curious about carbs

[klh63]

So in short summary......I am super active, in my late 50's, slightly chubby, history of good A1C and good normal glucose numbers, even as recently as a physical for minor surgery a few months ago....A month ago I suddenly became insanely thirsty for 10 days and could not drink enough juice, quit eating but was consuming huge volumes of fluids.....ended up in the hospital in the critical care unit with DKA and glucose at 820....released from the hospital taking 60 units of insulin in a 12 hour period and instructions of 60-75 carbs per meal then snacks after each meal 30 carbs.....they are calling it type 2 that was never diagnosed even though my entire life blood history has glucose and A1C in normal ranges......they suspected a potential virus or infection driven trigger but could locate neither in my blood, PCR test neg for Covid as there are cases of DKA with people without a history of diabetes but they presented with DKA and tested positive for Covid, but I did not....so they are calling it type 2. But they said bizarre with my blood history.

So I have been studying up and reading all I can about diabetes as this is new for me..that is how I ran across this forum..But in reading all the posts I see low carbs are the way people are managing, but I have to do high carbs to counter the insulin...With all that said, I have flipped to dramatic and repetitive lows which has required larger consumption to get the numbers out of the low ranges and the doctors have been steadily dropping the dosage over the last two weeks they have dropped it to 20 units in 12 hours...30% of the original dosage.

Curious as to why they are having me intake such high carbs for type 2 as they have classified it when I see the general consensus here is low carbs......am I missing something? C peptides are normal as well.......but in the hospital with DKA everything was crazy with my blood but now it is all normal...I have to use the meter often because of the tendency to be low and I have to keep working at getting the numbers up.

So what is it I dont understand? Everyone says to do low carb but they are having me consume a fairly large amount of carbs even as they lower the dosage? Any input appreciated as I try to understand all this new normal.....for the record, before this happened I was kind of a low carb person, meats and veggies especially leafy veggies I am a huge fan of but have had to cut back on my normal diet because I cannot eat all the fish and veggies I like because I have to consume so much carbs on top of it...

 

[EllieM]

Hi @klh63 , what is the health care like where you are and what is your health plan like? (I see from your introductory post that you are in the US.)

If you were in the UK or Australia or New Zealand (whose medical systems I've experienced), I'd be asking you what tests had been done, in particular GAD and cpeptide, because I'd want to know why they are saying you are T2? (There are other forms of diabetes than T1 and T2).

And as an insulin dependent diabetic, long term there is no reason why you can't inject for your meals rather than eating for your insulin, so in your position I'd definitely push them on the high carb concept, and ask why you can't have the diet you normally eat and balance the insulin to that.

But it sounds to me that your insulin needs are still going down dramatically so you may need to be patient on this one.

What kind of insulin are you currently taking?

Lots of virtual hugs.

 

[Bubbleblower]

Everyone says to do low carb but they are having me consume a fairly large amount of carbs even as they lower the dosage?

When I lived in the US at some point I became a WSI and was taught when somebody drowns whatever you do do not jump in the water to rescue him. The reason was if something went wrong you might get sued, so they preferred to have people drown.

Same with glucose; if you go blind or lose your legs or so no problem, but if you get a hypo (which can kill you) doctors could be sued so they prefer higher glucose than healthy.

And of course insulin is extremely profitable in the US, just like the food industry.
It’s the economy, stupid:

Note 5. Dr. Bernstein on the American Diabetes Association (ADA)

 

[klh63]

What kind of insulin are you currently taking?

Originally before meals 8 units of NOVOLOG each meal and 36 units of BASAGLAR before bed.

They were slowly dropping the NOVOLOG and BASAGLAR because I began to drop into the 40's and 50's after each meal so we have thrown out the NOVOLOG completely and no longer take the fast acting one.....BASAGLAR they have been dropping steadily and now at 20 Units as of Friday because I was dropping in the 50's and 60's in the night...the lows are more than 50% of the time...so not only am I consuming this massive amounts of carbs which they have me continue to do.....I am consuming orange juice and sucking on candy and eating more than prescribed to get the numbers up and try to keep them up.....I test all the time due to the lows.

I have never in my life consumed this much food and if I back off food a little glucose drops..Normally a healthy eater this much consumption is not healthy, I feel like my stomach will explode from continual food intake..I have gained 11 pounds in just a few weeks and have increased my exercise to try and counter it - biking 6 miles a day and adding weight lifting and elliptical and stair climbing to my already active lifestyle (I walk over 10,000 steps a day).

When they said you have diabetes.....I thought how easy this would be because I favor a low carb diet....then they had dieticians and diabetes specialists telling me I had to consume such large amounts of carbs and that was not what I expected and doing research confirmed that followed by reading posts here.This is so confusing to me.

 

[klh63]

been done, in particular GAD and cpeptide,

I will have to look through the blood reports to get at the GAD but cpeptide is in normal range so they say that defines Type 2.

 

[klh63]

Note 5. Dr. Bernstein on the American Diabetes Association (ADA)[/QUOTE]

Thanks for video share !

 

[EllieM]

I will have to look through the blood reports to get at the GAD but cpeptide is in normal range so they say that defines Type 2.

If I were in your position I would be
1) pushing on matching the insulin to your preferred diet
2) asking for a second opinion on the diagnosis.

And new T2s normally have high cpeptide.....

Sometimes people don't fit easily into a neat diabetic box and it takes a while to diagnose.

Good luck.

 

[Daibell]

The advice to have that level of carbs sounds a bit strange and possibly not the best advice. I would be reducing the insulin together with the carbs to keep the BS within a good range. Frequent testing will be needed to avoid hypos but in general never match carbs to the insulin but vice versa. Also shortly you need to be carb-counting i.e. varying the Bolus to each mealtime amount of carbs

 

[klh63]

Thank You !

 

[klh63]

Thank You ! I am going to an endocrinologist this coming week and glad to learn what I can from this group so I am educated enough to participate in the discussion regarding my care. even if I have a lot more to learn....Have been going to a PA who keeps using the term "bizarre" and keeps saying "none of this makes any sense" she has been doing the adjusting down but is nervous about it since she is a PA not an MD or specialist and believes my case is out of her skill set so she set me up the appointment with the specialist.. The hospital had sent me to an MD for follow up but I tried to talk to her and she just kept cutting me off and told me to keep consuming the high amount of carbs and because of the lows I needed to eat more and wanted to prescribe a bunch of different meds which made me nervous since this was sudden onset......So I went to a small town PA who said "you should not be having to eat large quantities of carbs to counter the insulin that is not what we should be doing you should be able to eat your normal diet." She has been so nervous about it all because she could not get me in to the endocrinologist right away and she calls me every day for me to give her updates on my health ( came down with a few infections after leaving the hospital, and on antibiotics) and my numbers and she keeps adjusting down but is nervous about it after the DKA and the hospitals instructions and the MD's instructions which she finds bizarre but they rank higher in the hierarchy in the American medical system....I just need to learn all I can so when I get doctors I can actually understand and engage in the process instead of blindly following...I am thankful for your responses and this forum so I can learn beyond what I have been googling, directly from people who understand it. Our system is controlled by big Pharma and I also know all doctors are not created equal...Been my experience historically that PA's are safer bets..

Leading up to the DKA I sustained an injury and tried to bring it up to everyone in the hospital and the follow up MD who would listen to none of it...When I asked where my pancreas was in the hospital they showed me, after they said mine didnt work any more, which is where the pain was for a few weeks just before the DKA, fairly intense for weeks, went and got Xrays because I was sure I had broken a rib based on breaking some ribs 5 years earlier the pain was equal to that....Xray showed no broken rib and I lived with the pain..A good friend that lives many states away is a Dr. and she had heard about my stay at the hospital......she also knows me well and knew my blood history was all normal...first thing she asked was if I had sustained an injury and I told her what happened and where it hurt and that I tried to tell the Doctors at the hospital and the follow up MD and they wouldnt listen to it, they just kept saying I was an undiagnosed Type 2 and I had to have had diabetes for a long time and just didnt know it and when I tried to tell them my blood history the last one a few months before this or the accident happened they didnt want to listen and said I was mistaken.....they have health systems and the PA is outside of the health system and affiliated with a different one and she has my blood history the others didnt...

But here you have to be your own advocate and participate in the conversation and choices made or you end up where I am now.....eating massive amounts of carbs to not die from the lows that happen all the time...

Thank You again and I am going to keep reading up on it and your posts have been very helpful to me.

 

[EllieM]

Thank You ! I am going to an endocrinologist this coming week and glad to learn what I can from this group so I am educated enough to participate in the discussion regarding my care. even if I have a lot more to learn....Have been going to a PA who keeps using the term "bizarre" and keeps saying "none of this makes any sense" she has been doing the adjusting down but is nervous about it since she is a PA not an MD or specialist and believes my case is out of her skill set so she set me up the appointment with the specialist.. The hospital had sent me to an MD for follow up but I tried to talk to her and she just kept cutting me off and told me to keep consuming the high amount of carbs and because of the lows I needed to eat more and wanted to prescribe a bunch of different meds which made me nervous since this was sudden onset......So I went to a small town PA who said "you should not be having to eat large quantities of carbs to counter the insulin that is not what we should be doing you should be able to eat your normal diet." She has been so nervous about it all because she could not get me in to the endocrinologist right away and she calls me every day for me to give her updates on my health ( came down with a few infections after leaving the hospital, and on antibiotics) and my numbers and she keeps adjusting down but is nervous about it after the DKA and the hospitals instructions and the MD's instructions which she finds bizarre but they rank higher in the hierarchy in the American medical system....I just need to learn all I can so when I get doctors I can actually understand and engage in the process instead of blindly following...I am thankful for your responses and this forum so I can learn beyond what I have been googling, directly from people who understand it. Our system is controlled by big Pharma and I also know all doctors are not created equal...Been my experience historically that PA's are safer bets..

Leading up to the DKA I sustained an injury and tried to bring it up to everyone in the hospital and the follow up MD who would listen to none of it...When I asked where my pancreas was in the hospital they showed me, after they said mine didnt work any more, which is where the pain was for a few weeks just before the DKA, fairly intense for weeks, went and got Xrays because I was sure I had broken a rib based on breaking some ribs 5 years earlier the pain was equal to that....Xray showed no broken rib and I lived with the pain..A good friend that lives many states away is a Dr. and she had heard about my stay at the hospital......she also knows me well and knew my blood history was all normal...first thing she asked was if I had sustained an injury and I told her what happened and where it hurt and that I tried to tell the Doctors at the hospital and the follow up MD and they wouldnt listen to it, they just kept saying I was an undiagnosed Type 2 and I had to have had diabetes for a long time and just didnt know it and when I tried to tell them my blood history the last one a few months before this or the accident happened they didnt want to listen and said I was mistaken.....they have health systems and the PA is outside of the health system and affiliated with a different one and she has my blood history the others didnt...

But here you have to be your own advocate and participate in the conversation and choices made or you end up where I am now.....eating massive amounts of carbs to not die from the lows that happen all the time...

Thank You again and I am going to keep reading up on it and your posts have been very helpful to me.

Well, your PA sounds a lot more helpful, and the pain/injury/infection thing sounds interesting. I would definitely mention it to the endocrinologist, because there are other forms of diabetes than T1/T2 (eg T3c and MODY) and if your cpeptide is normal then your pancreas was definitely producing insulin when the test was done, though it sounds like it probably wasn't producing enough when you had the DKA.

I have to be careful what I say here because we can't diagnose on these forums (we're not doctors and we don't have your medical history) but you definitely don't sound like a typical T2 (who usually have high blood sugar for years before they need insulin).

I don't suppose you've ever had pancreatitis?

 

[klh63]

I don't suppose you've ever had pancreatitis?[/QUOTE]

I wondered if that was a possibility........hoping the specialist is going to check on things.

 

[HSSS]

I don't suppose you've ever had pancreatitis?

I wondered if that was a possibility........hoping the specialist is going to check on things.

I’d make a point of asking if that pain you described could have been pancreatitis (or similar) even if it went undiagnosed at the time it happened.
Let’s hope your endocrinologist is from the same mold as your PA , not the dr that has you overdosing on carbs then trying to fight back with huge amounts of insulin. As others have said if insulin as a requirement it should be matched to diet not the other way around

 

[klh63]

Let’s hope your endocrinologist is from the same mold as your PA

I really hope so !!!!