Type 2 Hypos?

[hogweed]

Hello all – I have borderline Type 2, and find that I can make symptoms go away, lose weight etc by adopting a low-carbohydrate diet, a bit like Atkins but with more fruit and vegetables.

However, my 14-year-old nephew has just been diagnosed with Type 1, and it seems that he spends his time avoiding hypos, by eating carbohydrate. While I understand that lack of insulin production can cause his blood sugar to rise too high (as with my insulin insensitivity), I don't understand why Type 1’s have such problems with LOW blood sugar.

My understanding is that when I stop eating carbs, my body starts to get its energy from burning my fat reserves – is that an ability you lose when you get Type 1?

Thanks a lot for your help
Roger

 

[hanadr]

T1s depend on injected insulin and not the feedback response of a healthy body to carbohydrate present. It's only too easy to inject too much insulin and cause a hypo. In fact T1s can go low carb and do very well on it. They have to adjust their insulin intake down to match. Bernstein calls this the "doctrine of small numbers"
With children, there is a prevailing pattern of Avoid hypos, whatevever the long term costs. As a Supply teacher, I have come across a diabetic child eating a mid morning digestive biccie, when her morning BG was 16!! As children grow, their needs and hormones keep the system changing.
It's a delicate balancing act. Read what our own Katharine has written about her son who is now about 16.
Adult T2s have different problems. What works for many of us here, is a low carb diet combined with/ or without exercise or medication.
I personally go really low carb. probably less than 40 per day. and exercise at least 4 times per week.
I'm planning to get off medication altogether.

 

[LittleSue]

Hi

Type 1s produce little or no insulin (rather than being very resistant to it) so need to replace it with injections. Usually this is a short acting one (bolus) to cover food and a longer acting one (basal) to work all day in the background, but sometimes both are combined in a mixture such as Novomix.

Of course once injected the insulin can't be switched off, so whereas a non-diabetic body would adjust for anything that reduces blood sugar, your nephew does this by taking in carbs. Lots of things affect blood sugar and compared with the natural pancreas, this is a fairly crude system. Hence plenty of scope for errors which cause low blood sugar. Insulin dose can be a difficult balance, especially in the early days (in my case the first 30 years!) and/or when growing.

in addition, many type 1s experience what is known as the honeymoon period, when the insulin producing cells recovers slightly after starting treatment. The they then produce some or more insulin, perhaps intermittently, so hypos are more likely. Injected dose may have to reduce drastically or even stop temporarily. This honeymoon period can last a few weeks or many months.

Hope this is clear
Sue

 

[hogweed]

Thanks both, that’s very informative. But I’m still not quite sure why insulin is relevant at all where a low carb diet is concerned... I assume (perhaps naively!) that the human body is capable of doing OK on a diet containing almost zero carbs (like Eskimos), and that under those circumstances, insulin should be irrelevant as there isn’t any carb to deal with?

I was hoping that then the difference between diabetics and non-diabetics would disappear... but it seems, from what you're saying, that diabetics differ from non-diabetics in that they actually always need some carbohydrate, because the injected insulin will cause some kind of havoc even when there isn’t any sugar in the blood for it to act on?

 

[hanadr]

the liver makes glucose from protein components called amino- acids and a few other things in a process called gluconeogenesis. thus even if you consume NO carbohydrates, you will have some circulating.
It is possible to live healthily on only fatty meat, like the Inuit used to and Many T2s can keep well on a very low carb diet. their residual insulin and insulin resistance can cope. I think I'm one of those.

 

[lowcarbfan]

hanadr

Agree with you. My Partner is T2 and we very low carb - NO MEDS.

Lowcarbfan

 

[hogweed]

the liver makes glucose from protein components called amino- acids and a few other things in a process called gluconeogenesis. thus even if you consume NO carbohydrates, you will have some circulating.
It is possible to live healthily on only fatty meat, like the Inuit used to and Many T2s can keep well on a very low carb diet. their residual insulin and insulin resistance can cope. I think I'm one of those.

Yes, my own experience as someone about to become a T2 if he doesn’t look after himself bears this out absolutely. The bit I can't understand is why T1’s get these potentially life-threatening hypos if we can exist WITHOUT carbs.

It’s perfectly easy to see how you can get in trouble with sugar in your blood if you can't produce the hormone which deals with it – what I can't see is how lack of that hormone causes problems with LACK of sugar if we don’t need the sugar in the first place!

 

[Jem]

Speaking totally off the cuff and uneducated ... (in other words, I have an idea but I'm not sure! so don't quote me or rely on this!!)

If an insulin user (regardless of type) pushes their regular dose of insulin (let's say 15 units) for their main meal which "usually" contains for example 45 grammes of carbohydrates

BUT

instead of eating there's an emergency and they DON'T EAT

OR

they eat a meal which does NOT contain anywhere near that level of carbs

THEN they have in their system a whole bunch of stuff designed to lower blood sugar (in reaction to blood sugar raise caused by ingesting aforementioned regular carb does) BUT NO (or little) CARBS >>> then the net result will be a dramatic and drastic reduction in blood sugar

leading to >>>

yep, you got it - a severe hypo

Now (in my humble opinion) you take an insulin using diabetic and they calculate what they're about to eat that affects their blood sugar - they use the mathematics advised by the hcp or insulin maker and carefully balance the carb-load with the correct dose of the correct insulin (all of which is totally beyong me) then you can exist on whatever carb value suits you - going for a reduction in carbs WILL reduce the amount of insulin you need. It will (probably??) never remove your need to some basal dose of insulin, but you can reduce what you take to counteract foods?

Does any of that make sense?

If not, I'll just mumble quietly in the corner about macadamia nuts

xxx

 

[diabetesmum]

Hiya,
My understanding is that we all need a certain amount of 'background' insulin. A non-diabetic's pancreas is constantly producing tiny 'squirts' of insulin, 24/7, even when asleep. Insulin does more than 'just' (!) regulate blood sugar levels, it is also a growth hormone, for example. Without a certain critical level of insulin in the body, diabetic ketoacidosis quickly develops. This is fatal without treatment, sometimes within hours. So even if a Type 1 never ate another gram of carbohydrate ever again, they would still need insulin to live. Thank goodness for insulin!
Sue

 

[Jem]

I thought that might be the case - thanks for the further explanation

I knew it did other stuff - but not entirely sure what ... that whole endorcine system has my head spinning!

thank you

 

[hanadr]

The endocrine system is complex with much of the metatbolism inter-connected. You have anabolism ( building) and catabolism( breaking down) going on at once and all this should be regulated by feedback mechanisms.I did once remeber loads of it, but after I passed the exams, I filed it. I still know how to look it up, but that's about all

 

[Trinkwasser]

The endocrine system is complex with much of the metatbolism inter-connected. You have anabolism ( building) and catabolism( breaking down) going on at once and all this should be regulated by feedback mechanisms.I did once remeber loads of it, but after I passed the exams, I filed it. I still know how to look it up, but that's about all

If you looked it up again now it would probably all be different!

Well not all of it but there's an order of magnitude more complexity with relatively recently discovered stuff like leptin, ghrelin, anandamide and further links to neurotransmitters like NO which were simply unkown a few years ago. And there's much more still to discover . . .