I'm in one heck of a confused state.

[TonyDalton]

I was diagnosed type two over 23years ago & started on diet, exercise & metformin.
10 years ago I was put on insulin, humalog 25 mix in the morning & humalog 50 mix in the evening.
Two weeks ago I was told to increase my insulin to 38 units a day of both of the above with a HBac of 7.5.
I have noticed every time I inject I feel ill for about 2 hours afterwards (Nausea lethargy & brain fog/headache)
My fasting blood results have never been anywhere near 7.5mmol they are normally in the range of 10 to 15mmol.
Anyway to my quandary:
10 days ago I thought I've had enough of this lifestyle & set off on a determination to reverse my diabetes.
I am eating a near zero carb diet max 20 grams of carbs a day. I thought if I am not eating carbs I don't need the insulin anymore.
I stopped the insulin & my fasting blood the day after was 8.8mmol the lowest I've had in months.
I have continued almost zero carbs for 10 days now about 1200-1500 cals a day & my bloods have increased to above 10mmol again (10 to 11) constantly. I am fasting for 12 hours overnight through till lunch.
I am not in Ketosis yet & was expecting to be after this length of time. I have double & treble checked what I'm eating & can't figure this out. I still exercise daily burning approx 800 cals on Strava.
Does anyone have an idea what could be going on? Do you think I may have another type of diabetes?

 

[xfieldok]

What are you actually eating in a typical day?

 

[K567]

I was diagnosed type two over 23years ago & started on diet, exercise & metformin.
10 years ago I was put on insulin, humalog 25 mix in the morning & humalog 50 mix in the evening.
Two weeks ago I was told to increase my insulin to 38 units a day of both of the above with a HBac of 7.5.
I have noticed every time I inject I feel ill for about 2 hours afterwards (Nausea lethargy & brain fog/headache)
My fasting blood results have never been anywhere near 7.5mmol they are normally in the range of 10 to 15mmol.
Anyway to my quandary:
10 days ago I thought I've had enough of this lifestyle & set off on a determination to reverse my diabetes.
I am eating a near zero carb diet max 20 grams of carbs a day. I thought if I am not eating carbs I don't need the insulin anymore.
I stopped the insulin & my fasting blood the day after was 8.8mmol the lowest I've had in months.
I have continued almost zero carbs for 10 days now about 1200-1500 cals a day & my bloods have increased to above 10mmol again (10 to 11) constantly. I am fasting for 12 hours overnight through till lunch.
I am not in Ketosis yet & was expecting to be after this length of time. I have double & treble checked what I'm eating & can't figure this out. I still exercise daily burning approx 800 cals on Strava.
Does anyone have an idea what could be going on? Do you think I may have another type of diabetes?

Hi. This has happened to me before and I was not taking insulin because there was hardly no carbs in the food I was eating so I didn't take fast acting insulin and my sugar was to reading high. Eventually I ended up in a DKA and my kidneys started to fail. I don't wish to scare you this is just what happened to me when I did what you are doing. I was told in hospital in each meal I should eat at least 50grams of carbs and to take insulin. It may be ok to have no insulin with maybe 1 meal but definitely not three meals on a regular basis as you will get ketones eventually. I don't think you'd have a different form of diabetes as they are pretty accurate when diagnosing. Hope this helps.

 

[TonyDalton]

What are you actually eating in a typical day?

Thanks for the reply.
I'm just eating meat & green cabbage to keep things simple in an attempt to make it easier to follow to begin with.

 

[lucylocket61]

Hi. This has happened to me before and I was not taking insulin because there was hardly no carbs in the food I was eating so I didn't take fast acting insulin and my sugar was to reading high. Eventually I ended up in a DKA and my kidneys started to fail. I don't wish to scare you this is just what happened to me when I did what you are doing. I was told in hospital in each meal I should eat at least 50grams of carbs and to take insulin. It may be ok to have no insulin with maybe 1 meal but definitely not three meals on a regular basis as you will get ketones eventually. I don't think you'd have a different form of diabetes as they are pretty accurate when diagnosing. Hope this helps.

the original poster is type 2.

Its helpful if you fill in your profile so we all know what type of diabetic you are, and what meds you are on. Advice/help is different for the different types.

 

[TonyDalton]

Hi. This has happened to me before and I was not taking insulin because there was hardly no carbs in the food I was eating so I didn't take fast acting insulin and my sugar was to reading high. Eventually I ended up in a DKA and my kidneys started to fail. I don't wish to scare you this is just what happened to me when I did what you are doing. I was told in hospital in each meal I should eat at least 50grams of carbs and to take insulin. It may be ok to have no insulin with maybe 1 meal but definitely not three meals on a regular basis as you will get ketones eventually. I don't think you'd have a different form of diabetes as they are pretty accurate when diagnosing. Hope this helps.

Thank You for the reply.
I will try what you suggest to see if it makes a difference. I was starting to think, maybe it's because i've stored that many carbs throughout my body that I haven't used them all up yet. I'm a big bloke at 6'4" even though I've lost a lot of my old weight.
I'm still muscley because of the exercise I continue to do. So they could be hiding in muscle.
I've completely given up alcohol too & still losing weight steadily. It just surprised me how high my bloods remained.
Thanks again pal.

 

[TonyDalton]

the original poster is type 2.

Its helpful if you fill in your profile so we all know what type of diabetic you are, and what meds you are on. Advice/help is different for the different types.

Thanks mate, much appreciated. I'll fill the bio in later when I get time.

 

[bulkbiker]

Thanks for the reply.
I'm just eating meat & green cabbage to keep things simple in an attempt to make it easier to follow to begin with.

May I ask how old you are now?

 

[Resurgam]

Treating type two with diet isn't a punishment regime.
You can eat any sort of meat, seafood, eggs, cheese, dairy too.
You don't need to restrict calories, they are not all that important. You do need to eat enough protein and fat to maintain and fuel yourself though.
Do get yourself some variety - frozen stir fry is always handy, mixed veges too, and there are all sorts of spices and herbs to give the food some zing.
I make stews of chopped beef with mushrooms and onion plus mixed veges all from the freezer with a bit of turmeric and then a little aromatic curry powder - the result is low carb, but nutritious.
You might be eating too few carbs to keep your response to carbs normal - I found that not eating carbs gave me higher readings than having maybe 10 gm with breakfast.
If you have been drinking alcohol regularly, plus injecting insulin, then your metabolism might have an awfully long climb to reach normal again. Do give yourself the best chance of attaining lower numbers by feeding yourself sensibly and well, you really should not need to beat your metabolism to get it to work well.

 

[lucylocket61]

Thanks mate, much appreciated. I'll fill the bio in later when I get time.

I was responding to @K567 but your bio is helpful too, thanks.

 

[EllieM]

I was told in hospital in each meal I should eat at least 50grams of carbs and to take insulin. It may be ok to have no insulin with maybe 1 meal but definitely not three meals on a regular basis as you will get ketones eventually.

T1s like us don't produce any insulin, so we have to inject it or, as you say, eventually go into DKA. (Probably fairly quickly in my case, though if you're a recently diagnosed LADA it may take you longer because you're still producing some insulin.) Dieticians tend to vary on the advice they give to T1s on low carb and keto. There's a fairly large group of T1s out there who swear by a keto diet, achieving flat line blood sugar graphs with no hypos or hypers, but one reason why the dieticians tend not to recommend it is that if you are in dietary ketosis it can be hard to tell whether you are in DKA or not, as the ketones are high either way. But plenty of T1s eat low carb, including me, and I have less than 100g a day.

Back to @TonyDalton's issues. As a T2, he is probably over producing insulin (at least originally), but has insulin resistance so it isn't working as well as it should, and he may need more than he is producing. (Personally, in his position, I would ask for a cpeptide test to find out how much natural insulin production I still had, as long term high blood sugars can damage the insulin producing cells in the pancreas.) In theory, if the insulin production is still there, and the original T2 diagnosis is correct, reducing carbs may well allow him to drop the insulin, though I personally would do this under medical advice.

But feeling ill for a couple of hours after you take insulin isn't right, so you should definitely talk to your doctor about this. There are T1s on here who've reported allergies to certain brands of insulin, and changed brands as a result.

Two weeks ago I was told to increase my insulin to 38 units a day of both of the above with a HBac of 7.5.

That corresponds to an average blood sugar of 9.4. Not sure how much insulin production you have left in your system after running at that sort of level long term, so do be aware that DKA is a possibility if you stop taking insulin. But reducing carbs should certainly reduce the quantity of insulin needed, even if you weren't producing any of your own.

Does anyone have an idea what could be going on? Do you think I may have another type of diabetes?

Hard to say, and we're not supposed to diagnose. If you had LADA I think you'd be in DKA by now without insulin. There are conditions like MODY out there, which probably weren't even considered when you were first diagnosed over 20 years ago. Ideally you'd see an endocrinologist, present your current results, and get the relevant c-peptide etc tests so as to work out what is actually happening in your case. I realise that this may be difficult in current COVID times....

Are you testing for ketones with urine testing strips or a blood testing meter? Just be very careful that you don't go into DKA, as you may or may not be producing you own insulin.

Good luck.

 

[TonyDalton]

May I ask how old you are now?

Hi, I'm 57

 

[TonyDalton]

T1s like us don't produce any insulin, so we have to inject it or, as you say, eventually go into DKA. (Probably fairly quickly in my case, though if you're a recently diagnosed LADA it may take you longer because you're still producing some insulin.) Dieticians tend to vary on the advice they give to T1s on low carb and keto. There's a fairly large group of T1s out there who swear by a keto diet, achieving flat line blood sugar graphs with no hypos or hypers, but one reason why the dieticians tend not to recommend it is that if you are in dietary ketosis it can be hard to tell whether you are in DKA or not, as the ketones are high either way. But plenty of T1s eat low carb, including me, and I have less than 100g a day.

Back to @TonyDalton's issues. As a T2, he is probably over producing insulin (at least originally), but has insulin resistance so it isn't working as well as it should, and he may need more than he is producing. (Personally, in his position, I would ask for a cpeptide test to find out how much natural insulin production I still had, as long term high blood sugars can damage the insulin producing cells in the pancreas.) In theory, if the insulin production is still there, and the original T2 diagnosis is correct, reducing carbs may well allow him to drop the insulin, though I personally would do this under medical advice.

But feeling ill for a couple of hours after you take insulin isn't right, so you should definitely talk to your doctor about this. There are T1s on here who've reported allergies to certain brands of insulin, and changed brands as a result.


That corresponds to an average blood sugar of 9.4. Not sure how much insulin production you have left in your system after running at that sort of level long term, so do be aware that DKA is a possibility if you stop taking insulin. But reducing carbs should certainly reduce the quantity of insulin needed, even if you weren't producing any of your own.


Hard to say, and we're not supposed to diagnose. If you had LADA I think you'd be in DKA by now without insulin. There are conditions like MODY out there, which probably weren't even considered when you were first diagnosed over 20 years ago. Ideally you'd see an endocrinologist, present your current results, and get the relevant c-peptide etc tests so as to work out what is actually happening in your case. I realise that this may be difficult in current COVID times....

Are you testing for ketones with urine testing strips or a blood testing meter? Just be very careful that you don't go into DKA, as you may or may not be producing you own insulin.

Good luck.

Wow, thanks for the effort you put into this reply. You've also educated me a lot & I didn't know about the average level from
the Hbac test either.
My diagnoses consisted of my Dr taking a fasting blood sugar in her office as it was 9.
I will look into your other advice too, thank you very much.

 

[bulkbiker]

Hi, I'm 57

So originally diagnosed at 34? That's pretty young for T2.
Was just wondering whether you were one of the T1 variants.
Keep a close eye on your blood sugars if you are trying without insulin and your sugars keep going up.
Do you have a blood ketone meter.. would be goo d keeping an eye on that too as the last thing you want is a DKA episode (diabetic ketoacidosis caused by lack of insulin with high ketone levels) as @EllieM mentioned.

 

[Andydragon]

So originally diagnosed at 34? That's pretty young for T2.
Was just wondering whether you were one of the T1 variants.
Keep a close eye on your blood sugars if you are trying without insulin and your sugars keep going up.
Do you have a blood ketone meter.. would be goo d keeping an eye on that too as the last thing you want is a DKA episode (diabetic ketoacidosis caused by lack of insulin with high ketone levels) as @EllieM mentioned.

I was 31 at diagnosis of type 2 so it happens. I believe it is increasing in school kids now too? Seems to be an increasing illness and obesity getting the blame generally

Coming up to my 13 year anniversary this week (diagnosed on my birthday weirdly)

How long have you been low carb @TonyDalton and how have your hba1c been over the last 10 years? It coming off drugs takes time, maybe it just needs a bit more time to adjust so that you don’t need insulin now?

 

[nutribolt]

So originally diagnosed at 34? That's pretty young for T2.
Was just wondering whether you were one of the T1 variants.
Keep a close eye on your blood sugars if you are trying without insulin and your sugars keep going up.
Do you have a blood ketone meter.. would be goo d keeping an eye on that too as the last thing you want is a DKA episode (diabetic ketoacidosis caused by lack of insulin with high ketone levels) as @EllieM mentioned.

I was diagnosed at 31 so it does happen. Guess it was down to all the coke I drank while at Uni.

 

[TonyDalton]

Problem solved!
Thanks for all the advice & replies guys. It turned out I am a complete numpty.
I bought some sugar free gum to help with my expected sugar cravings & it turns out it
contains a sweetener called maltitol. It didn't list it on the packets it just listed sweeteners.
I found the full ingredient list on their website & researched from there.
Three days in from my last piece & i've already had two sugar readings below 5 mmol to say I'm delighted is an understatement, it's the first time in 10 years I've been that low. It certainly taught me a lesson to fully research something before I eat it.