• Guest - w'd love to know what you think about the forum! Take the 2026 Survey »

Carb counting, not all that simple.

Omar101

Omar101

Well-Known Member
Messages
133
Location
Australia
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Ignorance, laziness.
So I've recently ended a weightloss/cutting phase and started bulking up. I did the usual increased calorie intake, increased carbs and fats, I noticed almost immediately that my basal dose was not enough to keep my blood sugars at 4-5 and I was waking up in the morning with 7's or 8's and correction doses (which for me used to be 1 unit equaled -3mmol of blood glucose) now barely dropped my blood sugar by 1mmol for 1-2 units of novorapid.

I lowered my carbs but kept my calories high and still I had a high insulin resistance and needed more basal and around 2x the amount of short acting for my meals. This left the fats. Upon cutting my fats back to normal my insulin sensitivity returned and I required less basal and my blood sugars settled back to the 4's and 5's. My carb to insulin ratio stayed the same even when I re-upped my carbs.

Needless to say I did some quick research on the effects of dietary fats and blood plasma triglycerides and found that higher levels of fats will acutely decrease insulin sensitivity and skyrocket insulin requirements to compensate.

http://care.diabetesjournals.org/content/36/4/810.full
https://www.joslin.org/news/dietary-fat-can-affect-insulin-requirements-in-type-1-diabetes.html

It seems to me; and the above study suggests that simple carb counting algorithms are heavily reliant on your daily average fat intake ie changing fats will change your carb exchange ratio.
Just thought it pertinent that I post this here as I know there are many T1's who are either following low carb diets or find they need increasing amounts of insulin and cannot explain why.
 
Thank you, we have discussed the Wolpert 'pizza' study before but I can't find it.
Gary Scheiner mentions this fat induced insulin resistance
His explanation is basically much the same as yours .
http://www.mendosa.com/The-Fat-of-the-Matter-How-Dietary-Fat-Effects-Blood-Glucose.htm
In some parts of low carb 'fraternity' they call this physiological insulin resistance and consider it benign. (but the guy writing has working islets)
http://high-fat-nutrition.blogspot.fr/2007/10/physiological-insulin-resistance.html

I think that you soon learn that carbohydrate counting isn't a definitive science.
There are also some of us that think that protein is a factor.
Jennie Brand Miller (of GI 'fame' ) has been investigating using the insulin index (an index based on the amount of insulin that various foods elicit in normal people) for calculating meal doses.
http://www.ncbi.nlm.nih.gov/pubmed?term="Diabetes care"[Jour] AND 2011[pdat] AND Bao[author]&cmd=detailssearch
A few T1s try to use what they call the TAG method, total available glucose.
http://kellywpa.com/2010/11/10/total-available-glucose-tag-2/

To a large extent though I think that that experience counts, you learn what meals may need more than the insulin dose based on carbohydrates alone.
 
Last edited by a moderator:
Thanks for the info guys. I had never heard of this phenomenon, of all the Doctors/endo's, nurses and educators I've met none of them have even mentioned it which I find surprising as it elicits such an immediate and substantial effect on our blood sugars.
 
Omar101 said:
Thanks for the info guys. I had never heard of this phenomenon, of all the Doctors/endo's, nurses and educators I've met none of them have even mentioned it which I find surprising as it elicits such an immediate and substantial effect on our blood sugars.
Click to expand...

If you read Gary Scheiner's book Think Like a Pancreas he discusses this very subject.
 
Back
Top