How many carbs are enough?

staffsmatt

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The other option you have @Bluemarine Josephine is to have a half way house. go back to Tresbida but have moderate carb intake, that might give you the best of both worlds. The carb intake at tea might stop the overnight hyos and it definitely sounds as if tresbida suited you better than levimir...
 
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RuthW

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It isn't true that the brain needs carbs. It is true that the brain usually runs on glucose. If you stick to protein and vegetables, then your body will burn most of the protein for energy. How much is left to maintain your body?
I see from your postings that you were managing fairly well before the DAFNE course (though your blood sugars were a little high?). Perhaps go back to your old diet to relieve stress, regain your confidence, and then sit down and assess what you need to learn to move on.
I think you might benefit from looking at all the postings about dosing for protein. But if, as a Type 1 you go for high protein/high fat eating, rather than low fat, fairly low protein, plus carbs, you are going to need to take a LOT of injections AFTER meals. Or you need a pump. Really, I think we should all be on pumps!
 
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RuthW

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I feel much better when I am eating carbs. They give me energy. I am unconvinced that T1s can function "in ketosis".
 

Gaz-M

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I have always eaten carbs, I only average around 120 a day so its not alot in reality.

I did however get a tad confused when I joined up here and started watching everything I ate, low carb/high fat etc, I have a heart condition and well it never worked out for me and I have been (as far as I know) type 1 for 43 years and now just eating what I always have, that is a normal healthy diet with carbs, veg, meat etc
 
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Cathn61may

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I have 180 carbs a day same as when I was diagnosed in 1967.
 

Cathn61may

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I was told to avoid anything to do with ketones. KETONES MEAN DANGER.
 

Clivethedrive

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Ditto i'm much sharper now running at an average 3.8 and consuming 30 g of carbs a day
 
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Clivethedrive

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Then if ketones mean Danger anyone on a diet losing weight is in ketosis
 
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ladybird64

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Then if ketones mean Danger anyone on a diet losing weight is in ketosis

Is it a different scenario for type 1's though Clive? I'm not sure if you are on insulin or have been but your profile says diet only? I don't know enough about how this affects insulin users to comment (and yes, I know there are many type 2's on insulin but you all know what I mean lol)
 
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Clivethedrive

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Regarding diet and users of insulin,the less carbs the less insulin ,providing you are eating a balanced lchf diet , dr Richard Bernstein in his book Diabetes Solution 4 th edition, discusses this at length.and you are right i am now controlling by lchf only and keeping my bs's in the 3.6=4.0 mmols am fasting and 5.6 pre dinner 6.8 post dinner on average. The ideal ketosis is to be eating just enough to force your body to burn its own fat reserves
 
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Gaz-M

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ketosis is not the way to go if you are type1 in my opinion, I have been hospitalised 3 times with ketoacidosis all 3 when I was young, 6, 7 and 9 years old and I have had it twice more in adulthood which I sorted out myself.

As a type2 and "IF" you are over weight then I could maybe see this a benefit of burning your own body fat as fuel and maybe just maybe if you are type1 and over weight, but for me it is not a risk I would advise doing.

Just my thoughts and not to be taken as an offensive reply
 

ladybird64

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Right. I have heard of Dr Bernstein (who was type 1 I believe?) but without wanting to derail the thread, I believe there is a difference between the presence of ketones meaning ketosis, or the dangerous ketoacidosis?

Edit - cross posted with Gaz! I was also wondering about the fat burning issue..
 
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Clivethedrive

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Er sorry but i posted about 47 mins ago under ketosis questions, a very good reply from brunneria, have a look,
 

ladybird64

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I saw when you posted Clive, not quite sure what that has to do with anything? Although I know we are flexible on this forum, I was questioning whether the presence of ketones could signal ketosis or ketoacidosis, as I'm aware the latter is dangerous. I also read the thread through, it was started by a type 1, this is the type 1 forum (although we all float in and out) and I noticed that most of those that were eating higher rates of carbs were type 1, even though it is acknowledged that the nutritionist referred to in the original post was talking codswallop.
I can't see that the original post was about ketosis, rather the benefit of a low carb diet for her personally. I questioned your reference to ketosis in relation to type 1's, not type 2's and also the matter of ketoacidosis, as I don't know if this influences the matter at all.

Hopefully the OP will choose to go with what is right for her.
 
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robert72

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Ketosis and ketoacidosis are not the same thing. It's OK to be in ketosis if you have sufficient insulin, i.e. normal blood sugars.
 
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robert72

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@Bluemarine Josephine you should go back to the carb level you were happy with. I don't understand why they switched you to Levemir. I have been doing very well with Tresiba and a low-carb diet for a couple of years now.
 

nigelho

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Good day! I hope that you are all doing very very well.

About a month ago, I concluded the DAFNE course. During the course, with the help of my educators I made several adjustments with regards to my background insulin, my ratios and my carbs intake.

I am still in the process of adjusting my background insulin and my Novorapid ratios so, please, disregard the blood glucose levels that I am about to mention (this is still a work in progress) because, the idea behind this post refers to nutrition and carbohydrates.

Prior DAFNE, I was on an ultra low carbs diet, consisting only of green vegetables and protein (no eggs though).

During my DAFNE course, my nutritionist insisted that I eat at least 30 grams of carbs per meal (which is 90 grams overall per day) referring only to carbs such as bread, yogurt, milk, cereal etc without considering the “hidden carbs” in green vegetables or protein or subtracting dietary fiber.

For the time being, my ratios are 2:1.
I am very slim, former athlete, and my BMI is at the lower side of the healthy range.
On a basis of 2:1 ratio, I need 6u of Novorapid to cover my meal.
If my calculation is correct, each correction unit lowers me by 2 mmols.
Therefore, if I want to have a meal which consists of 30 grams of carbs + 2 units of adjustments then, I need overall 8 units of Novorapid…
Now… that sounds like a lot of insulin to me…

I do it but, I am not happy about it.

So, today morning, I decided to do a basal test because I suspect that my background insulin isn’t enough.
My fasting was 10.8
Pre-lunch was 14.8
It seems to me that my morning Levemir needs adjustment.
If I eat 30 grs carbs for lunch on a 2:1 ratio = 6u
and if each adjustive unit lowers me by 2 mmols, I need some 4 additional units.
A total of 10 u of Novo....and I am not confident to do that... I just cant...

However, (and here is the point of this long post) during the basal test this morning, I realized how much I have missed the benefits of a low carbs diet. For the first time after about a month, I didn’t feel the stress deriving from the possibility of over-injecting, of making a mistake, of the ‘what-if’s in my head…

My God, I had missed that freedom!!

I felt more confident to drive and work and run to the banks without constantly thinking “I wonder what is my Novo doing now” and “why did I just have that dizzy spell? Am I dropping more than I calculated?” and “Did I walk too much? Was the walk too brisk maybe?”

My nutritionist insists that, for the brain, in order to function properly, we need, at least 130 grams of carbs per day. I was on a next-to-nothing carbs since I was diagnosed 3 years ago and my brain was working alright (or so I believe, at least.) I am not advocating that I do not see the nutritional benefits of a greek yogurt or an apple or a glass of milk but, do all these carbs have to be altogether in each meal every single time?

Please, share your thoughts with me and also, please guide me, how many carbs are enough or too many?
Thank you
Josephine.
I did my DAFNE Course in 2013 and we didn't use a nutritionist at all. I note you keep mentioning that each additional will lower your BS by 2 mmols. This is just a basic guide and you'll have to work out what works for you. I use Apidra and before that novorapid but I used a correction ratio of 1:1 and aim to reach 5mmol. I do 4 -5 hour testing as it takes my Apidra and tablets that long to work. My course informed us that we could eat ..whatever..as long as you allow the correct insulin to cover the carbs. However, use your common sence. My meal ratio is 2:1CP generally but I prefer to use 1:5 grams carbs as it's easier for me to calculate. At breakfast my meal ratio is 1:4 grams of carbs as I'm insulin resistant in the mornings. I also take 2 metformin 500mg SR tablets at each meal. Depending on activities I will alter my ratios accordingly and I get it right most of the time.
If you prefer to low carb then do so and forget what others say...If something works for you then stick to it. I now follow what I learnt on DAFNE but adjust the info to suit myself. Dafne changed my insulins in 2013 but since then I've gone onto Apidra as the novorapid stopped working and I've changed to Humulin I. The 2 tablets per meal was by trial and error. I started on 1 tablet a day but that didn't work so I increased the tablets until I found what worked. I still e-mail one of the DAFNE nurses that I trusted. My HBA1c is now 6.7% and BSs are usually fine.
 

TorqPenderloin

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ketosis is not the way to go if you are type1 in my opinion, I have been hospitalised 3 times with ketoacidosis all 3 when I was young, 6, 7 and 9 years old and I have had it twice more in adulthood which I sorted out myself.
Not offensive, but what is your rationale behind your opinion? Are you basing your opinion solely on your own personal experiences? What risks are you concern you?

The conditions for nutritional ketosis and the conditions for DKA are polar opposites and assuming you understand the basic concept behind each state, common sense would dictate whether or not you should be worried.

Nutritional ketosis is characterized by "starving" your body of carbohydrates to a point where it begins to seek an alternative energy source.

DKA is characterized by "starving" your body of INSULIN. Your body cannot deliver glucose from your blood to be used as energy. Your body seeks an alternative energy source, but begins to RAPIDLY breakdown body fat. MASSIVE ketone levels develop (10-20x that of nutritional ketosis) which are slightly acidic. However,in these massive quantities, the pH of your blood is lowered which is what can lead to a coma.
 
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Gaz-M

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well @TorqPenderloin just the way I was taught was that ketones was a bed sign and if any were presant in a urine sample to treat it accordingly. I know there is a difference and that is why I put it as (in my own opinion) so if people are happy to try that diet then thats their own choice :)
 

Clivethedrive

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well @TorqPenderloin just the way I was taught was that ketones was a bed sign and if any were presant in a urine sample to treat it accordingly. I know there is a difference and that is why I put it as (in my own opinion) so if people are happy to try that diet then thats their own choice :)
Please read dr richard bernsteins Diabetes solution 4 th edition he explains ketosis much better,clive