Fat

[Spablauw_]

Hello,

I'm really struggling lately with finding the right meals that suit both me and my Diabetes.

I've been using the freestyle libre since a couple of days and have been scanning all day long to see what happens when I eat this or what happens when I eat that.

So I've always been on a "high carb, low fat" diet: 60carbs in the morning 80 at lunch and 80 at dinner and for that I've always been told not to eat too much fat since it slows digestion.
However, my problem is that with 80g carbs I just don't seem to have eaten enough (I know it sounds pretty unbelievable but I am 18 years old, pretty active and have a BMI around 20 so I'm fine) and that's why I decided to have butter on my bread, put some cheese or peanut butter on my bread and so now and then I'd like to have full milk so that I'm not hungry 3 hours after my meal.

When doing this I get normal readings 2 hours after meal with little spikes in my BG but then 3 hours after my meal I start rising which is completely logic because of the fat that slows digestion and all that stuff but I just wanted to know what I should do? Should I keep correcting my high BG 3 hours after meal (I'm on pens so that sucks...)
Or should I eat more carbs in stead of fat? The reason I'm asking this is because I think 80g of carbs is already quite a lot..

As I said, I'm quite active and I never gained any weight since I started adding fat to my meal because of being hungry and quite active throughout the day but I just don't know how many carbs I'm allowed to take at my age and my level of activity? (My dietician is really bad and just keeps telling me to go on a diet of 50 carbs per meal with low fat and which eventually will let me starve ;( )

Hope someone can help me out!

 

[azure]

Hi @Spablauw_

I eat moderate carbs and a reasonable amount of fat because I have a fast metabolism. I have butter and cheese, peanut butter (lots!) and always have full fat milk.

The first thing to check is that your rise is due to the meal fat rather than a basal issue. Have you done a basal test recently?

Also,do you eat snacks? I find that a good way to keep full.

You could experiment with bolus splitting (some before your meal, some at some time after your meal to catch the delayed spike).

 

[TheBigNewt]

I don't think 900 calories of carbs is all that high. Figure you consume about 2500 calories/day (like me), that 36% of calories from carbs, so a similar amount from protein and fat. That sounds reasonable for an active 18 year old. A BMI of 20 is pretty lean (I'm 22). Sounds like you're doing pretty well compared to some people around here.

 

[Spablauw_]

I don't think 900 calories of carbs is all that high. Figure you consume about 2500 calories/day (like me), that 36% of calories from carbs, so a similar amount from protein and fat. That sounds reasonable for an active 18 year old. A BMI of 20 is pretty lean (I'm 22). Sounds like you're doing pretty well compared to some people around here.

Ty for the reply,

I wrote down what I ate today and this is where my 2800 calories came from.

Carbs : 920 calories (33%)
Fat: 1280 calories(46%)
Protein: 600 calories (21%)

I did had a pizza today though...

You reckon this is too much fat?
At lunchtime I had 70g of fat of which 24 whas saturated according to the app I use.
I also had 85g of carbs and 45g protein.

I attached the graph of my freestyle libre app so you can see what happens:

I was at 80 before meal --> 138 after meal (1,5hours) --> 105 2,5 hours after meal --> started rising to 180 3 hours after meal and then stood there untill dinner time.

 

[DaveTC]

That's a similar macro ratio to what I eat, but I typically stuff over 3500 calories a day down. What are your sugars like before bed? You might want to aim a bit higher there and do a bit more basal, to me that graph looks like your correcting too much and not enough basal, but one day doesn't really show much of a pattern especially without the evening section being there.

 

[azure]

I think a basal test would be wise too @Spablauw_ as I mentioned above. That could be the cause of your rise and the time you're spending up there.

 

[GrantGam]

Hello,

I'm really struggling lately with finding the right meals that suit both me and my Diabetes.

I've been using the freestyle libre since a couple of days and have been scanning all day long to see what happens when I eat this or what happens when I eat that.

So I've always been on a "high carb, low fat" diet: 60carbs in the morning 80 at lunch and 80 at dinner and for that I've always been told not to eat too much fat since it slows digestion.
However, my problem is that with 80g carbs I just don't seem to have eaten enough (I know it sounds pretty unbelievable but I am 18 years old, pretty active and have a BMI around 20 so I'm fine) and that's why I decided to have butter on my bread, put some cheese or peanut butter on my bread and so now and then I'd like to have full milk so that I'm not hungry 3 hours after my meal.

When doing this I get normal readings 2 hours after meal with little spikes in my BG but then 3 hours after my meal I start rising which is completely logic because of the fat that slows digestion and all that stuff but I just wanted to know what I should do? Should I keep correcting my high BG 3 hours after meal (I'm on pens so that sucks...)
Or should I eat more carbs in stead of fat? The reason I'm asking this is because I think 80g of carbs is already quite a lot..

As I said, I'm quite active and I never gained any weight since I started adding fat to my meal because of being hungry and quite active throughout the day but I just don't know how many carbs I'm allowed to take at my age and my level of activity? (My dietician is really bad and just keeps telling me to go on a diet of 50 carbs per meal with low fat and which eventually will let me starve ;( )

Hope someone can help me out!

I agree with @azure that you should get your basal sorted first. It makes everything easier. A sturdy house is built on strong foundations and well controlled diabetes is built on a solid basal dose.

I personally try to limit high fat meals as I get a prolonged BG rise hours after meal that I can't properly manage on MDI. I don't omit anything from my diet, but I will often choose a smaller portion for meals that contain a lot of fat or eat them for lunch vs dinner. At least if it's lunch then I can correct during the day. Later evening meals often result in a BG climb overnight which causes me to wake high.

I stole this from a very knowledgeable forum member, it's a very good explanation of how too much fat (the amount is entirely individual to your body) can cause high BG hours after meals:

http://www.mendosa.com/The-Fat-of-the-Matter-How-Dietary-Fat-Effects-Blood-Glucose.htm

 

[Spablauw_]

Oke thanks,

I think I will have some fasting to do then!
Last year I switched from 1x a day Levemir to 1x a day Lantus because Levemir wouldn't last long enough for me so my doctor told me to switch to Lantus.
Since then I got some issues during the night at around 3am (5 hours after having my lantus) I am dropping a lot so I'll have to try a Basal test (I don't like fasting...)

 

[GrantGam]

Oke thanks,

I think I will have some fasting to do then!
Last year I switched from 1x a day Levemir to 1x a day Lantus because Levemir wouldn't last long enough for me so my doctor told me to switch to Lantus.
Since then I got some issues during the night at around 3am (5 hours after having my lantus) I am dropping a lot so I'll have to try a Basal test (I don't like fasting...)

As far as I'm aware, Levemir is generally perceived as a better insulin to Lantus. I'm very surprised that your diabetologist/DSN never suggested a split dose of Levemir - it tends to be accepted as the better option.

Lantus is also claimed to be a 24 hour insulin, but the reality is that it's somewhere between 16 - 24 hours for the majority. I'd be surprised if you find any difference between the two, but if you do - then superb

Lantus can cause rapid hypoglycemia if you hit a blood vessel, which Levemir does not. But this wouldn't explain your 3am hypos. A basal test should pin point why that's happening though.

Good luck and let us know if you improve matters and how you got there

 

[tim2000s]

As far as I'm aware, Levemir is generally perceived as a better insulin to Lantus. I'm very surprised that your diabetologist/DSN never suggested a split dose of Levemir - it tends to be accepted as the better option.

NICE number 1 recommendation is levemir twice daily, but it is more expensive than Lantus which is why Lantus is prescribed more.

 

[Spablauw_]

As far as I'm aware, Levemir is generally perceived as a better insulin to Lantus. I'm very surprised that your diabetologist/DSN never suggested a split dose of Levemir - it tends to be accepted as the better option.

Lantus is also claimed to be a 24 hour insulin, but the reality is that it's somewhere between 16 - 24 hours for the majority. I'd be surprised if you find any difference between the two, but if you do - then superb

Lantus can cause rapid hypoglycemia if you hit a blood vessel, which Levemir does not. But this wouldn't explain your 3am hypos. A basal test should pin point why that's happening though.

Good luck and let us know if you improve matters and how you got there

The only difference I noticed when switching to Lantus was that I wouldn't rise around 7-8 am because my Levemir would've worked out.

They also told me that Lantus has less peeks compared to Levemir but I found that hard to believe, I even dare to say it's the other way around...

I also proposed to split my Levemir dose before getting Lantus to have better Basal control but she disagreed with me. Everyone of her patients is one Lantus so she told me to aswell.

I'm currently having low BG's between 6 - 14
Hours after I took my Lantus and having good/rising BG's around 14-24 hours after I took my shot.

I would've said that 2x a day Levemir would've been the solution..

I will start doing some basal testing tomorrow.

How should I test the morning though? Since it's difficult to test with your liver dumping glucose to wake up and because I have my last meal at 6pm so I wouldn't be eating for 18 hours? Wouldn't this affect the test?

Thanks!

 

[GrantGam]

They also told me that Lantus has less peeks compared to Levemir but I found that hard to believe, I even dare to say it's the other way around...

That does seem to be the general consensus. Although, it's not a 'one rule fits all' scenario, you may well not find that to be the case - which seems to be what's happening.

I also proposed to split my Levemir dose before getting Lantus to have better Basal control but she disagreed with me. Everyone of her patients is one Lantus so she told me to aswell.

You just need to tell her politely that you're not every one of her patients You are entitled to switch back if you wanted to, as a patient - you have a good say in what treatment route you go down.

How should I test the morning though? Since it's difficult to test with your liver dumping glucose to wake up and because I have my last meal at 6pm so I wouldn't be eating for 18 hours? Wouldn't this affect the test?

There is no easy way round this. Do you definitely have DP or liver dumps during that time though?

Personally, I've never done a basal rate test in the morning as it's too difficult. I have DP and also a waking rise that needs a bolus as soon as I'm up. I know that my basal is set correct though, because any higher a dose and I have hypos between 1800-0000 or 0000-0600. On MDI there is only so much flexibility you can have with your basal dose, so if my BG's are okay between 1800-0000 and 0000-0600 then that's about as good as it's going to get.