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Increasing basal on low carb
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<blockquote data-quote="smidge" data-source="post: 635533" data-attributes="member: 29301"><p>Hi BellaBella!</p><p> </p><p>I'm glad you're enjoying low-carbing. I've looked at your profile but can't see any detail about how long you've been diagnosed etc, so it's quite difficult to advise as I don't know your general exeperience with diabetes and dose-adjustment. However, I'm a little uneasy about some of what you've said in your post, so a couple of insulin-using low-carb principles:</p><p> </p><p>1. Basal should normally be used to keep levels stable - not to try to cover meals. There are some good exceptions to this; notably some low-carbing LADAs who are still producing sufficient insulin to not need bolus insulin for low-carb meals. This group will often use the basal partially to supplement their own insulin production, but they are relying on the fact that their own insulin is strong enough. It is not an approach that would work well for full Type 1s. Another exception would be where your basal is an intermediate acting insulin such as Insuman or Insulatard - these have a strong 4 - 6 hour peak action which can be timed to cover or partially cover a low-carb meal - again, it tends to work well for certain LADAs or Type 2s who are supplementing rather than replacing their own insulin.</p><p> </p><p>2. Rapid-acting needs to be taken with the meal generally. Your BG will start to rise just because you are eating - whatever you are eating - so you need to take some insulin to stop the rise. However, with some low-carb meals you might need to split the rapid-acting dose and take a small dose with the meal to counteract the immediate rise and a further small dose later to counteract a further rise at 4 or 5 hours post meal - that's trial and error I'm afraid.</p><p> </p><p>3. Carb-counting is only part of the story for adjusting bolus doses for low-carb - it is a starting point. You need to add a bit for the protein and probably a small amount just for eating - at least I do! As long as the carb is low, with experience it is usually possible to 'guess' the amount of insulin needed by the size of your meal.</p><p> </p><p>Obviously, as others have said, if you feel a hypo you must test.</p><p> </p><p>Good luck</p><p> </p><p>Smidge</p></blockquote><p></p>
[QUOTE="smidge, post: 635533, member: 29301"] Hi BellaBella! I'm glad you're enjoying low-carbing. I've looked at your profile but can't see any detail about how long you've been diagnosed etc, so it's quite difficult to advise as I don't know your general exeperience with diabetes and dose-adjustment. However, I'm a little uneasy about some of what you've said in your post, so a couple of insulin-using low-carb principles: 1. Basal should normally be used to keep levels stable - not to try to cover meals. There are some good exceptions to this; notably some low-carbing LADAs who are still producing sufficient insulin to not need bolus insulin for low-carb meals. This group will often use the basal partially to supplement their own insulin production, but they are relying on the fact that their own insulin is strong enough. It is not an approach that would work well for full Type 1s. Another exception would be where your basal is an intermediate acting insulin such as Insuman or Insulatard - these have a strong 4 - 6 hour peak action which can be timed to cover or partially cover a low-carb meal - again, it tends to work well for certain LADAs or Type 2s who are supplementing rather than replacing their own insulin. 2. Rapid-acting needs to be taken with the meal generally. Your BG will start to rise just because you are eating - whatever you are eating - so you need to take some insulin to stop the rise. However, with some low-carb meals you might need to split the rapid-acting dose and take a small dose with the meal to counteract the immediate rise and a further small dose later to counteract a further rise at 4 or 5 hours post meal - that's trial and error I'm afraid. 3. Carb-counting is only part of the story for adjusting bolus doses for low-carb - it is a starting point. You need to add a bit for the protein and probably a small amount just for eating - at least I do! As long as the carb is low, with experience it is usually possible to 'guess' the amount of insulin needed by the size of your meal. Obviously, as others have said, if you feel a hypo you must test. Good luck Smidge [/QUOTE]
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