reasonable level of carbs but his/her rationale makes no sense to me.