insulin/DAFNE and low carb

[curlyheadfreak]

thanks everyone for your help on the other low carb questions I posted, much appreciated

To those of you who are type 1, I'm wondering how this all fits in with the whole DAFNE approach?

I assumed that if you have a meal without carbs, you don't take any Novorapid - that has worked for me in the past when I've had a meal without carbs - but I see from researching on the net that people seem to take rapid acting with extremely low/zero carb meals? I'm confused!!! What do others here do?

I've had pretty dreadful BG today doing lower-carb/higher-fat-for-me meals even following DAFNE. I've given insulin for the carbs as normal but something else seems to be at play because the BG has been way high after two hours and still too high at the next meal.

eg breakfast

1 large apple, green vegetable juice, 1/2 avocado, green salad, handful sunflower seeds.

20g carbs, 1 unit N.R - I am a 0.5u/10g ration. BG 5.2 at start, 11.4 2 hours, 8 by lunch

lunch

125g blueberries, green salad, olives, pumpkin seed oil, 150g borlotti beans, some fresh coconut

DAFNE says do not count the beans, so that makes approx 7g carbs...gave 0.5 units for that and a 0.5 u correction, BG 8.4 at start, 15.4 2 hours, 13.2 by next meal :shock:

Can anyone enlighten me?!

I have to say that one of the reasons I really want to get into the low carb approach is that DAFNE doesn't quite "do it" for me. Sure, the BG generally is back down nicely for the next meal, but when I have been "naughty" and tested between meals I have discovered that I am sitting around at 10+ for most of the day without realising! I'm not happy with that at all...used to do my own system before DAFNE so that I was always back down to under 7 two hours after meals and had an A1c of 5.9, unfortunately way too many hypos which was really getting me down. DAFNE has solved the hypo issue for me but I just can't be satisfied with the between meal levels even if the nurse/dietitian say it's OK.

Has anyone got any advice or comments? Thanks so much...

 

[phoenix]

don't low carb, nor done dafne but it seems strange if dafne says not to bolus for borlotti beans. There are about 25g carbs in 150gm (canned and drained) albeit relatively low gi.

 

[fergus]

The problem with DAFNE is that it presumes that carbohydrate is the largest proportion of a typical meal, much along the lines of the so-called 'eat well plate'.
In the presence of significant anounts of carbs, very little protein will be converted to glucose by the metabolism so its effect on blood sugar is largely ignored. Without the carbs, protein can generate a significant amount of glucose - up to 60% according to some sources.
In short, if you're type 1 and your basal insulin is properly set, there will be a need for a bolus dose for every meal. No free lunches! I use 3 units for a breakfast of eggs, bacon and mushrooms (negligable carbs) as an example.
Hope that helps?

fergus

 

[hanadr]

DAFNE doesn't know about carbs. Beans meanz carbs

 

[curlyheadfreak]

thanks everyone

Fergus - yes, that makes sense! I guess it's trial and error to find your own insulin needs for virtually 0 carbs meals and then back to DAFNE for carby meals...

I feel like a scientist sometimes, all these experiments and keeping records and changing this variable then that

Hana/Phoenix - according to DAFNE, the carbs in beans, sweetcorn and grapefruit bizarrely are considered to be so slow absorbing that you don't need to bolus for them. I agree that's weird! I seem to get away with the sweetcorn on that basis, but I know I need insulin for grapefruit and it looks like the same might be true for beans...