No support at breaking point now.

[Key_master_]

Hi again @Key_master_ ,

Going to tag in @robert72 . (While I remember it.) Haven't seen him on the forum for a few weeks. But he may pop in to help with his angle..

Personally, I can understand what you mean when the HCPs just don't get what your doing with diabetes managment..
I'm not quite as low as yourself on the carb count. (But this arrangement works for me.)
My new current DSN is pre-D & advocates a banana for breakfast & the baked spud for tea. Lol. Fair enough!
I just don't do em...
Not when I can have a fry up without the "usual suspects" or a spicy pork lettuce wrap..?

Your A1c of five point three is brilliant! Don't lose faith in yourself..

Thanks @Jaylee, I’ve even told them to have a look at dr Bernstein’s approach to try and help others or at least give the ones who want to do something about their diabetes the chance. Did they bother of course not. It’s like so many people are saying to me and dr Bernstein when he said about testing his own blood sugar to his then endo in the 1970’s who was at the time the head of the American diabetes association, I can’t have them doing that I need them to come and see me to have that done. Haha!! They need us poorly and reliant on them. The same as the big pharmaceutical companies we are just ££££££££££ I’m no good to my dsn or diabetes consultant thriving on low carb, fitter, stronger and healthier than I’ve ever been. Apart from the insulin making me work harder splitting and stacking doses I’ve had really good outcomes. Just wears me down when I know it’s not quite working and there’s a possible solution out there.

Your dsn is in for a shock then if that’s their approach, won’t be pre-D for long doing that, especially if not on insulin like they should be now or very low carb. I found baked spuds caused havoc on my sugars and not that much of a slowed down affect due to butter and cheese added either. Switch it up and take away the carbs and I’ll chew that protein and fat straight up quite quickly.

One of my breakfasts for example.
10g hemp seed, 10g chia, 8g walnut, 9 Brazil, 1g cinnamon and 150g alpro no sugar yogurt will power pack my sugars without sufficient insulin onboard and it’s like 6g carb total even less now alpro have a sugar free yogurt. the energy from the fat side of the nuts and seeds will go pow in a few hours not like that of supposed other fats that can be an 8 hour affair. again a small split dose is required for this as well.

 

[tim2000s]

@Key_master_ - whilst I appreciate that you're struggling with the Novorapid not lasting as long as the protein takes to absorb and undergo gluconeogenesis, you technically don't need Actrapid or any other regular insulin to handle it.

You can legitimately use Novorapid as @helensaramay suggested. While Bernstein talks about regular for his protein driven patients, having had experience of it in the past (Actrapid), it's darned slow, and really hard to exercise on, as it has a very long tail, so if you are looking to get back into exercise, I'd make sure you are aware of that.

I do think you need to look at basal testing, as described by others in the topic, and also your novorapid dosing, as I suspect that due to the former being incorrect, the latter will be too, and you need to do the experimentation to understand how your novorapid really works.

 

[Key_master_]

@Key_master_ - whilst I appreciate that you're struggling with the Novorapid not lasting as long as the protein takes to absorb and undergo gluconeogenesis, you technically don't need Actrapid or any other regular insulin to handle it.

You can legitimately use Novorapid as @helensaramay suggested. While Bernstein talks about regular for his protein driven patients, having had experience of it in the past (Actrapid), it's darned slow, and really hard to exercise on, as it has a very long tail, so if you are looking to get back into exercise, I'd make sure you are aware of that.

I do think you need to look at basal testing, as described by others in the topic, and also your novorapid dosing, as I suspect that due to the former being incorrect, the latter will be too, and you need to do the experimentation to understand how your novorapid really works.

Thanks @tim2000s you mention hard to exercise on, is this because of having insulin still active at the time of exercising?

Do you split your doses also to cover protein and use novorapid?

My metabolism is pretty sharp and I run on very low carb all the time. 6g in the morning if I have my yogurt, seed and nut mix, if I have an omelette I don’t consume any additional so just cover the protein, if I have sausage bacon and egg I’ll add 2 Scandinavian crackers making up the 6g and put those on top Linda topped cracker. Same if I have it in the evening with the addition of mushrooms to add more carbs to achieve almost 12g. Make up my lunches with salad and low carb homemade scones, around 3G carb per scone. My evening meals using cauliflower, broccoli, green beans, cabbage, courgettes, other low carb veg or salad stuff. Have a healthy reduced carb stir fry twice a week to get a bit more variety in the veg department.

I have been currently reducing my protein slightly as I have a less demanding lifestyle at the moment due to less exercise and my caring roll with my dad that had me on the go pretty much all day which ended when he passed away the end of August. I’ve also been away from home now since the 3rd week of August and stopping with my mum so my evening walk around the estate has stopped after my tea. A steady mile and half walk was adequate to help my meals and insulin work nicely together causing no noticeable peak from them. It’s not ideal here now as she lives in the sticks and it’s just dark lanes to trek around. Now I do some core weight training with 6kg dumbbells and also use my trusty sit and cycle which I would use if it was raining to replicate my evening walk.

I will be performing basal testing once I shift this cold I picked up at the start of the week, nearly gone now so will get straight on it once fully recovered.

 

[tim2000s]

Thanks @tim2000s you mention hard to exercise on, is this because of having insulin still active at the time of exercising?

Do you split your doses also to cover protein and use novorapid?

Actrapid hangs around for about eight hours plus, so you never really get it out of your system. That's why it can lead to less predictability during exercise.

I used to split dose Novorapid for protein, yes.

 

[Key_master_]

Actrapid hangs around for about eight hours plus, so you never really get it out of your system. That's why it can lead to less predictability during exercise.

I used to split dose Novorapid for protein, yes.

I thought as much regarding it still being active, it’s all quite a mine field really. In an ideal world we would be able to do things at the exact same time everyday and try and predict and deal with the possible dip with planned glucose tabs like dr b teaches. He gets you to formulate the additional glucose you need yourself for your physical activity but it pretty much has to be the same exercise, amount of time etc.

Are you saying avoid the actrapid then and stick it out on the novorapid? Stick to splitting doses. When you said used to, what do you do now instead? Seems a lot of people who have commented are using pumps.

 

[slip]

As Tims not currently on line I'll answer for him, he's a pumper (well he's a bit more than an ordinary pumper in that he's running a closed loop AP).

I do agree with him and others that a proper basal test and most likely slight change in both basal & bolus ratios will be needed.

 

[tim2000s]

The difficulty with Dr B’s approach is that it generally requires a relatively high level of routine, and for many of us with normal lives, that just doesn’t work.

If you don’t want to eat many carbs, just sticking to a lower carb approach can make life easier and many do so successfully. For a reasonable period of time I low carbed with MDI and it worked okay with Novorapid. I’d suggest looking at Sugar surfing to get an understanding of the principles that seem to work well for lower carb, more protein.

 

[Kateyo]

I've just been reading through this thread and it sounds so familiar! I have tried the Dr B approach before and gave up and have tried again this week but I find it to be so unpredictable and really difficult to manage. I actually find my control to be better on lower carb rather than LCHP/F. I use Fiasp, which does run out quicker than novorapid for me but take tonight for example I had steak burger with avocado for dinner and sat steady for 2-2.5 hours, I seen my BS start to creep up so took another few units to try and prevent it climbing further but it was too late and I went up into the 8s (v.quickly!) having sat in 4s for the couple hours after the meal. The same thing happened this morning after having made LC pancakes. I use dexcom so am always watching for any change. I would love to achieve the numbers those who successfully low carb do but I just don't know that it works for me, I wish it would Hope that you can find a way to work with protein/fat, it looks great if you can work with the gluconeogenesis/delayed absorption from fat.