Extended fasting with a closed loop system

[Gpad]

Hi all,

Looking for some input in what I'm about to undertake. I'm looking to do a 7 day fast to kick start a little weight loss (I'm no good at reducing caloric intake to a much lower level to do things 'properly' but I find fasting very easy). I use the Libre 2 plus and the Omnipod 5 so pretty much a completely closed looped system.

I had planned to do this a few weeks ago, got to day 4 and my ketones were 3.8. Felt fine, I'm 90% sure these were nutritional ketones and would've been fine to carry on, but the high number freaked me out a bit and I called a stop to it and broke the fast to get a jolt of insulin in.

So i suppose the question I have is whether it was safe to continue? On the days I was fasting I was averaging about 15-20 units basal so still getting insulin on board, I'm sure I'm not at risk from DKA as I'm on a closed loop system so absolutely no chance of ever not getting enough basal. Anybody have any thoughts, or ideally, experience with long term fasts like I plan to do?

Many thanks.

 

[grantg]

might want to update ur treatment type from other.

tbh i'd be looking at contacting dsn/endo to ask them about risks. i also have moderate levels of ketones.. and was warned recently to increase carbs a little more. I was admitted with DKA in hospital in january.

regards the difficulty with libre sensor getting hold of for your fast if decide to go through with it 7 days imo is long time no idea how you can go without food for so long. it might be worth your time signing up for dexcom free trial (10 days) would most definately fingerprick and test if feeling at all unwell ketones.

advice i received is if above 1.5 seek medical attention ie call dsn. if 3+ direct to a&e. bear in mind lada zero insulin currently. same any glucose level with the above figures alongside plently of fluids to help pee out any ketones. prior advice when injecting insulin was a dosage of that if high sugars. really depends on the acidity of your blood would be my guess...

 

[SimonP78]

@grantg, I can see your concern about ketones in the case of not taking insulin (and therefore not knowing how much/whether you have any on board if your body has decided to not produce any on a given day.)

I think that guidance is very conservative for those who do take insulin (see my thoughts linked in my sig), I regularly have ketones in the 3's after exercise (which is similar to fasting in that one is using more carbs than are being consumed, so fat makes up the shortfall) without any ill effects. I do, however, always have basal insulin onboard and I think this is the important factor.