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Help please!

A

Ali H

Well-Known Member
Messages
790
Location
Somerset
Type of diabetes
Type 2
Treatment type
Insulin
Ok, so if you lower your carbs you should be able to lower insulin, yes? Typically, 20 units of Novo covered 40g of carbs at teatime. I have cut carbs even more the last fortnight, my levels and ratios are dire. I have worked so hard to get my A1C to 6.5 from 9.2 last June. I had 19g carbs for tea and 20 units of Novo have still left me at 7.6. My pre meal was too high, we were out all day, my error. It was 9.4. but the novo should have sorted that and covered my carbs at tea time.

I managed 35g of carbs in total one day in the week, my readings were 7s and 8s all day still with similar pre low carb amounts of insulin. No weight loss either. Does anybody know why this is happening?

Ali
 
Blimey, 64 views, a forum of devout low carbers and nobody has any ideas. Doesn't surprise me because I am fresh out of ideas too. Now sitting at 9..8 after a rise from 6.5 following 16g of carbs for breakfast and 10 units of Novo. My previous breakfast of 30g of carbs would normally be dealt with by 12 units of Novo!!!!
 
Wow you seem to be having to take a lot of insulin for the amount of carbs you are eating. Have you got your background insulin right? Maybe you need to ensure you've got that sorted first before you work on your ratios.
 

As hels says, if your also using a basal insulin this may need adjusting if your pre-meal readings are high, I would show your DN/DSN your bg diary and get their take on things, but weight gain can cause insulin resistance so your insulin usage should come down once you do begin to lose weight.
 
Yes my basal has been fine, within 1.7 mm variance from sleeping until waking and usually well within 0.5 actually. Oh my weight never changes, nothing I do changes it, for the last 20 years it has been the same. I haven't gained weight whilst taking insulin either because I have been careful with the carbs. I had a check up on New Years Eve, the consultant was delighted with everything. So I thought right, I will take this a step further now, see if I can reduce carbs even further and alongside that, my insulin. BAM! It has all gone wrong, ratios blown to bits, no weight loss and my BS figures are 7s and 8s rather than 5s and 6s.

Ali
 
ask dr...you may need to bolus for protein, TAG total available glucose, could start at 50% of protein counted as a carb..and adjust up and down from there, you may need to split the dose too, diabetes pizza effect
 
Could you be starting to be Insulin resistance? as I have heard it can happen in Type 1's, it's just a thought though. Maybe an appointment with your DSN or GP would be helpful. Hope you can get it sorted out Ali H. Good luck

RRB
 
According to the OP's profile she is a Type 2 and already on Metformin.
 


Well that's good if your basal insulin is fine, if you've increased the amount of fat in your diet this may explain your higher bg levels, there's was a study last year that found dietary fat can cause insulin resistance resulting in higher insulin usage in type 1's, appreciate your a type 2 Ali but it still may still be relevant:

http://www.sciencedaily.com/releases/2013/03/130327190328.htm

When you next speak to your diabetes team ask them if a insulin such as Actrapid would be better suited to your low-carb diet, it has a longer duration than Novo and IMHO would be better suited to someone like yourself who restrict their carbs so much.
 
No not taking any oral meds now and zero tolerance of metformin in any form, including slow release. Will have a read Noblehead, thanks.

Ali
 
Going to go back to basics I think, start with checking basal again and go from there.

Ali
 
Basal seems fine but yet again breakfast was 16g of carb, only 6g if you deduct the fibre and yet 10 units of Novo still left me on 8.7 from 6.2 on waking. Prior to LC, I could take 12 units of Novo for 30g of carbs and be back in the low 6s for lunchtime.

Ali
 
Well a week down the line and nothing has improved. My carbs are down to less than 50g a day now and still no movement in BS levels or weight. What's the point?

Ali
 

Are you deducting the fibre content in all your calculations ? If so, ( and assuming you are in the UK ) , you may be underestimating your bolus, as the figures given are total carbs with fibre already deducted . Also, are your ratios the same throughout the day ?

It's an annoying problem that ratios and carb tolerance can change for no apparent reason, usually when you are feeling satisfied that you have it under control

Signy
 
No I am talking about items made from scratch where the recipes show fibre and net carbs not processed foods with the carb count on the pack. So you print a recipe, it is broken down into net carbs which are the figure being trumpeted, but for me, I have to add back in the fibre content then bolus pretty much 1 unit per gram. Utterly ludicrous.

Ali
 
That sounds grim
I didn't actually mean processed foods, but carbs in everyday foods used in recipes. I cook everything from scratch , and take the carb count from the label ( for some odd reason, chickpeas are higher from Wairose than Aldi ! ) and/ or use the values given in cook and count . Both use net carbs in which fibre is already deducted . But I digress ...

I just wondered if most of your carbs come from low GI foods, in which case I agree with @noblehead that it may be worth checking with your HCP about changing your bolus insulin. The older insulins like HumulinS seem to be better at dealing with slow release carbs than Novo. Also, has your doctor suggested an alternative to Metaformin ? That could make all the difference .

It doesn't sound as if any of this is related to you low carbing, because what you said is correct, lower carbs generally mean less insulin doses, not an increase . It must be immensely frustrating for you

Just had a thought - not wanting to sound as if I'm teaching you to suck eggs, LOL, but is your Novorapid in date, and is your pen working as it should ?

Signy
 
I changed both vials first off to eliminate spoilt insulin as a cause, pens seem fine, only 7 months old. Will have to speak to GP about combatting the Insulin Resistance because this is just ridiculous.

Ali
 
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