UK insulin for low carb high fat/protein/Bernstein Diet

tnharvey

Newbie
Messages
2
Hi,
24yo, T1D for 12 years.
I've been on the low carb diet for a couple of years and it's greatly improved my blood stability. That said, I'm having some trouble with Novorapid as a primary fast acting insulin as it seems to peak much faster than the slow rise caused by gluconeogenesis from proteins - its effects then subside too early. This leads to bloods going too low, and then too high afterwards unless I inject 3 or 4 times for one meal over the course of 3 or 4 hours, which I still haven't completely got the hang of and is inconvenient at the best of times. It also makes exercise within this window a bit inconvenient and unpredictable. At the moment I inject a quarter of the dose at the time of eating, another quarter one hour later, and then the remaining half of the full dose the hour after that. Still doesn't work perfectly and has some fluctuation.

On the Bernstein diet book he recommends using Humulin (R) for the reasons mentioned above, but this isn't readily prescribed in the UK. I was wondering if anyone was using a different type of insulin that made this more convenient? If not, how are you adjusting your insulin to make sugars more consistent?

I'm currently on between 10-12 units of Lantus a day, and I seem to have to use a lot more Novorapid than I should need for protein - some might be from short term insulin resistance. I inject Lantus in the morning because of a problem with hypos at night, but recently I've found my blood sugars rising at night as well - especially after eating later in the day. I'm also experimenting with intermittent fasting for this reason.

Thanks a lot and would greatly appreciate some help/feedback.
 

ert

Well-Known Member
Messages
2,588
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
diabetes
fasting
Welcome. We can't give dosing advice, you will have to contact your consultant or diabetes nurse. If you record your waking, bedtime and before breakfast, lunch and dinner BS, insulin dosing and carbs (and protein), over a few days, send it in, and they should be able to advise you on your background insulin, insulin dosing for different times of the day due to IR, dose splitting for higher fat and protein meals etc.

However, like you, I follow Bernstein. I'm on Fiasp and Levemir. With Fiasp, I try to use exercise as a substitute for the second part of a split dose, but only after my BS have bugan to rise. I don't have fixed timings but just follow the numbers.

I recommend this book:

Stephen W. Ponder, Sugar Surfing: "How to manage type 1 diabetes in a modern world."
 
Last edited:

Ian DP

Well-Known Member
Messages
712
Type of diabetes
LADA
Treatment type
Insulin
Dislikes
Chips
Hi tnHarvey,
I am T1. low carb for 7 years, following dr Bernstein solution. I take 3 units of novorapid prior to meals (give or take a unit depending on my BG levels). Meals are always around 10g carb. Like you if not careful I can go to low then go high.... I am sure it’s the protein. Happens more if I eat fish than meat, more if I eat large portion rather than small. It helps if I take half my insulin an hour before meals (I find the novorapid kicks in after 1.5hrs). I would then take the other half an hour or two after eating. This tends to work, but is more hassle, and easy to forget.....
if eating at home, I don’t worry to much about going a little low, as it’s easy to correct. Quite nice to have a strawberry or a couple of chocolate squares!.

not an exact science is it... to many variables. But the great thing about low carb and low units of insulin is that you can’t be too far off the right dosage as the amount injected is so small. I have a half unit memory pen. So often will have 3.5 units if a little higher than Bernstein’s recommendation, and 2.5 units if a little under.
We are all different though. And I have found sometimes I have had the exact same meal as prior and exact BG levels and exactly the same units of insulin, but end up 4 hour later with quite different BG levels as before!
 

Stefans

Active Member
Messages
30
Type of diabetes
Type 1
Treatment type
Insulin
Hi Tnharvey!
I have been doing Bernstein/LCH/keto for 5+ years.
I can't remember what Insulin I used in the beginning, but as you say it was to fast, I have now changed to use Actrapid for food and I only use novorapid for adjustment.
It works much better for me, as you say I needed to take 2-3 doses before, and it is the same thing as Bernstein recommends, just a different brand.
So I'm not sure if Actrapid is sold in the UK, but there should exist at least one Short-acting/regular insulin.
If I google I can also find, Regular, Novolin, Velosulin, ReliOn and Iletin which all are described as regular/short acting.
Ask you doctor for a short-acting/regular insulin.
Keep you NovoRapid for adjustments.