Having problems

[VickiT11979]

I've been eating reduced carbs for about 6weeks, around 100g a day, and overall it had improved my post meal BG spikes, but not all the time. I'm type 1, on a pump, last HbA1c 54 but I know it swings up & down & want things to be more steady.
I've been reading Dr Bernstein's diabetes solution, and though I don't think I can stick to his strict criteria, I have been reducing my carbs more & trying to inject for the protein, as I wondered if that was why I still got spikes sometimes.
I must say that I've only been doing this for a couple of days, and I've not altered my basal rate or any of my insulin:carb ratios, but I'm back to being high after meals each time & don't know why.
I was 5.6 before lunch today, having not eaten breakfast cos I was testing my basal rate (which was fine). I ate 3 slices of low carb bread which I make myself, weighed & the carbs worked out, with chicken, lettuce & 1/4 avocado, lettuce, 2 cherry tomatoes, some prawns, 1 tablespoon seafood sauce (jar said 2.7g carbs), 3 chicken drumsticks & a weight watchers yoghurt. Total carbs 16g, bolused for this. Didn't bolus for the protein in the chicken drumsticks as forgot to weigh them before eating. Rest of meal was 1.5oz protein, did a "combo bolus" for the protein over 3hrs using Bernstein's formula (oz of protein/3) altered for using Novo rapid. I have some nutritional scales which tell me how much protein & carbs is in foods if I enter the code for that food.
BG 1hr 45min after eating 12.9. I still had 0.09u of my protein bolus to come, but pump said I needed 0.75u to correct the high BG.

Last night I wasn't so high - around 9 - but it stayed at 9 for hours after eating, even until 1:30am, despite correcting. That was after chicken breast with various veggies (kale, asparagus, cauliflower mash).

I feel I'm trying so hard - thinking about everything I eat, weighing it, adding up loads of numbers, testing up to 14 times a day, but not really getting anywhere.
I know there's a ton of detail above, I just want all the info to be there in case anyone can suggest anything I could do differently.
Food is feeling like the enemy right now, and I'm skinny enough already - I've lost half a stone since going lower carb, which I didn't want to.

 

[Hobs]

Are you cutting back on fats as well?? Since I've gone onto what some would call high-fat I have felt much better in my self with more of a casual visual portion control rather than gauging/weighing everything kind of thing. I think being too precise makes the diet take us over rather than us controlling what we eat.

 

[VickiT11979]

I'm not cutting back, but I'm not seriously trying to increase my fat intake either. If it increases, it increases, is my attitude. I am eating more of it (snacking on cheese, or peppered salami rolled up around egg mayo), but I'm buying reduced fat creme fraiche or soured cream to add to my veg mashes, and I've found Asda's low fat Greek yoghurt has less carbs than the regular version. I've read some of the stuff about high fat being fine if you eat low carb, but haven't made my mind up yet, and still have some unanswered questions (like how low carb do U have to be before high fat is OK?).

Vicki rr

 

[kt78]

Hi there Vicky! I feel for you doing all your sums - know exactly how you feel! I don't have a magic equation and in my experience bolusing can be more of an art than an exact science (despite what they tell you at clinic!).
I always try and think about the 'waves' of insulin and whether my BG is coming up or down. If you were 5.6 and rising then that would of course give you a different BG in a couple of hours than if it was 5.6 and falling.
I have also recently really cut down my carbs - no more bread, pasta, potatoes, rice (or cake - obvs!) and have found that my levels are really good if I eat so that I don't have to bolus more than 2.5 units. That's how I've done it - kind of in reverse! I don't eat anything that would mean having to bolus any more than 2.5 units and I have seen really dramatic improvements.
Also, did the 0.75u correction work, if it did - maybe that's what you needed for the chicken legs?! Good luck :thumbup:

 

[kt78]

(Just to add - I am nowhere near perfect - must have over-bolused and had to suspend insulin for an hour as 4.6 and still 0.7u on board!) :lol:

 

[VickiT11979]

Thanks KT,

Sometimes it's nice just to hear from someone else who knows what I'm talking about, so thank you for your comments. I totally agree about how knowing the trend of your BG would help a lot, that's why I intend to pay for CGM when I get a new pump.

BG was 12.7 at 16:25, so no, the correction bolus didn't work. I've found that before - my correction boluses seem OK if it's hours after eating & all the food has been digested, but they never seem to cover my BG adequately if they're calculated 2hrs or so after eating. I'm going to change my lunch I:C ratio from 1:7 to 1:5 tomorrow & have changed my evening one from 1:10 to 1:9, and will see what effect that has.
I did another 1.2u correction 40min ago, so will check again in half an hour to see what's happening.

Looks like tea will be a few hours away....

Vicki