I have read that many who follow LCHF are able to maintain good and tight blood control.
Are there any who are able to manage BG well on a higher carb diet? perhaps about 100g +/- 30g carbs daily (or more carbs/day)?
I hope that LCHF is not “all or nothing”. Reducing carbs is generally a good thing. (When I think back on the soda, juice and twinkies that I often ate as a child or teenager, I shudder. I’m happy to not eat those foods) But I find it difficult to stay within Dr. B’s guideline (because I enjoy a variety of food so much that I can’t really stay on the diet.).
On a moderate carb diet, (compared to the SAD) would we still have improved blood chemistry, such as lower triglycerides?
It depends upon how you define “managing BG well.” I typically eat between 120 and 150 carbs/day. I’ve maintained an A1c between 5.5 and 5.9 for the past 3+ years. But I have a much wider range in my BG values than many individuals on a lower carb diet.
Since I didn’t become diabetic until age 70, I don’t feel the necessity of keeping as tight control as someone who might expect to live another 40 years or more. I aim to keep my BG from going over 160 as much as I can, but when I eat potatoes, pizza, rice, etc. and don’t get my timing right, I do end up over 200 on average about once a month. I also end up with quite a few lows, mostly in the 50s and 60s, though I have had a few in the low 30s over the past three years. I’ve never had one I couldn’t handle myself, though, and only twice at night (a 52 and a 60).
My triglycerides have been terrific on this diet, just 55 last time. In the last seven lab tests, the highest for trigs was 99. TC and LDL don’t look so good, though. My total last time was 250, with 83 of that being HDL. My LDL calculated using the Friedewald formula was 156. If you check the research online, Friedewald formula is notorious for overstating LDL when one has a combination of high total, high HDL and low trigs, though, but I still haven’t convinced my doctor to do a direct measure LDL instead. Using the lesser known Iranian formula, which was designed for high total, high HDL and low trigs, my LDL last time would have been 126 instead of 156.
When eating a meal consisting of brown rice (1/3 cup), meat (chicken, pork, beef, fish), green vegetables, I experimented with pre bolusing. I tried pre bolusing by 30 minutes. 4 hours after insulin injection, the BG was 172.
Next, I’ve tried to split the bolus: 2 units at the beginning of the meal and 3 units when I finish the meal. One hour is the time elapsed between the first injection and the second injection. 3 hours after the second injection, BG was 148.
How much time do you allow between injections to accommodate “slow digesting” food if using MDI?
[quote=“Uff_Da, post:39, topic:55737, full:true”]
Another thing I do when having something like a carrot-raisin salad is to save part of my meal (in this case the salad) for a snack a couple of hours later, even though I’d bolused for it in the meal. That way the BG from the rest of the meal is coming down closer to pre-meal level before I eat the salad.[/quote]YES! Split-dosing food is a great strategy, and one I use all the time.
Especially for naughty stuff like pie, cake, etc. When we have something like that for dessert (as opposed to some fruit or something), I’ll eat half my (small) piece but with the full bolus, then have the other half an hour later or so.
Avoids the big carb spike up front, or the back-end low from overtreating with too much insulin trying to blunt the spike.
Don’t do this, though, if you’re going to have any trouble remembering to eat the rest.
5U was not enough insulin. After 4 hours, fast-acting is pretty much spent. Even though duration varies person to person, after 4 hours most of it’s done its thing regardless of brand or person. Are you carb-counting, and do you have your Insulin to Carb ratio figured out?
Given you landed at 150, and assuming another 10-20 drop from any residual insulin, you still need to correct at least 40 mg/dl or so. Given your correction factor, you can figure out how much more insulin, in this instance, was needed.
If you caclulated insulin from estimating carbs, you clearly underestimated. Go back and review your methods, portion estimates, etc. – it’s a routine part of getting “good” at being diabetic
I’m guessing you needed another 2-3U, which would have brought everything lower, and your BG down <100 after 4 hours.
@Dave26 Thanks for your comments. If I increased my insulin by 2-3 units, I would be concerned that my 8:15 pm would have been low (like 75, hypo low).
The solution to that is then to adjust the timing of the bolus. If you’re going low after eating but are taking the right amount of insulin, you need to delay the bolus.
So, take the additional insulin, but don’t bolus 30 minutes ahead. Bolus 15 minutes ahead, or, while your working this out, bolus when you eat.
The size of the bolus is, for the most part, governed by the amount of carbs in your meal. This shouldn’t be a variable you’re using to avoid hypos. Rather, adjust the timing to stay out of hypo territory.
Do you have hypo-symptoms @ BG 75 mg/dL, like an adrenaline release with increased heart rate and sweating? I’m just curious since my hypo symptoms don’t seem to appear until I’m down to 65 mg/dL or lower. I realize this is not an exact science since we’re probably using different meter brands with built-in imprecision and inaccuracy.
I don’t have hypo symptoms @ BG 75. At 55 or 60, I don’t think I have hypo symptoms either. I do not recall increased heart rate, sweating. In the past year, I’ve only experienced BG less than 60 twice. In both instances, I did not feel these symptoms. Therefore, I am concerned about having low blood sugar and not be aware of it. I believe the term is hypo unaware.
What I feel at times may be the large drop or change in BG. I may feel very hungry or jittery and upon checking the BG, it indicates 110, not especially high or low. ( Previously, the BG may have been near 180. I may feel the drop from 180 to 110; but not always.)
If you get a chance to try Afreeza I would highly recommend it. I had the same issues with post meal highs and my answer was to use Afreeza to counter them and/or novolog for a large or high fat meal for long term action. With a CGM i can just look at my graph to see when it starts to rise or lower and adjust accordingly. I could never go back to not having a CGM.
I mentioned Afreeza to my endo- he is against it. He was also opposed to using Regular insulin. He is inflexible in some ways. However, he is very eager to push all sorts of oral medications, Januvia, Trajenta…etc.
I understand what you mean. My endo was against afreeza too. I am on a pump so corrections are relatively easy, but I am investigating the diluting of insulin so I could give .10 correction amounts. (watch Bernstein video on it). My endo says you can dilute with sterile saline but I haven’t gotten any yet. I am trying to learn all I can because I don’t plan to be on the pump forever.
I asked him about diluting insulin, and he was opposed to that too!
I think it is easier to see, for example, a marking of "1 " in a syringe, rather than 1/4 or 1/2 or less. It’s difficult to see.
Mine was against it too so I got a new Endo. Actually internal med.
I refuse to let a closed minded Dr dictate my health care. I mean they get free samples to try so whats the harm! The pump does not take the place of something like Afrezza since it still uses slow acting Novolog. Afreeza allows fast corrections and for post meal spikes that Novolog wont handle unless you prebolus way ahead of time. And even then I have to go almost low to eat anything that really spikes my sugars.
I can give correction boluses of 0.1. What kind of pump are you using that you can’t give a 1/10 unit bolus? I use an Animas Vibe.
IMO diluting insulin really adds complexity to diabetes and it is increasingly hard to find diluent solution for insulin. There are enough rounding errors in diabetes management, I have a hard time envisioning many adults needing diluted insulin if you are pumping. (It might be different for those using syringes.) My meter readings aren’t perfect, my CGM is not perfect, carb counting is not an exact science, my hormones change from day to day, and my activity is not totally quantifiable.
I have never even asked for Afrezza although I would love to try it. Insurance doesn’t cover it and because my A1c’s are great and my Dexcom has saved me from ER visits, I don’t know how I could justify my need for it.
Lately yes cause I’ve been too lazy to put my pump back on. If it gets too resistant I take a shot. You get really spoiled on Afrezza, the idea of taking slow novolog is just like… ugh.
It is amazing what I have read about Afrezza in this community.
Here is a “naïve” question - Why don’t we all use Afrezza? Why don’t all the doctors prescribe Afrezza? It seems like it is not necessary to count I:C ratio when using Afrezza. It is out of the system in a shorter duration (Isn’t that more like the endogenous insulin produced by our own body?) .
Is there a place that we can sign a petition to have Afrezza made more readily available?
