Glycogen stores, hypos and low carb/keto diets

[EllieM]

That term raises various reasons. What exactly is brittle diabetes? Why don't T1s eating low carb or keto ever have it? What is the difference between poorly controlled and brittle diabetes? And what evidence backs up the assertion that these people don't make glucagon when required?

Good points, and I didn't mean to suggest that brittle diabetics (those with very sharp hypos) all had glucagon issues, just that glucagon issues could cause it. And if I had brittle diabetes I think I would try keto to avoid it. (Just psyched myself up to try dropping my carbs some more and maybe some more serious fasting )

 

[KK123]

Good points, and I didn't mean to suggest that brittle diabetics (those with very sharp hypos) all had glucagon issues, just that glucagon issues could cause it. And if I had brittle diabetes I think I would try keto to avoid it. (Just psyched myself up to try dropping my carbs some more and maybe some more serious fasting )

Hi Ellie, my Mum was described as having brittle diabetes (over 40 years) and they said that meant no matter how much effort went into controlling her levels (and a LOT of effort was made), her levels shot up and down chaotically, most of the time leading to several hospitalised hypo's and hyper's. Her Consultants devoted hours and hours and hours trying all sorts of solutions mostly to no avail. As with diabetes in general, there are many facets to it. x

 

[KK123]

But surely in the insulin dependent person, the amounts of insulin injected are governed by underlying blood glucose, eating/drinking in prospect, exercise, hormonal issues, carb counting and all the rest.

I appreciate that taking all of those things into account several times a day must be brain frying, but by and large, surely the major factors are carb ratios/prospective, historic eating/drinking and current blood glucose numbers. For low carbers, I believe there is a consideration that smaller amounts of insulin are likely to lead to "smaller" erros, but of course, I have no personal experience of this.

So, extremely simplistically, if an individual's blood glucose is 6, they intend eating 20gr carb, with a ration 1:10, they take 2 units, then review a while later? If they have no idea about carb counting or ratios, then it is more of a lottery.

Of course, I am massively, hugely over simplifying things.

As I read it, for T1 (and others in a similar position), hypos are part of life's rich pattern. How much the individual person then depends on their liver to rescue them is just as individual as they are, I'm sure. The good old Dirty Harry saying "Do you feel lucky ****?" comes to mind if they intend to serially allow their liver to save them.

Hi there, pretty much spot on. I'll tell you this, if MY levels were to drop into the low 3s and they often do, I will NOT be relying on my liver to step to my rescue on the basis that 'oh, eventually, probably after several hours unconscious, it'll have done its job'. By which time I imagine it would have dropped into the 1s! I just think even giving the impression this is somehow a solution to a hypo is dangerous, personally. My Consultant said that hypos (prolonged and often) can cause damage to the brain if left untreated and I believe him. x

 

[PeteN11]

And going off topic, does he say anything about lipid levels anywhere?

My understanding of Cholesterol readings is that HDL readings are the good ones and LDL readings are for the bad ones. If overall cholesterol increases it does not necessarily mean increased risk of heart problems it depends on those LDL readings.

I was recommended Statins pre diagnosis but declined however since I have gone on them and my Cholesterol has declined. Depending on next years blood tests I may try 6 months without, as long as I stay low carb that is.

I do not intend increasing my fat levels whilst low carb as I believe I am carrying more than enough to keep me going for many a year.

 

[Lynnzhealth]

I do not believe we can ever rely on our Livers helping out. Just one sniff of Insulin in the body and it just wont happen anyway. I am fortunate though to not have to worry about it as I do not believe I have ever had a night time Hypo.

Reducing the amount of carbs should also mean a drop in Insulin which may mean the Liver helps out more to begin with but the body should adapt to using stored fat instead.

I have been playing with low carbs for 3 months with 50g to less than 80g a day. I feel better for it now but the first couple of weeks I felt very tired and lethargic. I have now reduced my Basal Insulin by half and my Bolus by much more. The trouble with me is I am not strict enough with it so probably have not ventured too far into the Ketososis phase although I did lose over a stone in weight.

My BG levels used to fluctuate wildly with varying highs between 8 & 15, probably due to my bad management but with low carb the average was around 6 with whole days of between 5-6 readings including night time. I have never been able to do that before.

This you tube video is a discussion with Dr Ian Lake a T1 from age of 30 who is an advocate of low carb diet. There are so many interesting points in it. The main one for me is that only 10% of T1's in the UK reach a Hba1c of 7% or lower whereas those on a Keto diet it is 90%!

He also talks about his (and others) recent "Zero 5 100" event. No food for 5 days running/walking 100 miles. Around the 40 min mark he says that many of those taking part were regularly showing BG of 3 with no adverse effect or any of the usual Hypo symptoms.

I follow the Diet Drs, too, and also Dr. Richard Bernstein and his book, The Diabetes Solution. He was T1 since 1946 when he was 12, so he has many years of doing research, mostly using himself as a guinea pig. (And, he's still going strong at 86 yrs old). I like to think that he has lots and lots of experience, both with the old method and the low carb method. If he can do it, then I can, too. I was diagnosed T2 at 69, then T1 at 71 after a serious DKA episode and I'm now nearing my 73rd birthday. I'd like to live a healthy life for as long as I can, with no complications. Take care and stay safe.

 

[oldgreymare]

My understanding of Cholesterol readings is that HDL readings are the good ones and LDL readings are for the bad ones. If overall cholesterol increases it does not necessarily mean increased risk of heart problems it depends on those LDL readings.

I was recommended Statins pre diagnosis but declined however since I have gone on them and my Cholesterol has declined. Depending on next years blood tests I may try 6 months without, as long as I stay low carb that is.

I do not intend increasing my fat levels whilst low carb as I believe I am carrying more than enough to keep me going for many a year.

I can get great BG control with very low carb and lots of exercise, sadly I fall off the wagon frequently. But my T1 diagnosis at 51 made me reevaluate much of my diet and some of my lifestyle. Like pretty much everyone over 55 I have had statins pushed at me. I always decline, as although they will reliably reduce LDL-C, there is no evidence that they improve longevity for post menopausal women. I am already very stiff jointed, so not keen on known side effects of muscle pain and increased insulin resistance. I have always had high HDL-C levels, but evidence that this is protective is being questioned.

So how to manage my CVD risk - obviously both T1 and more so T2 are contributory risks. To cut a long story short, my go to resources are PeterAttiaMD.com and Thomas Dayspring. So I'm basically discarding the trad total Chol , HDL-C, LDL-C metrics. Instead focusing on Triglycerides & Apo B (more accurate LDL marker). I have also had lipo (a) measured - you only need this once as it is a genetic marker. Very recently I had an elective CT CAC scan - did show some coronary artery plaque. Only reliable way to reverse is significant fasting, so now exploring how to manage this as a T1...