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Fasting BG

Discussion in 'Type 1 Diabetes' started by Timostags, May 10, 2019.

  1. Timostags

    Timostags · Well-Known Member

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    I'm currently on a DAFNE course, 1 day a week for 5 weeks. I had my first day last week and decided I wanted to do a fasting day to check my basal dose was correct.

    We were told last week not to count carbohydates in baked beans as they are high in fibre and you should not count these carbs. I was amased by this as I have always taken insuling for beans the same as anyother carb, but I thought this would make a carb free fast day much easier.

    I was expecting with 30 hours of no carbs or bolus, just basal to see a smooth flat line maybe gradually going up or down showing I need to up or lower the amout of basal, but this is what I got and I don't understand why?

    These are my BG's over the day, I'll give 1 per hour ( I wear a libre so can see alot more details but want to keep it simple).

    Last Bolus\carbs taken 22:00
    00:00 - 5.0 (bed time basal 00:00)
    01:00 - 6.6
    02:00 - 11.7
    03:00 - 13.9
    04:00 - 13.3
    05:00 - 12.5
    06:00 - 12.1
    07:00 - 12.3
    08:00 - 10.6
    09:00 - 8.4
    10:00 - 9.4
    11:00 - 11.2
    12:00 - 12.4
    13:00 - 13.2 (chicken soup for lunch 13:15)
    14:00 - 15.7
    15:00 - 14.3
    16:00 - 13.2
    17:00 - 11.8
    18:00 - 10.9 (baked beans 18:15)
    19:00 - 13.6
    20:00 - 17.9
    21:00 - 18.0 (beef koftas 21:30)
    22:00 - 15.9
    23:00 - 17.2
    00:00 - 18.4
    01:00 - 19.3
    02:00 - 17.6 (basal 02:30)
    03:00 - 17.0
    04:00 - 17.0
    05:00 - 15.3
    06:00 - 13.9
    07:00 - 13.0
    08:00 - 11.8
    09:00 - 9.9

    I should also mention I fall asleep and miss my lantus @ 00:00 and don't take it until 02:30 (currently only single dose of basal) so during those hours theres no basal in my system either and yet BG comes down!
    Also I have zero activity during the day, I'm sat in meetings back to back which is why I chose this day to do the fast.

    What I see looking at these is....
    They're all too high! I normally get a spike in the morning around 7am as I am about to get up and do a correction for this, as I am delibrately not taking bolus during this test I don't correct.
    The chicken soup does seem to raise my BG a little so maybe there are hidden carbs in it?
    The baked beans definately rise my BG, so maybe I should cover these carbs with bolus as normal but count 50% of the carbs? (I did question the amount of sugar in the sauce at DAFNE but was told its not an issue)
    Apart from when I have eaten a "carb free" meal it does seem to be on a general downward trend which is interesting as on a normal day when I'm eating carbs and taking bolus I feel it goes up during the night and morning (I never eat breakfast) so expected to need to increase basal.
     
  2. EllieM

    EllieM Type 1 · Moderator
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    Are we talking traditional Heinz baked beans here, and how much? I've never done the DAFNE course but I would always have counted the carbs in baked beans, however delicious (guilty secret, I've been known to eat them cold from the can :)).
     
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  3. Timostags

    Timostags · Well-Known Member

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    Yep. I was really surprised, we were told that because the fibre content is high they pass through too quick for your gut to break the fibre down into glucose.

    I thought the same, I always take insulin for a tin a baked beans. It's not a small amount either and I don't remember going hypo after beans
     
  4. urbanracer

    urbanracer Type 1 · Well-Known Member
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    Can't speak for everyone but I count my beans (not literally of course ;))

    Down where I live we don't do DAFNE, we have something called IMAGE. First part of acronym stands for Insulin Management And .. I can't remember the end. I don't think were told to ignore beans
     
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  5. MeiChanski

    MeiChanski Type 1 · Well-Known Member

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    I think for soups, you'll need to look, I know some use cornflour as a thickener. For example Heinz chicken soup has 9.9g carbs for 1/2 can of soup. Again for beans, it does depend on the person, I usually don't count for beans because I have like 2 teaspoons and I did hypo prior to learning about it.
    From looking at your readings, maybe the background needs some tweaking? I know protein does spike me slightly when going "carb free".
     
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  6. becca59

    becca59 Type 1 · Well-Known Member

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    Very rarely eat baked beans anymore as find too sweet. But was taught on DAFNE to bolus for half.
     
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  7. EllieM

    EllieM Type 1 · Moderator
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    That makes more sense. I eat quite a lot of (non-sweetened) beans in stews etc. Presumably this also applies to all canellini, kidney, chick peas etc....? Home-made hummus has only half the carbs I was assuming?

    I am so confused.
     
  8. becca59

    becca59 Type 1 · Well-Known Member

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    @EllieM yes it does make sense. However I have found with pulses that they come back to haunt you a couple of hours later. Wearing the Libre enabled me to see this and I now whack more insulin in. A pump would obviously make this easier.
     
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  9. Babyweed

    Babyweed Type 1 · Active Member

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    I was told to count the carbs but the which sugars only for beans
     
  10. Fairygodmother

    Fairygodmother Type 1 · Well-Known Member

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    I always dose for the carbs given on the can for baked beans, no problems yet. I can’t remember being told not to on the Katie (Daphne for this area) course I was on.
    And that’s a very lengthy basal test! Blimey! Yes, it does look as though basal may need tweaking but of course I can’t advise you what to do.
     
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  11. Deleted Account

    Deleted Account · Guest

    I too dose for baked beans as it says on the tin.
    But one thing I do remember from my Freedom 4 Life (local equivalent of DAFNE*) was some people don't absorb the carbs from pulses such as lentils and chickpeas whereas others do.
    Perhaps, this is where the current baked bean philosophy comes from - perhaps, on average, less people absorb the baked bean pulse carbs so they simplified the message?

    *Given each area seems to have their own variation of DAFNE, is it time to review the original course?
     
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  12. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Timostags,
    Several things to point out and ask:
    Did you read what the sugars content on the packet of chicken and the baked beans are? If DAPHNE is about carb couting, why ignore them in the carb count if they do cause a response in some people.

    If i fast 18 hours i start to produce ketones, those breakdown products of fat, as i am in starvation mode. in this situation the ketonesmake my insulin less effective andzso skew the bsl results. The usual basal testing regime interval this site tends to use is 6 hours. I do a 12 hour fast as a compromise, whilst keeping a eye on ketone levels.

    When fasting, or having very little carbs, our liver changes some of any protein we eat into glucose, which may show up with some bsl rise at ? 3 hours later. So i am uncertain exactly what is in the beef kofta but it sounds like protein is an ingredient and ? some carbs?
    Your bsls are far above normal levels in your recording so your nurse's advice is needed asap.

    I am not a fan of Lantus but that is something you may or not may not wish to take up with your nurse or doctor.
    See diabettech.com Lantus: Lethal or Saviour?
     
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  13. Timostags

    Timostags · Well-Known Member

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    I checked for ketones at 08:00 and it showed 0.1

    I am at second day at DAFNE now and have been given levemire to try as this is easier to adjust than lantus, plus I can use it in a novopen so I will try to go back to 2 injections a day.

    I think I'll leave the dose while I switch to levemire and then look at dosage again.
     
  14. kitedoc

    kitedoc Type 1 · Well-Known Member

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    But you had the beef koftas 3 hours before that ketone measurement so that might have possibly reduced the ketone level somewhat?
     
  15. Timostags

    Timostags · Well-Known Member

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    I checked ketone at 8am after KOFTAS.

    From memory the koftas contained a total of 10g carbs according to packaging
     
  16. kitedoc

    kitedoc Type 1 · Well-Known Member

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    But what about protein content? And you may have had some level of ketones before that reading which could affect your body's response to basal insulin.
     
  17. Timostags

    Timostags · Well-Known Member

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    So should I have tested ketones throughout the day? I'm kind of reluctant to over use the ketone test strips as you only get 10.

    In my mind if theres ketones in my blood they would continue until my body gets another fuel source carbs?

    Should I also cut protein as well as carbs when testing basal? I don't think I can make it through the day on water, I'm already stick thin.

    I was told yesterday that there was no need to fast for so long. They suggested just 1 carb free meal.
     
  18. kitedoc

    kitedoc Type 1 · Well-Known Member

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    I think limiting the fasting sounds best and is what this site's articles on basal testing recommend.
    The high readings you are experiencing might make you prone to devloping DKA, so checking ketones makes sense.
    Now you need to discuss your results with your nurse to work out what to do next!
     
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