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Blip

Wurst

Well-Known Member
Messages
1,128
Location
Germany
Type of diabetes
Type 1
Treatment type
Insulin
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I had a blip 5 days ago and ate around 10 biscuits (chocolate) and the following evening the same. I was at work and didn't envisage having to stay past 5 so didn't bring a low carb evening meal, bizarrely the same thing happened the following day and stayed until gone 10pm again. I was starving and had a choice between biscuits or a possible hypo.

Anyway to cut a long story short my BS levels have been high (for a 'low carber') ever since. Levels are still within HCP limits so no point bringing it up with them! I've run around 30 km's since to no avail, normally this would suck the glucose out of me.

I'm on some lame Basal insulin called insuman which seems to have no effect whatsover even when I've upped the dosage from 2 to 5 units at night.

I was wondering if this blip could of caused further beta cell damage and reduced my capacity to produce insulin even further? I don't understand why a high carb serving could leave my BS levels higher than i'm accustomed to for so long afterwards.
 
I very much doubt you have damaged your beta cells from a 24 hour blip.

What I find more likely is that your system which has a preference for glucose if available has thought to itself - woohoo, nice! Let's store that fuel in our liver deposits! And now it is releasing it for you, too keep you fueled the good old way.

If you continue with the low-carbing and wait a couple days, I am sure that it will run out and send you back to normal.

You may find that a walk where you can easily breathe is better for your blood glucose at this stage because exercise that leaves you somewhat out of breath tends to send your BG higher, where as exercise that allows you to get enough oxygen all the time does not have this effect.

For the future, have a bag of almonds and maybe 1 or 2 protein bars around - they should provide you with enough fuel to get you through in a similar situation next time. And hehe, we both don't believe that it takes 10 biscuits to avoid a hypo do we?

*kicks person gently in bum and explains* 10g of carb will normally make your blood sugar go up by 2-3 mmol/l. If you are at 4 and wish to be at 6 the fast-acting carb way, you would want to eat 1-2 biscuits then wait and see.

But prevention is better than cure, so get hold of some almonds etc that will have a good shelf life should you need them again.

:D All the best.

PS. You are aware that you have added 150 percent to your normal insulin. It is normally recommended to only adjust by 1 unit at a time when you have that little insulin normally. Be careful when you run out of sugar again so you don't hypo. I would reduce that right back down and keep a hypo stopper of some sort (raisins in a small box for instance) around for a couple days.
 
Thanks for the explanation Mileana , the liver storaging extra glucose certainly explains what i've experienced. I'll be staying away from biscuits in future as they are rather addictive, probably better to take a dextrose tablet and be hungry.

I went a on late night run last night covering 10 Km. This morning my fasting BS was 4.6 and 5 after breakfast , last few days it's been in the 6.8's constantly. Guess i've depleted the stored glucose now.
 
I've checked your profile to see what type you where, it says you'll T1

Several things here...

Are you actually using a bolus insulin or are you using just an insuman background insulin which you are using to cover what you are eating!

If you've just been using background insulin...

Then to begin with this was out and what you've been doing is using food intake to feed the insulin... Background insulin if correctly set should hold your BG level within +/- 2mmol/l when you are fasting..

Even on a VLC you should be taking some quick acting insulin to cover the minimum carbs and the protein you eat when you eat!

Even though you eat the biscuits to treat/avoid a hypo, they still need insulin to counter react the carbs, but with a reduction of insulin if bg is getting low, or if already low should be treating with a fasting acting carb first to get levels back to normal..

The problem when following a VLC diet, is that carb/insulin ratio's are likely to be different for eating what you normal do, compared to eating carbs within normal carby foods such as biscuits.. This is due to the difference of fat/protein content/ratio in the VLC, the Fat/Protein ratio is a lot higher, Fat cause insulin resistance and often for the VLC'er it will increase the amount of insulin needed to cover a very small amount of carbs..

So when a VLC decides or has no alternative but to eat a normal type carb meal, they are likely to need a different carb/insulin ratio to cover the carbs..

If you've tried to get your levels back to normal, just using background insulin not surprised it really didn't work, any changes in background dose can take a couple of days to show it's true effect.. But also you get if as your BG's rises the more insulin resistant if becomes, For example, to correct a BG of 7mmol/l you need 1 unit of insulin to bring it down by 3mmol/l but a BG of 10mmol/l 1 unit of insulin will lower this by only 2mmol/l!

It seems that you were hit by several factors that compounded and did you no favours.. And no I doubt if it really did any further damaged to your beta cells..

Don't forget depending on biscuits, you had anywhere between 50-100 grams of carbs (most biscuits are either approx 5g or 10g each) either way, hell of a wack of carb intake, so needs covering with quick..

Just be very caution next time, with your carb/insulin ratio's though for a different type of carb/fat/protein to your normal intake
 
I've checked your profile to see what type you where, it says you'll T1

Several things here...

Are you actually using a bolus insulin or are you using just an insuman background insulin which you are using to cover what you are eating!

If you've just been using background insulin...

Then to begin with this was out and what you've been doing is using food intake to feed the insulin... Background insulin if correctly set should hold your BG level within +/- 2mmol/l when you are fasting..

Even on a VLC you should be taking some quick acting insulin to cover the minimum carbs and the protein you eat when you eat!

Even though you eat the biscuits to treat/avoid a hypo, they still need insulin to counter react the carbs, but with a reduction of insulin if bg is getting low, or if already low should be treating with a fasting acting carb first to get levels back to normal..

The problem when following a VLC diet, is that carb/insulin ratio's are likely to be different for eating what you normal do, compared to eating carbs within normal carby foods such as biscuits.. This is due to the difference of fat/protein content/ratio in the VLC, the Fat/Protein ratio is a lot higher, Fat cause insulin resistance and often for the VLC'er it will increase the amount of insulin needed to cover a very small amount of carbs..

So when a VLC decides or has no alternative but to eat a normal type carb meal, they are likely to need a different carb/insulin ratio to cover the carbs..

If you've tried to get your levels back to normal, just using background insulin not surprised it really didn't work, any changes in background dose can take a couple of days to show it's true effect.. But also you get if as your BG's rises the more insulin resistant if becomes, For example, to correct a BG of 7mmol/l you need 1 unit of insulin to bring it down by 3mmol/l but a BG of 10mmol/l 1 unit of insulin will lower this by only 2mmol/l!

It seems that you were hit by several factors that compounded and did you no favours.. And no I doubt if it really did any further damaged to your beta cells..

Don't forget depending on biscuits, you had anywhere between 50-100 grams of carbs (most biscuits are either approx 5g or 10g each) either way, hell of a wack of carb intake, so needs covering with quick..

Just be very caution next time, with your carb/insulin ratio's though for a different type of carb/fat/protein to your normal intake
 
Hi CBlake!

Be careful with increasing the Insuman basal. It is far from 'lame'! It has a very pronounced kick at the 4 - 6 hour mark. It does not hold your background steady like the other basals, it actually does reduce you BG over a period of time. It can actually cover a very low-carb meal without rapid-acting when it's at its peak and is often used alone for Type 2s or together with rapid-acting for LADAs as we are still producing some of our own insulin. I also find it takes 3 days to show a response to adjusting the dose up or down, so be very careful for the next few nights with the increased dose you have given yourself overnight!

Incidentally, I have the same reaction to carbs as you have described. I generally eat low-carb (less than 50g per day), but if I have a couple of higher days, the increased BG will last for three or four days. I usually find it easier to cope with this by adjusting the rapid-acting rather than the basal.

Smidge
 
Unfortunately i don't have rapid acting insulin yet. My HPC wouldn't give me any as i refused to start eating 'higher carb' meals. I have to wait unitl 28th August to explain my diet to the doctor and request rapid acting insulin to cover my meals.

Fat cause insulin resistance and often for the VLC'er it will increase the amount of insulin needed to cover a very small amount of carbs..

I don't fully understand what Jopar meant by the above quote. Does this mean when you are overweight / carrying too much bodyfat?
My understanding is when you are low carbing the body turns to Fat as it's energy source , therefore fat is 'burnt off' . As an example my weight on diagnosis (2 months ago) was 112 Kg today it stands at 92 Kg. I don't have any fat left on me :D
 
Sorry no it doesn't mean I'm saying you''ll overweight, even though an higher percentage of body fat does increase insulin resistance..

But I'm talking about food wise... Similar effect really..

Fat in food slows down adsorption of food, Protein around 57% will break down in a simple carbohydrate/glucose..

In a tradition diet, protein due to its slow adsorption rate the body normally burns off any glucose before it impact on the blood glucose.. In a VLC diet the protein ratio/portion is increased so the body doesn't quite burn if off, but the impact is slower on the blood glucose than a carb..

Fat, slows down both protein and carbs adsorption rates... But just like body fat it is also more resistance to insulin so a larger in crease in the diet has a similar effect... It's actually debated whether fat in the diet if high enough breaks down into a carb!

For example...

If I have a cheese omelette, even though it's go almost negligible amount of carbs... I need more insulin than if I hate 10g's of carbs.. So my carb/insulin ratio 0.7u/10g of carbs... For my omelette I need 1.6 units of insulin..

Similar with bread..

A slice of bread, the one I normally use has about 18g of carbs (I don't eat bread often)

If I toast it, or have a sandwich I count it as 18g's of carbs..
If I fry it, I count it as 22g of carbs, to work out my insulin dose, I need more insulin for the fat!
 
Thanks for the excellent explanation Jopar. I wasn't fully aware that more insulin is required if a high fat meal is consumed. I personally haven't seen this effect in my BS monitoring but then i'm not using rapid acting insulin yet :(

This morning I woke up with a 6 mmol BS reading, for breakfast I ate ~ 75g of full fat cheddar cheese along with 2 sticks of celery. 2 hours later my reading was still 6 mmol.
 
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