Low carbing help needed please

[YorkshireAli]

Hello - I'm new to posting here, but have been following this forum for a while, and it's helped me enormously so far. I've discovered the benefits of low-carbing for nearly a year now, and generally it's going well, but I've started going to a gym recently and I'm having some problems with my blood glucose levels. I'd be very grateful if anyone could help me sort it out.

Background - I've been T1 for nearly 20 years, on Lantus (split 24 morning and 6 at night) and Humalog. Last year I had a light-bulb moment when I went on a DAFNE course and changed diabetes consultants to one who suggested I try low/zero carbing to try and get my HbAiC under control. That was in May, and since then I've had some success with it - I've been keeping to 10g of carbs a day or less, and have reduced my HbA1C from 9.6 to 6.9, my weight by 2.5 stones and generally feel so much better. I seem to be quite insulin-resistant, and even with a zero-carb meal need to take Humalog quick-acting. My consultant is very pleased with the results and happy for me to continue with this until my next appointment in May, when we'll review and set new targets.

However, in December I joined a gym, as I want to get myself toned up and a bit fitter (and lose another stone), and my nicely controlled blood glucose levels have gone out of the window. I do an aquafit class three times a week, a weights gym session three times, and walk my dog every day (which is something I was doing before, so that's already accounted for). I'd thought that adding the extra exercise into my regime would bring my blood sugars down and that I'd need less insulin, but it hasn't proved the case. My sugars go up instead. By quite a bit as well - typically, I'll have a waking BG of say 7.0, have bacon and scrambled eggs for breakfast, with 24 Lantus and 3 Humalog, and do my class about two hours later. When I take a reading after the class, it'll be way up - to 14 or 15. I haven't seen figures this high since before last May and I'm baffled. And it takes ages to go down. I'll get to 7pm (without eating anything since breakfast and even possibly doing a corrective 3 units of Humalog along the way) and it'll still be 9 or 10.

All of this is going so much against what I've found logical that I'm having a hard time getting my head round it. All I can think is that my body is metabolising fat into glucose, but is that right? Can anyone shed any light on this for me please? I really do enjoy my classes, but my sugar control was so much better when I was a lazy so-and-so...!

 

[lily42]

Hi welcome to the forum I'm T2 so I'm sorry I can't help you, but I just wanted to say Hello

 

[Kat100]

It hello from me as well ..a type 2
Hate the word type ....but you need someone with expertise to assist you ...best wishes Kat

Someone will be here to help you ...

 

[AndBreathe]

Hello - I'm new to posting here, but have been following this forum for a while, and it's helped me enormously so far. I've discovered the benefits of low-carbing for nearly a year now, and generally it's going well, but I've started going to a gym recently and I'm having some problems with my blood glucose levels. I'd be very grateful if anyone could help me sort it out.

Background - I've been T1 for nearly 20 years, on Lantus (split 24 morning and 6 at night) and Humalog. Last year I had a light-bulb moment when I went on a DAFNE course and changed diabetes consultants to one who suggested I try low/zero carbing to try and get my HbAiC under control. That was in May, and since then I've had some success with it - I've been keeping to 10g of carbs a day or less, and have reduced my HbA1C from 9.6 to 6.9, my weight by 2.5 stones and generally feel so much better. I seem to be quite insulin-resistant, and even with a zero-carb meal need to take Humalog quick-acting. My consultant is very pleased with the results and happy for me to continue with this until my next appointment in May, when we'll review and set new targets.

However, in December I joined a gym, as I want to get myself toned up and a bit fitter (and lose another stone), and my nicely controlled blood glucose levels have gone out of the window. I do an aquafit class three times a week, a weights gym session three times, and walk my dog every day (which is something I was doing before, so that's already accounted for). I'd thought that adding the extra exercise into my regime would bring my blood sugars down and that I'd need less insulin, but it hasn't proved the case. My sugars go up instead. By quite a bit as well - typically, I'll have a waking BG of say 7.0, have bacon and scrambled eggs for breakfast, with 24 Lantus and 3 Humalog, and do my class about two hours later. When I take a reading after the class, it'll be way up - to 14 or 15. I haven't seen figures this high since before last May and I'm baffled. And it takes ages to go down. I'll get to 7pm (without eating anything since breakfast and even possibly doing a corrective 3 units of Humalog along the way) and it'll still be 9 or 10.

All of this is going so much against what I've found logical that I'm having a hard time getting my head round it. All I can think is that my body is metabolising fat into glucose, but is that right? Can anyone shed any light on this for me please? I really do enjoy my classes, but my sugar control was so much better when I was a lazy so-and-so...!

I'm not T1 or an insulin user so my comments are general.

Many people find that low impact exercise (like walking) lowers their bloods, and it can do so quite quickly. Higher impact exercise (getting sweaty, raised heart rate etc.,) can raise the blood scores for a short while.

Am I correct reading that you exercise, then don't eat for several hours because your bloods remain higher?

 

[YorkshireAli]

Yes, that's right. My bloods stay high - even if I inject the Humalog as a correction - and because of that I generally don't feel hungry, so it seems pointless to eat and inject again just for the sake of it, particularly since I'd like to try and get my weight down a bit more.

I've brought this up with both my consultant and the DAFNE course - about missing meals if my sugars are up and I'm not hungry - and both have said that's not a problem.

 

[Heathenlass]

First of all, welcome, and well done you ! So far you have done great, and it's fantast to hear of a sensible consultant !

When you exercise, there is a release of glucose, as @AndBreathe has said above. It can be dealt with however. I don't know how long ago you did your DAFNE course, but there is a section in the workbook that covers exactly this, and what to do about it . There is also a. Ok by Ginger Viera called ( I think! ) " Your Diabetes Experiment " that covers exercise and insulin requirements in some depth ( she is a Type 1 power lifter ) As I remember, she does say that for high impact exercise your insulin ratios do differ from the days when you are not exercising. Unfortunately I don't have the book to hand, but it's well worth reading .

Signy

 

[AndBreathe]

First of all, welcome, and well done you ! So far you have done great, and it's fantast to hear of a sensible consultant !

When you exercise, there is a release of glucose, as @AndBreathe has said above. It can be dealt with however. I don't know how long ago you did your DAFNE course, but there is a section in the workbook that covers exactly this, and what to do about it . There is also a. Ok by Ginger Viera called ( I think! ) " Your Diabetes Experiment " that covers exercise and insulin requirements in some depth ( she is a Type 1 power lifter ) As I remember, she does say that for high impact exercise your insulin ratios do differ from the days when you are not exercising. Unfortunately I don't have the book to hand, but it's well worth reading .

Signy

Thanks Heathenlass. I'm just always nervy about guiding T1s where meds are implicated. Waaaaay to scary for me!!!

 

[YorkshireAli]

Well, this is what's confusing me. I did the DAFNE course last June, and according to the book (as I understand it), I should either reduce my QA insulin before the exercise or take 1 or 2 extra carb portions. I've ruled out the latter, as that'd put my BG up in the twenties, I think! But equally, if I reduce my insulin dose, I'll get the same result.

I'm doing the same insulin on exercise days as I do on non-exercise days, which is the same as I was doing in pre-gym days. Then my BGs were under 10 post-meal and lower generally. Now, however, my BG is going up higher and for longer, so the net effect is I'm eating less and injecting more insulin. It just doesn't make any sense to me at all.

 

[YorkshireAli]

Heathenlass - thank you for that...I'm googling Ginger Vieira right now.

 

[sunshine84]

Hi,
You're not alone in this! I'm a T1 too and my levels can rocket after high impact execise, I have been known to go from around a 5 to 15 after a game of netball! I think it's your liver doing a bit of a glucose dump (there are definitely people who know more about this than me). I know a lot of people find having a few nuts or something before you exercise can help with this. I wouldnt starve yourself all day, that doesnt sound good!
I find I come back down pretty quickly (I exercise in the evening so might be different) if I bolus as normal for my evening meal.
There is good website called Team Blood Glucose that talks a lot about sport and diabetes, they might be worth a look.
Sounds like you've done loads of positive things for your diabetes - keep it up!

Sent from the Diabetes Forum App

 

[Heathenlass]

Well, this is what's confusing me. I did the DAFNE course last June, and according to the book (as I understand it), I should either reduce my QA insulin before the exercise or take 1 or 2 extra carb portions. I've ruled out the latter, as that'd put my BG up in the twenties, I think! But equally, if I reduce my insulin dose, I'll get the same result.

I'm doing the same insulin on exercise days as I do on non-exercise days, which is the same as I was doing in pre-gym days. Then my BGs were under 10 post-meal and lower generally. Now, however, my BG is going up higher and for longer, so the net effect is I'm eating less and injecting more insulin. It just doesn't make any sense to me at all.

That's the rub - in high impact exercise you actually need more insulin, not less to cope with the glucose release from not only the liver, but muscles too, or at least that's what I remember . That's sounds like it is worse, but it's not, as its a complicated bodily process, and insulin doses need some tweaking

Signy

 

[YorkshireAli]

There's clearly a lot more to this, isn't there?! I've ordered Ginger Vieira's book from Amazon - it looks like it'll be very helpful in working out how I can get myself balanced again. Thank you for that recommendation. Maybe, instead of walking the dog before I do a class, I could try taking her out afterwards and that might help to bring the BGs down for later in the day.

The amount I've learned about my diabetes in the last year, compared to the eighteen years prior to that, has been astonishing. Finding a consultant who was happy to take a radical course of action, and the DAFNE course, which gave me the support and confidence to go with it, has transformed my life and I can't believe how much better I feel these days.

If I can sort this challenge, then I'll be really happy - and I'll be really looking forward to my next clinic visit to find out my results (and that, in itself, is such a reversal of the last eighteen years!).

 

[shedges]

Wow... had similar experience last night, so it's good to read the responses.

I played high-intensity 6-aside football for 45 minutes. Normally this would drop my blood sugar level, so I ate a banana with no bolus before hand. By 9pm I was at 22.4!!! Corrective dose brought me back to 11 by bedtime, then 4 this morning. My change in circumstances is that I've reduce my daily carb intake from 250g to 150g... who'd have thought it'd make that kind of difference? Or it might have been something else completely??? It's never straight forward :0/

And you have a consultant who's happy with the LCHF diet? .... I'm still trying to convince my nurses/consultant. Am hopefully going to show up in June with a reduced hba1c - and then see what they say.

 

[YorkshireAli]

Wow... had similar experience last night, so it's good to read the responses.

I played high-intensity 6-aside football for 45 minutes. Normally this would drop my blood sugar level, so I ate a banana with no bolus before hand. By 9pm I was at 22.4!!! Corrective dose brought me back to 11 by bedtime, then 4 this morning. My change in circumstances is that I've reduce my daily carb intake from 250g to 150g... who'd have thought it'd make that kind of difference? Or it might have been something else completely??? It's never straight forward :0/

And you have a consultant who's happy with the LCHF diet? .... I'm still trying to convince my nurses/consultant. Am hopefully going to show up in June with a reduced hba1c - and then see what they say.

It's confusing, isn't it? It's like trying to understand a whole new set of rules! I think it must be that the liver is throwing out glucose when you exercise - same sort of thing as that 'dawn phenomenon' liver dump.

It was actually my consultant who suggested I try a radical change of tack and cut out the carbs for a while to see if my BG levels improved. I'd been having real problems in keeping them below double figures and he thought it might be because as well as being T1 I had insulin-resistance as well (there's been a lot of T1 diabetes in my family and apparently this is quite common). I only started seeing him last May, and he seems to have a much more flexible and forward-thinking attitude towards diabetes management than the people at the clinic I had been going to - they didn't like the idea of low carbs at all!

The results have been worth it, and in my first follow-up visit I actually had numbers I could look at without wincing. HbA1c down to 6.9 from 9.6, weight down 2.5 stones and all the other numbers down as well. My consultant was very pleased, and has said there's no reason to stop keeping carbs to a minimum if I choose and we'll review results and targets at the next appointment in April/May.

Sticking to 10g of carbs a day or less (probably most days I don't even have this) sounds drastic, but it seems to suit me and I feel great on it. Through trial and error, I need to take so much insulin for carbs that - for me - it's not worth it. Maybe once I reach my target weight the insulin-resistance will be less and I might be able to have carbs occasionally, but that doesn't happen, well, I can't say I'll worry too much about it - I've probably had more than my fair share of them in my life so far!

 

[Tweetypie]

From a type 2/not on meds perspective, I find if I do high impact exercise early in the morning, it raises my levels (especially if I have not eaten). I was about to suggest doing a little low impact after your high impact, as that helps to lower levels - I see you are looking to do that by walking dog after - great idea! I also follow the principle that if doing 30 mins exercise or more, it's a good idea to have something to eat on beginning and every 30 minutes after that (although what would be suitable and whether you'd need to inject you would need to work out for you). Then try to follow up with some protein after your exercise session, perhaps from your next available meal or snack - again, don't forget to inject if necessary.

Also, sounds a bit arduous, but have you thought about testing during your exercise if you can? It would be good to get a pattern, i.e see if you are dropping and then rising after that -just a thought.