Low carb - but high sugars - advice please!

Odin004

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@azure, @ kokhongw, @leslie10152, @catapillar, @Kristin251, @noblehead, @Oldvatr, @Fleegle, @ickihun, @DCUKMod, @ringi, @tim2000s

Hi all, I just wanted to namecheck everyone who contributed to this thread, just in case the following information is useful to you.

For the last three days, I've experimented with eating more carbs - about 125g per day (up from my usual 45-65g). I can't say exactly what's happened on a physiological level, but this seems to have completely restored my insulin/carb ratio to almost exactly 1 unit to 10g carbs; sugars have come down to normal range, and things do now appear to be back to "normal".

Thank you to everyone for your input and suggestions. Those of you who suggested upping the carbs a little, seem to have been right - and it only took at few days. Also, 125g carbs for a few days to get things back on track, isn't that bad - it's still really low by reference to the "average" diet. Diabetes doesn't give us the opportunity for many positives - but when an experiment like this works out, I have to say, it is quite a good feeling!

@catapillar - I was thinking of you in particular, as you mentioned you were thinking reintroducing carbs to get your ratios back; if you decide to do this youself, it would be interesting to see whether this works for you too. x
 

azure

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That's fantastic news @Odin004 ! :cool: Well done - and what a relief for you!

As you say, 125g carbs is still low carb and you've got an amazing result there. Isn't it great when things work out? :)
 
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noblehead

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Well done @Odin004 and pleased you've got your I:C ratio's back on track, I'm sure your diabetes care team will be happy to hear this. Best wises.
 
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Freema

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Well maybe a stupid question But isn't it very varied How much glucose a person need for his or her brain . I once hard a boyfriend who was a very clever chess player and he could loose around 4 kg in a weekend playing intense battles of chess ... if the body really needs the glucose in a much higher rate wouldn't the body start transforming muscles and tissue also into glucose ? Maybe not every one can go really low carb if for instance it is a Real intense brainy type ?
 

Oldvatr

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Well maybe a stupid question But isn't it very varied How much glucose a person need for his or her brain . I once hard a boyfriend who was a very clever chess player and he could loose around 4 kg in a weekend playing intense battles of chess ... if the body really needs the glucose in a much higher rate wouldn't the body start transforming muscles and tissue also into glucose ? Maybe not every one can go really low carb if for instance it is a Real intense brainy type ?
@Freema I am surprised at this question. I am pretty sure you understand that when glucose is missing, then our bodies manufacture glucose from protein by neoglucogenesis, and then can do the same trick with lipids via neolipidolysis, and failing that our brain can use ketones as a secondary fuel. So a low carb diet or even extended fasting is not a major problem. Only starvation proper puts us at risk. So there are people successfully following a Zero Carb diet for years. The Inuit / eskimos are close to zero carb diet too.
 
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ringi

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Just thinking out loud….,

How long and how often is the higher carb needed?

Only in the last 100 years would most people have been able to eat the same food all year round, I expect our body works better keeping to seasonal eating.
 

Freema

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@Freema I am surprised at this question. I am pretty sure you understand that when glucose is missing, then our bodies manufacture glucose from protein by neoglucogenesis, and then can do the same trick with lipids via neolipidolysis, and failing that our brain can use ketones as a secondary fuel. So a low carb diet or even extended fasting is not a major problem. Only starvation proper puts us at risk. So there are people successfully following a Zero Carb diet for years. The Inuit / eskimos are close to zero carb diet too.

Well I know What you are saying , just wondered if a person who ate too little of proteins when low carbing maybe would start Breaking down his or her body as well. To create enough glucose for the brains fuel ... dont Think that would happen if the person ate enough protein But maybe there are also genetic differences between People in How efficient They are in doing This neoglucogenesis ?
 

ringi

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Given how little glucose is needed, I think it would be very hard to eat too little protein unless someone never eat mean, fish, nuts, etc. Sorry but protein is too nice for me to consider this a real risk......
 

Freema

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As I have read of the subject some People use around 20 % of their energy in their brains so it is not just very little . I used to live among eskimoes actually i Greenland. And People there had a totally different looking way of storing fat on their body actuallty around their body and not on bag legs and arms like Kaukasian People do . Just thought that generations of a totally different eating pattern maybe also geneticslly made the eskimoes more efficient in transforming protein into glucose . They did also eat berries and herbs and their vitamin C They used to get from eating Raw eyes from seals
 
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Oldvatr

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Well I know What you are saying , just wondered if a person who ate too little of proteins when low carbing maybe would start Breaking down his or her body as well. To create enough glucose for the brains fuel ... dont Think that would happen if the person ate enough protein But maybe there are also genetic differences between People in How efficient They are in doing This neoglucogenesis ?
This is a criticism that used to be levied at the Atkins diet, but studies on that diet have shown that things have to go to extreme to make our body start consuming muscle and body proteins. Most of us have lot of excess fat that has to go first, Although the backup systems are not as efficient in converting protein and lipids into brainfuel, they cover most occasions. I think that Paula Yates had a wobble during the end stages of an olympic marathon and had to withdraw, and this could be due to overdoing the exercise, but most of us should be able to exercise reasonably well, joints permitting, without hitting starvation levels, In experiments designed to see how high dietary ketones rose when doing intensive training, it proved to be almost impossible to get above 3 -5 mmol/l. and DKA starts above 10 even with an SGLT-2 inside you.
 
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Freema

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This is a criticism that used to be levied at the Atkins diet, but studies on that diet have shown that things have to go to extreme to make our body start consuming muscle and body proteins. Most of us have lot of excess fat that has to go first, Although the backup systems are not as efficient in converting protein and lipids into brainfuel, they cover most occasions. I think that Paula Yates had a wobble during the end stages of an olympic marathon and had to withdraw, and this could be due to overdoing the exercise, but most of us should be able to exercise reasonably well, joints permitting, without hitting starvation levels, In experiments designed to see how high dietary ketones rose when doing intensive training, it proved to be almost impossible to get above 3 -5 mmol/l. and DKA starts above 10 even with an SGLT-2 inside you.

Thanks for answering me so specifically okay , well Yes Then This should not be a common worry I do though remember a case here of an eating disturbance and many days of hardly eating and still having very High blood glucose like around 9 mmol Daily even when not having eaten anything , But This personal story must be under the category of starving then ... where the body has changed almost totally to transforming bodyproteins into glucose as I can interpret that constellation Then
 

Eldra

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Hi,
This is a very interesting thread! I have had the exact same problem as you @Odin004. I switched to low carb about a month and a half ago. I am now between 50 and 80g carbs per day; I aimed initally at 120g but ended up slowly reducing inconsciusly... I was at about 190g/day before!!! However, these past couple of days my body reacted in the most funky way possible to insulin. Long story short, I would get higher after a meal than should be expected, and sometimes 6 units or more could do little to correct this. Needless to say this thread rang a bell to me!

I never used to count proteins however, and started to eat more of those to compensate in calories as I was losing weight. By the way, it seems even for me (76-77kg for 1.75 m high) LC diets make me lose weight (I am at about 73-74 kg now). This is annoying as I am actually NOT overweight and would like to avoid becoming underweight. I would be very interested in any feedback on similar issues with T1 who switched to LC diets, so feel free to give me feedback (maybe by MP to keep the thread topic-coherent.
To come back at this IR problem, I noticed today that the amount of proteins I ate for lunch should theoretically have been accounted by with 6 more units of insulin that I did NOT inject on top of the 5 units for 30g of carbs and 1 unit of correction. And 3h after the meal, I needed to inject... 6 units of insulin to cover the high BS value.

I am not sure how to handle the matter, but for the sake of science, I may try to account for proteins and see how my body reacts to this. However I believe on the long run I will go back to about 110-120g of carbs/day, as I don't see the interest of having to count for BOTH protein and carbs and end up injecting the same amount of insulin.

I will give you all feedback on the evolution of this matter so as to corroborate (or not) the results obtained.
Sorry for the quirky English, this is not my native language.
Best wishes to all.
 

Odin004

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Hi @Eldra - interesting to hear that you're having the same issues; if the objective in going low carb is to take less insulin, then I quite agree that there is little point in doing so if this means you have to take the same amount of insulin anyway. I managed to correct the situation by upping my carbs to about 125g for a few days - that seemed to do the trick; your initial goal of 120g therefore sounds quite sensible to me - perhaps increase carbs to this level, for a short while, to see what happens?

As regards your weight, people often do lose weight on low carb diets - partly because the calories aren't always being replaced by proteins and fats; but also because lower carb diets cause you to store less glycogen, and therefore water, in your muscles (so much of the weight loss is actually water loss).

Would be interested to hear how things develop - and don't worry, your English is very good!:)
 
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Eldra

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After a couple days I am very positive that my insuline sensitivity has been restored to much more normal levels. The issue is that I need now to pin down back again my diet a bit and my insulin dosage, so I have been experiencing some highs here and there, but nothing as critical as those 3-4 days of IR, where my BS would go up to 15-18 and stay there regardless of correction doses.

I think it is interesting this IR went away very quickly, at least for me. Basically the first meal with 40 or 50g carbs did the trick. The key for me was to fast until my BS was back to 6-7, then eat a meal with very familiar food to have little room for miscalculation. This is interesting simply because it takes months to trigger but takes a meal to go away. It may be because this is an advanced stage of starvation metabolism? Basically if carbs become very rare, a hormone such as insulin, whose job (amongst others) is to store sugars may not be practical, so it would make sense the body eventually starts to reduce its potency.

Second, I am wondering if this reaction is not evidence that carbs are actually important in a normal healthy diet? Dr Bernstein's stance seems to be that carbs are not necessary at all. It makes sense since the body can produce it from proteins for instance, or even from fat (basically from everything). However, not needing it may not mean that we are meant to not eat it in the first place. Considering our ancestor monkeys for instance, they do eat lots of fruits, which is full of sugars.

I believe Dr Bernstein's diet is a bit extreme, but then again rather than 50-60g carbs a day, he suggests 30g, which may be manageable even with IR. Also, I think he suggests to adjust for protein intake with slow-acting insulin, such as Glargine? It does seem to be very effective, but this is a lifestyle choice I guess.

Finally and most importantly, thank you very much to all of those people who helped Odin004 figure this out, and me at the same time; also a big thank you to @Odin004 himself for bringing this up and sharing his solution once found. I must say I was very stressed by this, I am trying to reduce my HbA1c very seriously now, as it has been around 7.5-8% for a couple of years, and I am quite nervous about being able to reach 7% for the first time since my honeymoon period possibly (and even maybe 6.5% eventually!). This was quite a big hit, but now that it is solved, thanks to all of you I can work further into sorting a more balanced, intermediate carb diet.
 

Odin004

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Hi @Eldra - that is absolutely my pleasure - and I'm really thrilled to hear that this solution has worked for you! I quite agree with you - it's very strange that the insulin resistance can be rectified so quickly. This suggests to me that insulin doesn't actually lose it's "potency" on a low carb diet - because if that were the case, one would expect a longer "re-adjustment" period, when normal carb intake is resumed.

I suspect that what's happening on a prolonged low carb diet is that the body (as you say) is manufacturing sugar from proteins and fats (including those stored already in the body) - causing higher levels of sugar in the blood - in a "normal" person, the pancreas would simply increase insulin production to account for this new sugar, and therefore maintain blood sugar levels in a tight range - however, with us diabetics, we'd need to actually inject more insulin - but at the same time, have no way of qualifying or quantifying the extra requirement; so it might not be "insulin resistance" at all - although it acts as such. When normal carbs are resumed, conversion from proteins and fats to sugars reduces accordingly - leading to an almost instant normalisation of dosages, as we've both observed. That's my theory at least - and keep up the excellent work!
 
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StewartH

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@Odin004 If you drop your carbs too low, you can get insulin resistance. That's one of the reasons I don't eat very low carb.

It sounds like this could be what's happened to you.

It's a myth that every T1 on VLC can reduce their insulin. Many end up bolusing as much for a no carb meal as they would for carbs.

If you've ruled out all the usual suspects for high sugars, then this might be the cause.


'Insulin resistant caused by eating too little carbs? As a moderator..you really need to back that statement up with a bit of science please. Sounds of gauntlet hitting floor.........