type 1 pump user - increase insulin on lchf??

[louisiv]

Hi everyone, I started lchf almost three weeks ago and my blood sugars have gone up instead of down. I'm type 1 for 30 years and wear an insulin pump. Since starting lchf I've had to increase my basal rate and my bloods are still not really coming down. I have scrambled eggs with grated cheese in the morning, a tin of tuna and cucumber with a dollop of mayo for lunch, meat or fish and green salad for dinner. I would snack on cheese, coldcuts or olives. I'm wondering if I'm eating too much protein? I'm not hungry and have no carb cravings, I am tired. I feel like I've become insulin resistant as I need to to take more insulin than before to bring blood sugar down, still very new to lchf and still a lot to learn, didn't think I'd need to take a bolus of insulin to cover scrambled eggs and a handful of grated cheese though anyone had a similar experience? I don't exercise at the moment but will be taking my bicycle out of hibernation this weekend. I drink two litres of sparkling mineral water every day. I lost some weight since I started and now weigh 12st 6, I'm 5'4, 41 years old. Started on lchf as hba1c running at 9% and also weight and body fat was too high (12 st 11, 42% body fat). I'd really appreciate any advice, thoughts or insights, thanks
Louisiv

 

[noblehead]

I'll 'bump' your post up the forum in the hope that you get a few replies from those who are type 1 and follow a LCHF diet, good luck Louisiv and hope you find some answers.

 

[louisiv]

I'll 'bump' your post up the forum in the hope that you get a few replies from those who are type 1 and follow a LCHF diet, good luck Louisiv and hope you find some answers.

Thanks noblehead

 

[donnellysdogs]

Yes, I have to count a egg as 4g of carb.
My basal went up when I included more dairy fat.
Avoidng dairy fat at the moment and just having avocado and olives with my salad (which is my only meal if the day). Changed this from having cheese and cream, which currently I have eliminated again.
I went up from 13.8 basal to almost 18. Am now back down to 15.3 and as the weather is starting to warm up my basal rates will drop back to 13ush and will be within 2 weeks of the clocks changing.
I've pretty much been a low carber all my life and basals always been quite static on
pump but adding more fat in did increase my basal.

 

[louisiv]

Hi donnellysdogs, thanks so much for your reply, I have been eating a lot of dairy fat so I'll cut back and see how that goes,will let you know, thanks again

 

[donnellysdogs]

Its only what happened to me. I decided to cut nack on dairy because my total cholesterol went up too. (Mess up by phlebotomist meant I didn't get a break down. However, the cream and cheese was the only major difference..
My basals are dropping everyday at the moment since cutting dairy. I have made a concerted effort though to keep avocado's and olives as a source of fat in my diet.

 

[Applenerd81]

You will need to consider bolusing for protein you are consuming.

I would typically bolus for 1/2 a meal's protein content (so bolus for 10g if the meal has 20g of protein). In addition the bolus would be an extended one over 2hrs as protein to glucose conversion is slower than digesting starches to glucose.

Basal rate (for me) is the same as pre LCHF. Your basal should really only cover your metabolic glucose release from your liver, not for your meals.

For a breakfast of 2 scrambled eggs with 20g cheese I would take enough insulin for 10g carbs and have it deliver over 2hrs (assuming total protein content of meal is 20g).

Figures may be slightly different for yourself so experiment (and test regularly!).

Hope this helps

 

[donnellysdogs]

You will need to consider bolusing for protein you are consuming.

I would typically bolus for 1/2 a meal's protein content (so bolus for 10g if the meal has 20g of protein). In addition the bolus would be an extended one over 2hrs as protein to glucose conversion is slower than digesting starches to glucose.

Basal rate (for me) is the same as pre LCHF. Your basal should really only cover your metabolic glucose release from your liver, not for your meals.

For a breakfast of 2 scrambled eggs with 20g cheese I would take enough insulin for 10g carbs and have it deliver over 2hrs (assuming total protein content of meal is 20g).

Figures may be slightly different for yourself so experiment (and test regularly!).

Hope this helps

Crikey... I just count the eggs and never extend or multi wave for an omlette!!!!

I think this just highlights how individual we all are.... I would do a straight 8g bolus...

I count my salads.... You may or may not.. But it just highlights that ine size doesn't fit all

 

[louisiv]

Thanks applenerd, willgive that a try too

 

[donnellysdogs]

Thanks applenerd, willgive that a try too

Its finding what works for you but for some of us including protein or fat helps....

 

[Applenerd81]

Depends what's in the salad, onions and toms yes. If I don't extend the bolus with protein I end up hypo.

 

[donnellysdogs]

Depends what's in the salad, onions and toms yes. If I don't extend the bolus with protein I end up hypo.

I weighed everything including lettuce (OTT) when I went on pump... It allows me to know I am exact...its amazing what is in a salad when for people like me 30 years ago you were told not to count salads!!!

 

[shedges]

Lol... have had this exact conversation with myself over the last few weeks. A month of low-carbing has done nothing for my bg levels, I've put on weight and generally feel ****. Don't know if I'm doing it wrong, or if my body disagrees with it? Going away for a few days this week (holiday) so no point in trying to tighten up control, but want to re-visit from next week onwards.

 

[Natalie1974]

I've only just started low carbing...currently on day 5. I can see a definite drop in my BS on the whole...usually lurking around 6-7 mark but have also recognised that I may need to inject for protein as this does tend to push my BS up into double figures. A problem that I've had a couple of times is correction doses...when I creep up to double figures...I really only need 1-2 units of insulin to correct but these tiny doses don't seem to be reflected in my readings..so not sure if they are working.

 

[iHs]

Since eating carb between 60-80g per day, my bg levels have been good but my bodyweight increased because of the nuts, cheese and full cream type yogurts. My basal increased from 13u to nearly 15u. As I dont work anymore, im not able to keep buying clothes, so I manage on a budget. My cholesterol levels also increased eating food with too much fat and calories so Ive now cut out the nuts and stopped the cream cheese. I believe in eating regularly though so always msintain 3 meals per day without too much carb and build up my small dinnerplate with veg like cabbage, csuli,froz peas, broccoli etc.

 

[tim2000s]

As someone who eats a lot of protein, I'd say that the insulin for protein is important. I'm not using a pump, but MDI, but I effectively have to bolus two or three times to counter the protein BG rise, which after a meal of 3 eggs, 125g of Corned Beef, cooked in Ghee, causes a steady increase over 4 hours that requires 2.5u at meal time, 2u 1.5 hours later and a further 1u an hour later....

Just to give you some idea!

 

[noblehead]

I've only just started low carbing...currently on day 5. I can see a definite drop in my BS on the whole...usually lurking around 6-7 mark but have also recognised that I may need to inject for protein as this does tend to push my BS up into double figures. A problem that I've had a couple of times is correction doses...when I creep up to double figures...I really only need 1-2 units of insulin to correct but these tiny doses don't seem to be reflected in my readings..so not sure if they are working.

As your a pump user could you not use the Extended Bolus feature of your pump or set a TBR when you eat meals which result in you hitting double figures, I find (irrespective of the meal eaten beforehand) that when my bg goes into double digits I need a lot more insulin to correct than I would when my bg levels are in single digits, for example 1 unit would bring my bg levels down by 2.5 as a rule below 10, but over 10 it would only bring it down by 1.5mmol.

 

[donnellysdogs]

If I ever rarely go above 10 its normally because of two reasons-
1) mechanical fault.. Ie a set... Then my levels will zoom upward very rapidly to well over 12.
When this occurs I have to change everything and literally double my correction
2) if it is a food bolus inaccuracy I know I would only climb to 11 at max.. This I treat with a normal correction.

However for foods such as very rare takeaways and puddings out in a restaurant I know now that I need to up my basal rate to double (at least) depending on just how bad the fat and carbs have been!!
That is purely because my bolus and basal will totally be out of the 50/50 ratio it normally runs at.