You May Not be to Blame for High and Low BG

Type 1 and LADA
41

Hi Jack,
I watched this even before my morning tea, but I think I understood most of it. I got stents in 2010 and had been low carbing for about 5 yrs if I remember correctly. I hadn’t had my cholesterol particles tested yet, but my trigs were very low so I assume the LDL particles were not small and dense. I have had my LDL particles measured twice since then once on low carb and then again this year. When low carbing after stents the amount of the bad particles couldn’t even be calculated and now they can be seen but are still extremely low in number.

This scientist would have looked at my numbers before the stents and would have said that according to my numbers there was no way I would need stents. Very low A1c, extremely low trigs, very high HDL, no fatty liver. According to him, my dense LDL particles were very few.
Am I missing something?

42

no, it sounds like your blood work was fine, So I don’t know why you attribute your vascular disease to the 5 years of low carb. Do you remember any of your blood tests from say 10 yers ago? I believe it happened over your life time.

I know I went low fat in the 70’s, I didn’t even put butter/margarine on my bread. I became obese eating the healthy grains and blew out my pancreas. I’m one of the 2/3rd of the population that can’t handle carbs and become over weight or obese.

43

I received the stents in 2010, but 10 yrs before that my A1c was in the non diabetic range. I don’t have a clue as to what my cholesterol numbers were like 20 yrs ago.

44

I agree with the smaller carbs approach smaller doses of insulin. I also agree with the simple single chain saccharides approach. Natural sugars as opposed to complex chain carbs. My doctor always does a test where I breathe in a tube or something for 20 minutes, and after he says well you can eat a 2,000- 2,500 calorie diet based on how your body is. I just nod my head say ok great. But to be honest I never eat over 2,000 calories a day. Almost never. 2,500 calories in a day I think I’d be sick or fat if I ate like that everyday. Honestly, some days I eat around 1,300. Some days even 800. Others around 1500,1600,1800. Today I had a buttered roll, some celery with cream cheese, some cashews, some cereal, and some ravioli with corn. Hardly a 2,000 calorie diet. I almost never eat 300 carbs in a day. I don’t think I could. Maybe 150. I forced myself to eat the cereal because I thought I needed to eat. I had no desire to eat cereal though. Problem with the insulin which really bothers me a lot is it makes you hungry. It’s like you have to eat sometimes. The insulin you take should be based on what you eat. They always say take your shot before you eat, but perhaps if you change your diet with specific types of foods, you may need to not take your shot, and then adjust if you need to at all very lightly with a much lower dose. I don’t know the body can be a little on its own schedule with things, but it also functions as a way we treat it. I’m not doing the simple carb diet now obviously with what I said I ate today, but I have in the past and was really surprised at the difference.

45

I don’t eat a lot of calories either since I am a small woman. The 300 carbs are all extremely healthy foods including fruit, root veggies, legumes, lentils. I rarely eat any carbs that aren’t healthy. I use 23 units of insulin. On 30 carbs a day I used 17 units. My insulin sensitivity has risen to 10 times what it was on low carb. My meals are all planned in advance and do not change too much day to day. I have a ton of energy. I am 68 and was dx in 1959.

46

That sounds like the right way to do things. That’s the way it should be treated and handled. Not changing much day to day, set regimen. Good for you. I find what you said about insulin sensitivity very interesting. Each person is indeed diffeeent which is why it’s difficult to say one plan fits all. But fitting schedules that are set and do not change I feel is important in helping to manage it.

47

I skimmed over the more recent posts. Yeah, low carb can make you more insulin resistant. But this is not the same type of insulin resistance that T2s have to fight with. The increased presence of fatty acids sort of “blocks” the insulin receptors. In a keto diet, this is not a problem, because you simply don’t eat many carbs. In fact, high insulin sensitivity could perhaps be counterproductive in such a diet. Your carb intake is so low that the liver has to generate most of the glucose that the body needs, and most tissue can also run on fatty acid, especially the skeletal muscle and most parts of the brain. So, it makes sense that particularly the skeletal muscle becomes insulin resistant - that way, what little glucose is there isn’t soaked up by the muscle, and remains reserved for those parts of the body that can only run on glucose.

If you eat a high carb low fat diet however, the situation is quite different. No fatty acids are blocking the receptors, and there is not nearly enough fat around to maintain the caloric needs, so the body dials up the glucose metabolism to power the cells.

What this means is that actually, both approaches are fine - LCHF and LFHC. Pick the one that suits you better. As for the concerns regarding bolus estimations with LFHC, keep in mind that the insulin sensitivity shoots up, so the overall insulin dosage isn’t suddenly high, and in fact may roughly remain the same.

I think what you need to avoid though is to constantly switch between LCHF and LFHC. The body needs a while to adapt to the new diet. Think about how people used to eat, and how many still eat in non-Western parts of the world: They largely eat the same diet everyday. Inuit eat very low carb (out of necessity) every day. Traditional Asian cultures eat very high carb and low fat (and lots of veggies) every day. They don’t switch around all the time.

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48

POOR LIVER… gets far too much blame for wayward BGs…I also have MS, Multiple Sclerosis, & now Addison’s. Having acquired Addison’s, I had to learn, (still learning) about Cortisol, adrenal function & such.

7 yrs ago, Jan 2012, I had a bad fall, broke 5 ribs, dislocated posterior fractures, hospitalized w/acute kidney failure, & lost some adrenal function. No more DP, no spikes for a cold, minor injury or even a flu shot. (no more fight or flight response). My diabetes became EASIER to manage, so I did not complain.

Then last Feb, (2018) I fell again, this time, as MY luck would have it, damaging my other / remaining adrenal gland. Among other things, I became “BRITTLE”, a label I was given on a ER trip last April. (actually started in March). That ended over a decade of good, stable, control since I was changed over to MDI (from ancient twice a day N+R mixed routine, w/dose based on urine sugars).

WHY, is beyond my comprehension, ENDOs ignore, ignorant, over look, or are clueless about adrenal function. I was sent to 3 endos, and not one of them wanted a “brittle” type-1 w/ Addison’s in their patient load.

Enter CGM. On my own I went to a walk-in clinic for a Rx for a Libre system. I added a MiaoMiao & Glimp (on my Android phone) to create a full fledged CGM system, (with corrections, alarms & more). The information / graphs of my BG patterns were shocking & enlightening. (I also have an analytical mind, aero-space avionics (recon/spy plane & Apollo diagnostics) background).

It did not hurt that I had learned how to test & adjust ALL my insulin factors when I was put on MDI, and able to test & adjust on the fly as needed…

Knowledge is POWER, nobody can possibly know/understand YOUR BODY, better than you, not even the brightest endo.

BRITTLE, is where BGs swing wildly, even between lows & highs quickly for no apparent reason. I was swinging between 40s & 400, sometimes more than once in just one hour! (can you say one heck of a WILD ride?)

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49

This is the recent conclusion I’ve also come to, prompted in part by @Marilyn6’s reports. Her experience is similar to others I’ve read about in the last year. I was highly skeptical at first but now attribute this phenomena to the inherent metabolic flexibility of the human body. It makes sense given the spectrum of food types and availability during our evolution.

+1 - We should never doubt the obvious knowledge and wisdom we gain from careful observation of our own body.

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50

A low fat plant based diet works well for type 2’s also. Many report that they are able to stop taking metformin. See the Mastering Diabetes website.

51

Marilyn, I am so happy to read your posts as I have been successfully following LCHF way of eating for the past 5 years but like you don’t really care for meat. I love veggies, MISS beans and potatoes and I’m intrigued by the way you eat. Do you aim for a certain amount of protein per day or just eat what comes naturally in legumes and beans? Do you eat tofu? Also, 15% fat is so low and I’m guessing that means you don’t cook with fat or add it in any way. Is that correct?

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52

Hi Marcia, I eat beans of some sort twice a day. I never worry about protein, and my blood tests show higher levels of protein than when following LCHF. No, I don’t eat tofu since it is full of fat. I use no oil but use water or organic veggie broth when oil is called for. My fat comes mostly from seeds, and a bit of coconut that I use in garbanzo bean cookies. I also eat lentils often and fruit. For lunch today I am having a garbanzo bean soup/stew and for dinner sweet potato dal. :grin:

53

Have you ever discussed managing diabetes and MS on this site? Would like to see that and how the two interact. Have been in conversation with a young man who has T1 and MS who is living in an area of the country where advanced medical care less than accessible to him.

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54

No, I have not. None of the MS drugs I take, or have been on, seemed to affect my BGs.

Prednisone was considered in 2010 when I got my Loooooong (decades) delayed formal “long standing RRMS” Dx, but was nixed because I am diabetic.

Enter Addison’s, which reared its ugly full blown head last Feb. Addison’s is a BIG time effecter of diabetes, big time!. With Addison’s, there is NO avoiding its effects on blood sugars.

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55

I totally agree about “smart carbs”, and feel that this very low carb tendancy is erroneous - for ME! Ex: yesterday, my husband and I both craved pasta - something we hadn’t had for months. I cooked it al dente, and we ate it with olive oil and garlic, and a sprinkling of parmesan. To start, we had green salad (plus a small piece of bread, then an orange for dessert). There was no post prandial spike and my glycemia was stable and flat all afternoon with the same amount of fiasp as usual. High carb but no protein… I find that the opposite also works. However, pizza and cheese fondue are my worst diabetic nightmares…
(I live in France where several small courses are standard, love cooking and eating, have been T1 for 44 years, would like to lose 4 pounds, try to exercise every day)

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56

My sister with type 1 D was diagnosed a few years back with Addisons, and her doctors have told her that it shouldn’t really influence her bg control. I’ve tried to do some research on how these two interact, but I’m a bit limited by the fact that, well, I’m not her. I don’t know her day-to-day patterns and feelings. So far, I’ve found that if the Addison’s medication is too low, then she may be more susceptible to prolonged lows. I’m not really sure about the specifics or exactly the best way to counteract that though.

Do you have any resources you could provide? Or perhaps you could share your treatment strategies (you could use a personal message if you’d prefer)? I would really, really appreciate any helpful insights you’re willing to share!!! She’s struggled a lot with health stuff in the last year, and she’s trying to get through college (she’s only 20). I’m hoping she can find some treatment methods that enable her to continue attending school and living life to the fullest.

57

When you are a type-1 diabetic, you are walking a tight-rope 24/7. When Addison’s is added to your mix, you in walking that tight-rope in a wind. Unexplainable BG LOWS can be the first and sometimes ONLY Sx that Addison’s has decided to take up residence.

I was asked to share what I know about dealing with type-1 (actually type-1b, in my case), and Addison’s. I found information on the web & even my DOCTORS, sorely lacking (putting it mildly, & I am no Clark Kent, nor Superman. I am going to try and start a new thread. It will be based (probably exclusively) on MY PERSONAL experience.

One critical bit of advice for any diabetic, especially a type-1 of any flavor, that gets blessed or cursed (is more like it) with Addison’s;

GET A CGM, if you do not have one!

Katers87… I am going to post about my having to deal with having Diabetes with Addison’s PUBLICLY. I looked long and hard to find help and information, and found mostly a desert instead. Maybe if I stick my proverbial neck out there, a few more just might join, and share their experiences & knowledge with us.

For those of us that have needed to go on STEROIDS, Addison’s or not might find this coming thread interesting or helpful, or have something worthwhile to contribute.

Katers87 please feel free to post anything either openly or via private email, whichever you are comfortable with. I feel sorry you sister has to deal with both diabetes & Addison’s, I went thru HELL, and still not quite at the end of the tunnel of tribulations with this myself.

Just because I am an old dog, does not mean I can not learn NEW TRICKS!

 **_ KNOWLEDGE IS POWER_**

  **_It takes one, to know one_**
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58

I am on Prednislone. Over the past 6 or so months, I have learned a bit about how it affects ME.

My first, BIG Sx was massive hypos, hard to correct. Actually the syncope that preceded the hypos may have been the first.

Between Addison’s taking up residence, and starting treatment, I became a “BRITTLE” diabetic, with wild swings in both directions, between Hyper to Hypo, sometimes so fast my head would spin. Plus I had indescribable diarrhea that landed me in ER.

The following is based ONLY on MY personal experience with MY diabetes & Addison’s
… #This is NOT medical advice#

-1- If your cortisol seems a little LOW, that can/will cause HYPOs!

-2- If MY Cortisol is a little LOW, say later in the day, last dose (morning) wearing off, I have had serious Cog issues. (took me a while to figure that one out)

-3- While Pred in theory can be taken only once a day, I found I needed to spread my dose, throughout the day. I take a dose just before bed, then again at breakfast time, and I found, for ME, a dose around noon, seems to work best so far for me.

-4- 5mg Pred helped (especially the Nausea starting dose), 7.5 was better. I ended up going to 10mg, then 12.5 (all mg ## are daily total) I seem to need more than (claimed) average.

-5- I had occasional bouts of nausea, that I finally figured were keytone related. While my BGs were up a little, not usually high enough to cause keytones, I checked and BINGO, I tested (with keytone test strips) mild positive. Water, carbs & insulin fixed that. So if find that I need to watch more closely for keytones. I had long gotten out of the habit of checking them, so I had to start checking more often.

-6- I think, for me, it also helps with more consistent insulin dosing.

-7- I try to mimic, a little, a circadian rhythm, I do let the pred wind down some as the day go on. However, if I let it the pred effect wear down too much, then I have problems.

Every diabetic is different, same goes for Addison’s, so what & how they affect me, may not be the same for another person.

IN short, how things affect me, & what has worked for ME, may not be the same for someone else.

I am still a work in progress. I expect to refine my doses/days more as time goes on. I am still learning.

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59

Exactly right. Need to know the basics. Need to plan. But definitely need to react to stuff.

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60

how do you get by on 23 units (including basal?) a day while eating 300 mg in carbs?

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