Fasting Medication Experiences ?

Bwel

Member
Messages
19
Type of diabetes
Type 2
Hi all,
I’m a Type2 and am on LCHF with 18:6 fasting. I have Basal and Bolus Insulin as well as Metformin etc. I’m trying to work towards Remission if possible and have started an occasional prolonged fast. I had my first 24hr fast a week or so ago and that was fine. I did not adjust meds for that one.

Now I’m in my 2nd day of a 48hr fast (currently at 43hrs). I feel perfect and have done my daily 5 mile walk as a breeze and full of energy.

However, my Blood Glucose is raising this morning even though I’m fasting. (Below is my Libre CGM-graph). The 5 mile walk did not bring it down either. Of course I have not taken any Insulin or Metformin today. My liver must by producing the Glucose as there is no other source.

For those others whom practice Prolonged Fasting and are normally on Insulin,
- what is your experience when fasting ?
- what do you do about Insulin ?
- do you ever get raised BG during the prolonged fast ?

Many thanks
Bob

189B6AFC-686A-4C7B-ACF2-1B85CAF3E595.png
 

xfieldok

Well-Known Member
Messages
4,182
Type of diabetes
Type 2
Treatment type
Tablets (oral)
What are you eating in a typical day please?
 

Bwel

Member
Messages
19
Type of diabetes
Type 2
What are you eating in a typical day please?

During the 24 or 48 hour fast, I’m eating absolutely nothing, just drinking plenty of water.

On my other ‘normal’ days I follow 18:6 fasting periods, So I eat at 2pm and 7pm. High fat, low carb. I try to keep carbs at no more than 50g per day. Plenty of salads with oil dressing, oily fish, various meet proteins and veg.
 

Antje77

Oracle
Retired Moderator
Messages
19,284
Type of diabetes
LADA
Treatment type
Insulin
Of course I have not taken any Insulin or Metformin today.
Do you mean you haven't taken your basal insulin either?
Have you spoken to your consultant about skipping the metformin on fasting days?
 

xfieldok

Well-Known Member
Messages
4,182
Type of diabetes
Type 2
Treatment type
Tablets (oral)
The metformin will help stop liver dump. When I fasted I had some bone broth.

Under what conditions do you take insulin?
 

xfieldok

Well-Known Member
Messages
4,182
Type of diabetes
Type 2
Treatment type
Tablets (oral)
@Bwel can you please confirm what type of diabetes you have? Different types are treated very differently.
 

Bwel

Member
Messages
19
Type of diabetes
Type 2
The metformin will help stop liver dump. When I fasted I had some bone broth.

Under what conditions do you take insulin?
I normally take 8 units Morning and night of Background Insulin (Levemir)
And then as I’m on a Los Carb, High Fat diet, I count the Mealtime Carbs and take 1 unit for every 10g of NovoRapid with meals. That being said, because of the low carbs, I take only take a few units over the day when eating.

Now with these extended Fasts, I’m wondering about dropping off the Background Insulin as well.
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
I normally take 8 units Morning and night of Background Insulin (Levemir)
And then as I’m on a Los Carb, High Fat diet, I count the Mealtime Carbs and take 1 unit for every 10g of NovoRapid with meals. That being said, because of the low carbs, I take only take a few units over the day when eating.

Now with these extended Fasts, I’m wondering about dropping off the Background Insulin as well.

your situation reminds me of patients treated by Jason Fung (of fasting fame).
I can’t make any suggestions about dose, but you could check out his website/blog to see what he does.
From memory, in one of his lectures, I recall him mentioning a structured step down on insulin and other t2 diabetes meds, in order to prevent hypos when fasting.

another source you might find helpful is the talks and discussions around Virta. As a non-client you won’t get personal advice, but their info may well give generic info on how they reduce medication, and over what timescale.

Obviously, regular testing will be your best route to finding out what works for you.
 

Bwel

Member
Messages
19
Type of diabetes
Type 2
Do you mean you haven't taken your basal insulin either?
Have you spoken to your consultant about skipping the metformin on fasting days?
I only took my Basal Insulin on my first. Owning, but not since. If you see my CGM picture, it shows that my Blood Glucose was low through that first day and overnight. It’s only been higher today. I will finish my fast in 2hrs, so will take insulin accordingly then.

I wanted to avoid Hypo’s caused by Insulin Injection when Fasting.
 

Bwel

Member
Messages
19
Type of diabetes
Type 2
your situation reminds me of patients treated by Jason Fung (of fasting fame).
I can’t make any suggestions about dose, but you could check out his website/blog to see what he does.
From memory, in one of his lectures, I recall him mentioning a structured step down on insulin and other t2 diabetes meds, in order to prevent hypos when fasting.

another source you might find helpful is the talks and discussions around Virta. As a non-client you won’t get personal advice, but their info may well give generic info on how they reduce medication, and over what timescale.

Obviously, regular testing will be your best route to finding out what works for you.

Yes, I read and follow everything by Jason Fung as well as DietDoctor and have explored Virta. I have not found the protocols for stepping down Insulin / Meds on the fasting and remission journey, but suspect they are only reviewed when under the subscribed coaching and treatment programs. Unfortunately the treatment/coaching programs are not available outside of the US.
 

xfieldok

Well-Known Member
Messages
4,182
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Thanks for clarifying your type. I was on humulin I. My Specialist nurse said that if I wanted to, I could reduce it by a unit a day. It might be worth ringing your nurse and asking. Some may say reduce every 3 days depending on your numbers.
 

Jaylee

Oracle
Retired Moderator
Messages
18,213
Type of diabetes
Type 1
Treatment type
Insulin
Hi all,
I’m a Type2 and am on LCHF with 18:6 fasting. I have Basal and Bolus Insulin as well as Metformin etc. I’m trying to work towards Remission if possible and have started an occasional prolonged fast. I had my first 24hr fast a week or so ago and that was fine. I did not adjust meds for that one.

Now I’m in my 2nd day of a 48hr fast (currently at 43hrs). I feel perfect and have done my daily 5 mile walk as a breeze and full of energy.

However, my Blood Glucose is raising this morning even though I’m fasting. (Below is my Libre CGM-graph). The 5 mile walk did not bring it down either. Of course I have not taken any Insulin or Metformin today. My liver must by producing the Glucose as there is no other source.

For those others whom practice Prolonged Fasting and are normally on Insulin,
- what is your experience when fasting ?
- what do you do about Insulin ?
- do you ever get raised BG during the prolonged fast ?

Many thanks
Bob

View attachment 40871

Hi Bob,

If you have skipped your basal today on the second day of a fast? The rising numbers on this second day without your prescribed meds are reflecting this in the Libre graph.
I'm not sure what your goal is regarding the fast. & the good news is you have a sensor to help.
Do you have a BG meter to as a back up?

Speaking as a T1. Regardless of whether I eat or not I do need my basal as a foundation in the background. Regarding BG managment in the right zone.
It looks like you are advised to split dose Levimir? Take a look at this link on basal testing. On the first day you apear to be drifting into hypo territory? https://www.mysugr.com/en/blog/basal-rate-testing/
 

Bwel

Member
Messages
19
Type of diabetes
Type 2
Thanks for clarifying your type. I was on humulin I. My Specialist nurse said that if I wanted to, I could reduce it by a unit a day. It might be worth ringing your nurse and asking. Some may say reduce every 3 days depending on your numbers.

When you started reducing Insulin, were you already fasting and if so, which fasting protocol / schedule were you using ?

Have you now managed to get off insulin completely ?
 

xfieldok

Well-Known Member
Messages
4,182
Type of diabetes
Type 2
Treatment type
Tablets (oral)
I was only fasting 18:6. I was on insulin to try and control the effects of steroids on my bg.