1st day of low carb, food diary.

[nathansdiary]

Today was my first day of going low carb. I have kept a very very close eye on my sugars today.

Here goes, the start was a little high but the rest has been pretty good, although maybe a little too low through the afternoon so tomorrow I will decrease the lunch time dose a little further. I am also going to knock a few units off my lantus at night as at present I am taking 40 units.

Before Breakfast - 11.3 Insulin 22units (bigger dose to reduce)
Breakfast - Galia Melon (half)

Before Lunch - 5.5 Insulin 14 units
Lunch - Chicken Soup, 1 slice wholemeal bread + 1 apple
Snack - apple
Mid afternoon - 4.7 (a small amount of lucozade used)

Before evening meal - 4.9 (2-3 sweets just to bump up a little while dinner finished cooking)
Insulin 16 units
Dinner - Pork topped with cheese & apple, broccoli, dwarf beans, carrots and gravy

I am very impressed how this has made such a difference so so quickly. I can't wait to take this to my diabetic nurse next week.

 

[fergus]

Great stuff Nathan,

Half a day at the freaky eating and you've got normal blood sugars already! Seriously impressed.

fergus

 

[Siobhan]

Hi Nat,

What insulin do you take and how much? It seems alot to have a sugar of 11.3 and do 22 units while eating half a melon! I would probably do 7 or 8 units of humalog.

 

[nathansdiary]

I use novorapid and normally with my old carb laden diet I was taking around 20-28 each meal and sometimes needed a booster a little while later as was still to high. Tomorrow morning I will be reducing the breakfast dose quite a bit as I am hoping that I won't have a repeat of this morning.

I know some people probably thought I was being a bit much by jumping on the lucozade at 4.7 but I have had an average range of 6-12 (under doctors orders) for quite a while. For this reason I do start to feel hypo symptoms at around 5. I am hoping that after a few weeks of getting my control back down to normal that I will get back to normal hypo range. At the moment it gives a slightly more restricted range to me as I am trying to keep below 8 for the time being. I can then reduce this more as I get more adjusted over the next few weeks.

Cheers for all the replies so far peeps, I appreciate any help and advice.

Kevin (I know my screenname is different lol....long story ha ha!)

 

[Siobhan]

That seems loads of insulin the doctor said I was doing too much when I said I was doing 1 unit for 10 grms of carbs. He said it should be 1 unit for 20 grms of carbs, How much do you do for 10grms of carbs??

 

[Dennis]

According to the Diabetes Health website, the correct ratio of insulin to carbs should be:

"An "average" might be 1 unit of insulin for every 10 or 15 grams of CHO for an adult, or 1 unit for every 20 to 30 grams for a school-age child, depending on the calculation method used."

But also:

"People with insulin resistance will need more insulin for each CHO serving than people who are more insulin-sensitive."

 

[fergus]

It sounds as if you know what you're doing, Kevin.
Not only do insulin to carb ratios vary between individuals, they vary depending on other factors such as lean muscle mass and exercise levels so that ratios don't remain constant for individuals either.
If it helps with your transition to low carb, when I made the change I reduced my evening meal dose from 30 (yes, 30!) units of Humalog to 7 units. Before anyone asks, I probably eat more, rather than less food now too. I reduced my dose by a couple of units at a time so that any mistakes were small ones, and it took a few months before I became settled at my lower doses.
I think I'm more sensitive to insulin now, since I lost a fair bit of weight and became less insulin resistant due to the lower doses themselves.
As Eddie suggested, you should keep a record of your diet and insulin as you make these changes. If nothing else, it'll amuse you to look back at how things used to be when you a 'healthy, balanced diet'!
All the best,

fergus

 

[nathansdiary]

I have not started working out carb to insulin ratios yet. I will look at that shortly once I have got a better control. I am hoping that my resistance to insulin will drop once my body gets used to smaller doses. I am also hoping that the low carb will help with my weight problems. I have been struggling with my weight for quite a while now but recently found out that I am on a medication which has a major side effect of weight gain. The same doctor who put me on this is the one that was complaining I was putting on weight....go figure ha ha! I am now off these tablets so hopefully the diet and lack of pills might help.

The only downside though....very dissapointed this morning when I woke up and tested to see 12.3!!! I really don't understand how, it did upset me a bit as I was getting on so well yesterday. I suppose I should not expect every reading to fall into place overnight but I was only 7.6 before bed.

Anyway, i'll keep the food diary going and keep you all posted to see if you can spot any bits I could change. I really appreciate all the help so far and am really pleased I found this site.

Kev

 

[hanadr]

They all seem to do this
I am on a medication which has a major side effect of weight gain. The same doctor who put me on this is the one that was complaining I was putting on weight....go figure ha ha!
That is except mine who isn't worried about my weight, becaue I'm losing slowly. I've gone from 107 kg to 90 kg in a year. He has aid to me that the diabetics whohave the biggest trouble keeping control, in his experience, are the very overweight ones. I suggested they go low medication/low carb and he said. "It looks like opinion is going that way." I'm sure it was that dreadful Gliclazide, which put me up to 107.

 

[Nellie]

I don't like the idea of low carbing so perhaps I shouldn't comment but I would find myself very hungry after eating just melon for breakfast!
How about 30 gms of granary bread, a boiled egg I/8th slice of melon. Same carb count but much more filling and I think better balanced :wink: (add a small pot of low fat yoghurt (5gms carb) to include some dairy!)

As to going higher overnight. The obvious candidate is dawn phenomenon but this is unlikely to be a new thing.
It may also be that you took too much insulin for your dinner, went low and the liver supplied some extra glucose. I would do 3am tests to find out what is happening in the night.


Whaterver the reason you should I do wonder if your lantus doseage is correct anyway. You were using quite a high insulin to carb ratio. Could it be that because your basal was not correct during the day you have been using part of your mealtime insulin to correct rather than simply cover the carbs? On the other hand your level did stay the same between mid afternoon and dinner, despite the lucozade which would suggest that for that period it is correct.(confusing?)
The trouble is that whilst altering your meal pattern it will take some time to work out whats affecting what!

 

[fergus]

Nellie,

Since you don't like the 'idea' of low carbing you're perhaps not best placed to advise someone who has seen the compelling logic behind it and is looking to try it themselves. Melon, incidentally, is almost entirely carbohydrate, but that's not the issue here.
Of the many clinical studies undertaken on macronutrients and satiety, the great majority appear to favour fats and proteins when it comes to satisfying the appetite. Since carbohydrate necessitates insulin secretion, and since insulin is a primary stimulant to appetite, the idea that carbohydrates promote satiety doesn't sit comfortably with the science.
All of the low-carbers on this forum and elsewhere seem to report a reduction in appetite on a low carb diet. That has certainly been my experience.

All the best,

fergus

 

[chocoholic]

And mine. Much to my surprise.

 

[nathansdiary]

Day two has gone well, I will post the figures tomorrow as its too late now and I need some sleep. I am really really hoping for a better start to tommorow.....I am currently 7.6 and have not eaten for a couple of hours so there is no food lurking to play havoc with the sugar level.

Fingers crossed and i'll let you know tomorrow what happens!!

Kev

 

[Nellie]

Since you don't like the 'idea' of low carbing you're perhaps not best placed to advise someone who has seen the compelling logic behind it and is looking to try it themselves. Melon, incidentally, is almost entirely carbohydrate, but that's not the issue here.

so what is? That was my point, the breakfast could have been more satisfying by changing its content. People who eat well at breakfast are normally less likely to snack mid morning.
The breakfast I suggested had exactly the same number of carbs (about 20gm) simply having more protein and fat! I was in no way changing the op carb intake for the day since of course everyone has the right to experiment how they wish .
Is this a public forum or not?

edited to add sorry to the original poster, I don't wish this to become a big discussion on your diary thread. As I said my suggestion was aimed at giving you a more filling breakfast not deranging your diet.

 

[nathansdiary]

edited to add sorry to the original poster, I don't wish this to become a big discussion on your diary thread. As I said my suggestion was aimed at giving you a more filling breakfast not deranging your diet.

Thats quite ok Nellie, I am always happy to hear alternatives. At the moment I am signed off so my activity levels are not what they used to be. Once I get back out to work I may well need to introduce a little bit back in to compensate. I am currently on a scrambled egg phase for breakfast, I absolutely love them and adding loads to them to make them super yummy!

Today was a much better start, I was 8.4 before breakfast which was great, a great deal better than the double figures I have been getting. I reduced my Lantus last night to 30, maybe these reductions at night are helping. What dose of lantus do other people take at night? I was on 40 so am happy to have dragged it down a fair bit but I am not sure if this is still quite high?

 

[Siobhan]

I take 29 units every night at 9pm, I use to be on Levemir but after nine months of taking it once a day it wore off after 15 hours so was ending up having sugars of 20 in the morning! The lantus working brill.

 

[fergus]

Hi Nathan,

i don't think you can go far wrong with scrambled eggs for breakfast. I'm waiting for the day when I become tired of it, but no sign yet.
As for others doses of Lantus, you'll find a pretty wide range, I'd expect. Type 2's may have a degree of insulin resistance and therefore higher doses, while type 1's like me may have no insulin resistance at all and relatively low doses. Diet has an significant influence also. The important issue is what keeps your blood sugars at a stable level throughout the day because this is essentially the purpose of your basal dose.
If it's of interest, I use 5 units Lantus at bedtime and 3 in the morning. You may have seen it discussed already, but many people find that Lantus doesn't actually last a full 24 hours and splitting the dose gives a better coverage over the course of a day.

ps apologies if I misunderstood your post Nellie, I blame the rioja.

All the best,

fergus

 

[Siobhan]

I've never heard of lantus not lasting 24 hours :?: I know from experience that levemir is rubbish, I hope the lantus doesn't stop working for me, then I'm screwed

 

[Pattidevans]

I don't think Levemir is "rubbish" - since my my Hba1cs have been consistently in the mid 5s since I've been on it. Last 3 have been 5.3, 5.5 and 5.5. (and that is not at the expense of constant hypos) It's just that it doesn't last 24 hours, but even the manufacturers suggest you split it. Splitting the dose allows you to administer it as needed and not all in one lump. e.g. I need more overnight, so I take 15u at 8pm and only 8u at 8 am. That's not set in stone and it's easy to tweak it if necessary.

 

[Siobhan]

I say its rubbish you say its good, we are all different!