Managing Low Carb diet side effects

I was initially diagnosed with GD at 13 weeks with my first pregnancy. It didn’t fully go away after birth, I still had high postprandial blood sugars, I managed it with diet. Second pregnancy I was on insulin in my first trimester. After my second pregnancy, it seemed to go away. I had repeated A1Cs that were 5.0, the last one was in August. A few weeks ago I noticed some symptoms, exhausted, constantly hungry, thirsty a lot, suddenly gaining weight after my weight being pretty stable for almost 2 years (since the second baby). Sure enough, my fasting blood sugar is now over 100 (postprandial seems ok, basically the opposite of how it was before :woman_shrugging:). I had a lot of testing early on, because my family history and presentation made me “atypical.” So I know I’m negative for MODY 1-5. As of almost 5 years ago I was negative for ICA, GAD and 1 other antibodies, and c-peptide was normal. Three years ago my fasting insulin was low (<2.0) but my fasting blood sugar was 91 so that doesn’t necessarily mean anything.

I have an appointment next week, but long story short, it looks like Prediabetes. Ok, so I need to go back to a low carb diet. I’ve done it before, I know how, and I can stick to it. Except I always feel really terrible when I eat low carb. Weak, depressed, really irritable, constantly starving, exhausted. According to my husband I become impossible to live with. I’m not sure how to approach it differently so that doesn’t happen this time.

Make sure that you are well hydrated and that you are not electrolyte and salt deficient or you will get the low carb keto flu which are most of the symptoms you describe above. Also lean toward a high fat (avocados are plentiful and cheap right now) diet along with the low carb. Get yourself a keto mojo starter kit which includes 10 Ketone Strips and 10 Blood glucose strips to monitor your keytone. Once you have gone through the 10 BG test strips, I would order a contour next one (it is the most accurate available) meter to monitor my blood glucose and use the Keto Mojo only for keytones. Here are some links that I hope will be helpful.

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Fortunately I have several blood meters and a bunch of test strips left over from when I was pregnant (couldn’t use my own on hospital bed rest).

Most BG meters are not very accurate and when going low carb you want to stay in tight control because if you have frequent dips that your current meter is not properly picking up, you can periodically go into hypoglycemia territory which also causes the symptoms you describe.

I was definitely eating high fat when I did it in the past. I was not limiting salt, how much would I need to avoid the side effects?

Like everything else, it depends because depends how much Sodium you are eating in your diet. Salt is about 40% sodium and you need 3000-5000 mg sodium per day. I try to minimize salt so you may want to start with 1/4 tsp and then work your way up. Salts can be interesting if you vary between Himalayan sea salt and Lawry’s salt and others to get some variety. Eating broth and/or bouillon daily in the beginning is an easy way to get enough with just little bit extra salt on your food.