My diabetes nurse had never heard of LCHF!

[smag3]

I knew this appointment would be a rocky one. Since I last saw my diabetes nurse I have started using freestyle libre bg monitoring and gone LCHF.
HbA1c was down from 71 to 51 which she thought was amazing, so did I! Cholesterol still at 4, fine. Everything else was normal she said and weight down by 5 kilos.
She was very positive and said to keep on doing whatever I am doing! So having been told by my consultant to try harder, when I said I needed help losing weight, I will carry on doing exactly what I am doing.

 

[Celeriac]

Well done ! I'm not surprised that she hadn't heard of it, they seem to know low carb by Atkins.

 

[smag3]

Well done ! I'm not surprised that she hadn't heard of it, they seem to know low carb by Atkins.

I did point that out to her! She is a practise nurse with specialist diabetic training, so I guess she just takes on board what she is trained in and what she is given to read.
Not terribly confident, I asked to come off Lantus and onto a longer lasting base insulin and she would not or could not advise me so will get in touch with consultant at hospital!

 

[britishpub]

That's a great result, but no surprise about LCHF. I had found this site before my official diagnosis, and mentioned I might try this route to my GP, and his reaction was as if I wanted to follow some voodoo style treatment.

When I went back 3 months later with an HbA1c of 32 instead of the previous 88 he had only a slightly different attitude, and still wouldn't accept it was a legitimate and sensible diet choice.

 

[Gezzabelle]

It seems they will never accept LCHF no matter how well It works. My nurse went mad when I told her I was eating very low carb and higher fat. All we can do is go on doing it our way and leave the medical profession to catch up at it's own pace. I thank god I found this site...I dread to think where I would be if I hadnt

 

[Spiker]

I asked to come off Lantus and onto a longer lasting base insulin and she would not or could not advise me so will get in touch with consultant at hospital!

I'm not sure there is any longer lasting basal insulin than Lantus. There is degludec, which is the same period of action (I think?) and "flatter", more uniform. But from posts on here it takes a lot of pushing to get degludec because it's more expensive.

What's the basal problem that you want to solve?

 

[Pam6201]

I'm not sure there is any longer lasting basal insulin than Lantus. There is degludec, which is the same period of action (I think?) and "flatter", more uniform. But from posts on here it takes a lot of pushing to get degludec because it's more expensive.

What's the basal problem that you want to solve?

I'm not sure there is any longer lasting basal insulin than Lantus. There is degludec, which is the same period of action (I think?) and "flatter", more uniform. But from posts on here it takes a lot of pushing to get degludec because it's more expensive.

What's the basal problem that you want to solve?

can't remember where I first saw this, but a lot of people split their lantus into 2 doses. I started with taking it only at 10:00 pm each night, but had trouble making myself have bed time snack because the sugar seemed to be high enough. (ie 6.0, and over). For some people it only seems to last a bit less then 24 hours. I have had much better evening numbers since I split my dose. Amount has not changed, I still do 10 units total, 6 at night and 4 in the morning.. Also my fasting level is better, as I was getting the occasional morning low, but did not want to actually decrease the basal dose.

 

[Spiker]

Ah ok. Yes a split basal is often very successful. It's normal way to use Levemir / detemir and can also be done successfully with Lantus / glargine. I posted a link to a paper on this in the Research forum a few days ago in fact.

 

[robert72]

I'm not sure there is any longer lasting basal insulin than Lantus. There is degludec, which is the same period of action (I think?) and "flatter", more uniform. But from posts on here it takes a lot of pushing to get degludec because it's more expensive.

What's the basal problem that you want to solve?

Degludec supposedly lasts 42 hours, although it's taken once a day. I haven't tried pushing it that long but it certainly doesn't run out like Lantus used to for me. It's also quite forgiving if you vary injection timing.

 

[debhem83]

like to try lchf diet, I am type1 for 34 yrs and my last hb result was 64. what,s a typical lchf meal?

 

[Spiker]

Degludec supposedly lasts 42 hours, although it's taken once a day. I haven't tried pushing it that long but it certainly doesn't run out like Lantus used to for me. It's also quite forgiving if you vary injection timing.

All durations of action of insulins are dose dependent. Normal, quick acting insulin will last a hundred hours provided you use a big enough dose. The manufacturers claims about duration are usually based on high doses that are beyond therapeutic levels for most diabetics, certainly most T1s, they are only seen in extremely insulin resistant IDD T2s.

 

[Gezzabelle]

like to try lchf diet, I am type1 for 34 yrs and my last hb result was 64. what,s a typical lchf meal?

Have a look here to get some info and ideas

http://www.dietdoctor.com/lchf

 

[robert72]

All durations of action of insulins are dose dependent. Normal, quick acting insulin will last a hundred hours provided you use a big enough dose. The manufacturers claims about duration are usually based on high doses that are beyond therapeutic levels for most diabetics, certainly most T1s, they are only seen in extremely insulin resistant IDD T2s.

Fair enough, but at 0.18 u/kg in my case it certainly outperforms Lantus/Levemir for duration. Levemir I took twice daily and Lantus tapered off after about 18 hours for me.

 

[smag3]

I'm not sure there is any longer lasting basal insulin than Lantus. There is degludec, which is the same period of action (I think?) and "flatter", more uniform. But from posts on here it takes a lot of pushing to get degludec because it's more expensive.

What's the basal problem that you want to solve?

I do take a split dose. I have always been told if my dose is correct my night time level should be very close to my morning level and it usually was so bed time say 8 and waking about 7.6. Since low carbing the lantus is knocking my bed time reading in half by the morning, usually. I am playing with the dose but thought there might be something longer lasting and more predictable. I have been on it for 28 years and thought there might be something out there I did not know about!

 

[smag3]

like to try lchf diet, I am type1 for 34 yrs and my last hb result was 64. what,s a typical lchf meal?

Definitely worth giving it a go. Have a look at the forums on here for meal ideas. Lots and lots of good help on here. Probably much more than you will get from your diabetic professionals unles you are very lucky.

 

[Kingsland]

My diet nurse is enthusiastic about low carbing will you believe? She's not a lot of help as frankly I know more about it than she does - but give credit where its due, its very encourageing to find support through the nhs. Perhaps we're getting through to them!

 

[Spiker]

I do take a split dose. I have always been told if my dose is correct my night time level should be very close to my morning level and it usually was so bed time say 8 and waking about 7.6. Since low carbing the lantus is knocking my bed time reading in half by the morning, usually. I am playing with the dose but thought there might be something longer lasting and more predictable. I have been on it for 28 years and thought there might be something out there I did not know about!

Sounds like your basal was too high and was incorporating some of the carbs in your diet.

I can't say this enough, do a 24 hr fasting basal test or other decent basal test before embarking on low carb.

I don't think you need to change your basal insulin type.

 

[donnellysdogs]

Sounds like your basal was too high and was incorporating some of the carbs in your diet.

I can't say this enough, do a 24 hr fasting basal test or other decent basal test before embarking on low carb.

I don't think you need to change your basal insulin type.

Agree with above... Depending upon the carbs that you were eating they may well have contributed to higher basal rates.

Some find they use more, some less basal insulin but a starting point is that a consultant will lok to see if your basal and bolus are running at 50/50 ratio. If you are effectively reducing carbs and therfore probably reducing your bolus it will throw your basal bolus ratio out. If you are running on 70/30 like I do it doesn't matter. It would be interesting to look at your ratios what you were previously when eating carbs to what your ratio is now.

Just because you have reduced carbs at a set time it doesn't mean to say your basal follows at the same time. My stomach works very slowly so food takes longer to digest and hit my blood stream but when it does can be night time a day later or longer from when I ate it. If my stomach blocks up my readings will go sky high. We will all have different foods and different transit times. Those that suffer from any for of constipation will have differing times for adjysting basals rates etc..