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Confused and concerned

Discussion in 'Ketogenic diet forum' started by Lord Midas, May 30, 2017.

  1. Lord Midas

    Lord Midas Type 1 · Well-Known Member

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    Hi everyone.
    Being an insulin dependent T2D I'm having trouble managing my blood sugar on a keto diet.

    I've since learned about the Dawn Phenomenon, as after I wake my BS can rise from 4mmol/l to 15 in about 1-2 hours. All without my consuming carbs. This will stay like this throughout the day unless I bring it down with Humalog.

    I've had a bulletproof coffee and a bag of pork scratchings and about 5g of cheddar cheese, and my BS rose to 17mmol/l. I took 14 units of humalog and an hour later my BS hasn't changed.

    This has been going on for weeks. I don't understand why my BS rises so high and why I'm finding it difficult for it to lower. I'm hearing so many great stories of people reversing their meds and losing multiple kg in weight. I do get that because I am still taking insulin this can be why I'm not losing weight. After 2 months of very low carb/keto I've not lost any weight, my BS rises as if I was eating carbs, and I'm still having to take as much insulin as I used to.


    Has anyone experienced this?
    Can anyone shine any light on why this might happen?
    Does anyone who is an IDT2D have a solution to this problem?

    Many thanks :nurse:
     
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  2. azure

    azure Type 1 · Expert

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    @Lord Midas Am I remembering correctly that you might be LADA?

    I wouldn't worry about Humalog not bringing your BS down in an hour. It can take around 3 hoyrs if your BS is high.

    What basal insulin are you taking? Are you bolusing for protein?
     
  3. Lord Midas

    Lord Midas Type 1 · Well-Known Member

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    Hi @azure
    You know I think you might be right. I didn't take into account the amount of Protein consumed. It wasn't that much, and I didn't expect it to spike my BS so high.

    I take basal Lantus. I've tried lowering the amount I take to see if I can ween myself off it. But even when taking my normal dosage my BS was going very high.

    I was told by my doc I had gone from a Type 2 to a Type 1. After joining the forum I was told this can't happen, so I then thought that I was a LADA. But again some seemed unhappy that I was self-determining my condition. So rather than rattle any cages I stuck to being what I was and that's an IDT2D. Pretty sure it doesn't matter at the end of the day. I just have to manage my carb intake, my BS and insulin doses.

    I'll double check my BS in an hour to see where I'm at. I'm just going through some harsh hyper muscle cramps and the metallic smell you get when bs is high (and the general ickiness).
     
  4. azure

    azure Type 1 · Expert

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    You're right in saying that controlling your BS is the most important thing no matter what type you are :)

    But if you were LADA/Type1 then you wouldn't be able to wean yourself off insulin.

    If you think you're LADA then don't be worried about saying so :) You could also ask for info from an Endo so you know for sure.
     
  5. Lord Midas

    Lord Midas Type 1 · Well-Known Member

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    I do need to find out for sure. Just so I can set realistic goals for myself. If I'll never be able to come off insulin then at least I don't need to have this as a goal I can never reach.

    It's just the high BS that gets me. I think my Liver is rebelling against me and pumping out too much glucose.
     
  6. azure

    azure Type 1 · Expert

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    Very low carb diets can cause a form of insulin resistance. Perhaps that's an issue, along with not bolusing for protein?
     
  7. donnellysdogs

    donnellysdogs Type 1 · Master

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    I'm T1 and without doing my first injections without eating starting at 4am... my levels will go up to 20 within 2 hours of getting up without food.....

    If this happens every morning then to be honest you need to know whats happening from 3am onward. Ie what time your levels start to rise and whether they get worse when you get out of bed.

    I would recommend testing one day at 3am, 5am, 7am, 9am

    And one day on the even hours...

    Test immediately you wake up and again an hour after you get up...(without eatinng).

    Keep your background basal injection how you normally do it..

    It may be the timing of your basal injection etc but without a clear idea of the time rises start etc its difficult to recommend whether you may need to change the time of your background/split your background.

    However, it would enable you to get full data to discuss with your diabetes medics too.
     
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  8. Lord Midas

    Lord Midas Type 1 · Well-Known Member

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    I've never done 2 hour testing throughout the night. I might give that a try.

    Also, what's best, taking more basal or more bolus?
    I'm thinking perhaps increasing my basal dose so i would take less bolus.
     
  9. catapillar

    catapillar Type 1 · Well-Known Member

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    Here's a guide on how to basal test - https://mysugr.com/basal-rate-testing/
     
  10. donnellysdogs

    donnellysdogs Type 1 · Master

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    The basic first step is to see what happens when you dont eat or inject bolus. If your levels climb, then you will need more basal...

    Another basic is to try and keep 5 hoyrs clear between eating and watch what happens.. do levels go up or down 2-3 hours after eating.. (forget one hour and 3-5 hours). Do your levels drop to normal by 5 hours witjout a need for more insulin or hypo stopper. This can be done for breakfast time, lunch and evening meals but you really want to check how well your basal injection is working.

    You need to test before going to sleep and during the night from 3am oneards to account for what happens before and after you wake..
     
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  11. Lord Midas

    Lord Midas Type 1 · Well-Known Member

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    Thanks @Donnellysdog
    I'll try the waiting game between meals and see how my bs responds. I actually think at the moment it just creeps up and up.
    I'll let you guys know how it goes.
     
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  12. Lord Midas

    Lord Midas Type 1 · Well-Known Member

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    An example of normal eats.
    6pm = dinner
    12pm = lunch
    I effectively fast for 18 hours every day. Though I do mostly break that fast with a bulletproof coffee.
    Today I woke with 8.8 and 3 hours later, with a BPcoffee in there I was 11.7
    I've taken 8 units of bolus. I'm now only going to have forest fruits tea until 12pm. And see what my BS is at then.

    I just want to be taking less insulin, like others who are on the keto diet. Less insulin = fat loss. Why are our bodies so rebellious against us. Why!! :***:
     
  13. azure

    azure Type 1 · Expert

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    @Lord Midas Perhaps you could try eating breakfast and bolusing. LCHF can cause physiological insulin resistance which can mess with your insulin sensitivity. It can also mean you need higher correction doses.
     
  14. Lord Midas

    Lord Midas Type 1 · Well-Known Member

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    If I am unable to manage this, then I will certainly try adding some egg or something into my morning routine. Though isn't one of the points of LCHF is that you eat when you're hungry. I tend not to be all that hungry in the morning. I used to eat breakfast and bolus, but that was just going through the motions of the 'eat 3 meals a day'.
     
  15. azure

    azure Type 1 · Expert

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    It depends what suits you control-wise. If you're not hungry (or in a hurry) even a small breakfast and bolus can help a lot.

    Going too low carb sometimes just swaps one set of problems for another. We all have a sweet spot as far as carbs and control is concerned. As with everything with diabetes, there's no magic diet/insulin regime sadly.

    If you're trying to lose weight, you may even find a slight upping of your carbs helps as it could increase your insulin sensitivity.

    So experiment and see what works best for you as an individual :)
     
  16. Lord Midas

    Lord Midas Type 1 · Well-Known Member

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    Thanks @azure. I never thought that upping carbs would improve insulin sensitivity. Sounds counter to what I've read :)

    As to my update, I've tested about at 11:20am and my BS is 10.7. Which is 1mmol/l down in 2hr20mins. I think I'm becoming more resistant to insulin.

    More experimentation needed.
     
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  17. donnellysdogs

    donnellysdogs Type 1 · Master

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    Maybe that you need a bolus like some do for getting out of bed?
    I have to have insulatard at 4am, again at 8am with a bolus just to stop rises from 5 to 20 in 3 hours.

    I also fast a lot. I have tried to introduce a brunch other than that I just eat one meal a day about 5.30/6pm.

    Do you give a bolus for getting up?
     
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  18. Lord Midas

    Lord Midas Type 1 · Well-Known Member

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    Indeed. I have to bolus in the morning. Even if my BS is around 5 in the morning, 1 hour later it can be to 12 or so. I bolus to try and bring that down.
    I have tried ignoring the rise in the hope it will go down by itself, but I will simply rise to 18 or more. A bit like you really.

    How is your fasting going?
     
  19. donnellysdogs

    donnellysdogs Type 1 · Master

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    My fasting is just me.. I have no
    hunger and just prefer to eat one meal aday..
     
  20. Chook

    Chook Type 2 · Expert

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    Hello @Lord Midas

    I know exactly where you're coming from. I am a Type 2 and I used to be on insulin (both basel and bolus) - and even with the insulin I used to have massive BG rises in the morning, whether I ate or not - its dawn phenomenon big style. I could go up from 16 to 28+ by mid morning especially if I skipped breakfast.

    The only way I managed to come off insulin was by eating a very low carb diet and it is only recently - after 20 months of low carbing - that my dawn phenomenon is reducing. All I can say is keep at it. Keep your carbs very low, have something to eat as soon after getting up as you can (I normally have egg and bacon or two boiled eggs and a buttered Lidl protein roll) - it stops the DP rising any more and (for me) makes my BG lower all though the day because I start at a lower number.

    About reducing / coming off the insulin - I know that I will have to eat a very low carb diet every day for as long as I live. My BG levels are good now but it would only take one slip up or inflammatory style illness for it to zoom back up again. It took me several months on a less than 20g a day carbs and very slowly reducing insulin to reduce my BG enough to finally stop the insulin and some of my other meds and, from what I understand, I am one of the lucky ones who were able to do this.

    I hope that you, too, are one of the lucky ones. :) :)
     
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