Hey the good people of the forum,
This may be a bit of ramble. Please be patient....but curious for your thoughts.
I've been following a low carb/ketogenic paleo style diet for about 18 months now. I feel good eating this way, and my mood, temperament, and concentration levels are all better now that I've avoided a lot of the swings in blood sugar that come with a more typical western diet. My Hba1c has improved dramatically but there is still room for improvement.
Anyway, I am due to start on the Medtronic insulin pump on Tuesday and have been speaking with the dietician who will be my professional involved in my care during the induction period. My opinion of her is that she is a very warm, inquisitive and caring professional. However, I was completely honest with my way of eating, and we had a bit of back and forward discussion on a few things with some disagreements. She obviously has concerns around my disclosure that it is likely my body produces ketones in the absence of dietary carbohydrate. She explained that part of the day of the insulin pump going live is testing for ketones before you are allowed to leave the hospital. In any case, I've just been provided with ketone sticks for my meter, having not had any in years. I've been type 1 since the age of 12, and have never really tested for ketones as I've always been pretty ritualistic with always taking my background insulin and having a level of circulating insulin to prevent DKA from happening. Touch wood that DKA never happens (touches head).
I'm currently getting back into running. And because I now have the ketone strips I now have the option of testing my ketone levels to see what they are. Today, after lunch, I ran for 8 miles. I never took anything on board during the run. I am by no means very good at running but part of my reason for eating very low carb is so that I can train my body to rely on fat rather than glucose and so avoid my blood sugars dropping. And it works. I also like the idea of being able to build up to going out running for a couple of hours or more and not having to think about diabetes too much and having to take in gels or glucose tablets. For me running is a time for thinking and a bit therapeutic in a way if that makes sense. Call it escapism from reality if you like.
So when I finished my run and tested by blood glucose level it was 6.6, having been 7.5 before I left. Very happy with that. I then went to test my ketone levels and they were...3.3! I'm not overly concerned at that, because my blood sugars are in range and I have a level of insulin circulating in my body, but I am worried about the reaction of the medical staff when we test for ketone levels on the day I go live with insulin on the pump. It is likely they will be in a similar range.
Are there any other type 1s who have went on the insulin pump that have faced a similar situation? I have no desire to change my eating habits - even though the dietician requested that I give some thought to doing so while I begin setting up with the pump. It's not by any means an unreasonable request but at this stage in my life I'm very comfortable with my nutrition and the energy levels it provides. So I'm inclined to just keep doing what I'm doing plus I might as well be realistic and honest in my approach. However, I now have this foolish nagging thought at the back of my mind that they won't let me out of the hospital on Tuesday with ketone levels that high despite decent blood glucose levels. And will they allow me to keep the pump? I fear I'm going to be bombarded with questions on Tuesday and that rather than it being a positive experience I may be on the defensive for large chunks of the day. Anxiety and paranoia I hope. I guess we'll see.
All a bit of a rant I know. But it turns out that ranting is almost as therapeutic as running. Almost. Anyone with a similar experience or advice please jump in. Cheers.
This may be a bit of ramble. Please be patient....but curious for your thoughts.
I've been following a low carb/ketogenic paleo style diet for about 18 months now. I feel good eating this way, and my mood, temperament, and concentration levels are all better now that I've avoided a lot of the swings in blood sugar that come with a more typical western diet. My Hba1c has improved dramatically but there is still room for improvement.
Anyway, I am due to start on the Medtronic insulin pump on Tuesday and have been speaking with the dietician who will be my professional involved in my care during the induction period. My opinion of her is that she is a very warm, inquisitive and caring professional. However, I was completely honest with my way of eating, and we had a bit of back and forward discussion on a few things with some disagreements. She obviously has concerns around my disclosure that it is likely my body produces ketones in the absence of dietary carbohydrate. She explained that part of the day of the insulin pump going live is testing for ketones before you are allowed to leave the hospital. In any case, I've just been provided with ketone sticks for my meter, having not had any in years. I've been type 1 since the age of 12, and have never really tested for ketones as I've always been pretty ritualistic with always taking my background insulin and having a level of circulating insulin to prevent DKA from happening. Touch wood that DKA never happens (touches head).
I'm currently getting back into running. And because I now have the ketone strips I now have the option of testing my ketone levels to see what they are. Today, after lunch, I ran for 8 miles. I never took anything on board during the run. I am by no means very good at running but part of my reason for eating very low carb is so that I can train my body to rely on fat rather than glucose and so avoid my blood sugars dropping. And it works. I also like the idea of being able to build up to going out running for a couple of hours or more and not having to think about diabetes too much and having to take in gels or glucose tablets. For me running is a time for thinking and a bit therapeutic in a way if that makes sense. Call it escapism from reality if you like.
So when I finished my run and tested by blood glucose level it was 6.6, having been 7.5 before I left. Very happy with that. I then went to test my ketone levels and they were...3.3! I'm not overly concerned at that, because my blood sugars are in range and I have a level of insulin circulating in my body, but I am worried about the reaction of the medical staff when we test for ketone levels on the day I go live with insulin on the pump. It is likely they will be in a similar range.
Are there any other type 1s who have went on the insulin pump that have faced a similar situation? I have no desire to change my eating habits - even though the dietician requested that I give some thought to doing so while I begin setting up with the pump. It's not by any means an unreasonable request but at this stage in my life I'm very comfortable with my nutrition and the energy levels it provides. So I'm inclined to just keep doing what I'm doing plus I might as well be realistic and honest in my approach. However, I now have this foolish nagging thought at the back of my mind that they won't let me out of the hospital on Tuesday with ketone levels that high despite decent blood glucose levels. And will they allow me to keep the pump? I fear I'm going to be bombarded with questions on Tuesday and that rather than it being a positive experience I may be on the defensive for large chunks of the day. Anxiety and paranoia I hope. I guess we'll see.
All a bit of a rant I know. But it turns out that ranting is almost as therapeutic as running. Almost. Anyone with a similar experience or advice please jump in. Cheers.