High levels despite low carb and insulin

M

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forget fasting

Bit of a sweeping statement considering that it could possibly turn out to be the only course of action in returning some insulin sensitivity. Insulin resistance cannot be fixed with insulin. Personally I think all options need to be considered, and further discussion with the endocrinologist is recommended.
 

Juicyj

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Bit of a sweeping statement considering that it could possibly turn out to be the only course of action in returning some insulin sensitivity. Insulin resistance cannot be fixed with insulin. Personally I think all options need to be considered, and further discussion with the endocrinologist is recommended.

In light of the fact the OP is on fixed doses of insulin then no it's not a sweeping statement Jim. Omitting food whilst taking insulin is dangerous and can result in hypos.

The fact that the OP is on fixed doses of insulin and not carb counting is not going to help her control, we typically hit insulin resistance around 12 mmol/l meaning more insulin is required to bring levels down into target. So adjusting insulin to suit the individual's needs is the most suitable course of action.
 
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Juicyj

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Insulin resistance cannot be fixed with insulin.

We all have our own individual ways of tackling insulin resistance, I run and cycle which knocks my control into shape if running high, some take a hot bath, but generally will take a correction dose to get levels back into range.
 
M

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In light of the fact the OP is on fixed doses of insulin then no it's not a sweeping statement Jim. Omitting food whilst taking insulin is dangerous and can result in hypos.

Yes this has already been discussed. It doesn’t mean that fasting should automatically be discounted on a whim. The endocrinologist has already advised that OP is heavily insulin resistant. If this is indeed the case, then it will not improve unless the glucose footprint is reduced. For sure though it remains to be seen what is the best course of action.

Agree to disagree then.
 
M

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We all have our own individual ways of tackling insulin resistance, I run and cycle which knocks my control into shape if running high, some take a hot bath, but generally will take a correction dose to get levels back into range.

A heavily insulin resistant type 2 cannot fix their resistance with a bath or a run around the block. You are looking at this through the lens of a type 1. In the interest of not cluttering the thread, that is the last I will say on the matter ;)
 

Juicyj

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@Jim Lahey Regardless of insulin resistance and how to tackle it..

Fasting on fixed doses of insulin is dangerous advice, please do not advise an insulin dependent diabetic to fast.
 
M

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@Jim Lahey Regardless of insulin resistance and how to tackle it..

Fasting on fixed doses of insulin is dangerous advice, please do not advise an insulin dependent diabetic to fast.

Hence...

You would probably benefit from extended fasting but you’d be well advised to research carefully and also be very vigilant with glucose monitoring and insulin dosing while you’re doing it.

And...

And as already said, you would need to monitor your glucose and insulin fastidiously or run the risk of unexpected hypoglycaemia. Have a read around here and do a lot of research, and please don’t rush into anything based on the musings of a total stranger from the internet :D
 
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DCUKMod

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@mortigger1968 - as you can see you've started quite a lively debate here.

There is often more than one way to skin a cat, but your issue is a bit tricky, is say. Nobody has, so far, asked if you are healthy, aside from your T2? Do you have any other health conditions that could be impacting things? Some conditions, and some medications can affect blood glucose numbers.

Moving on.

You are on fixed doses of insulin, and that is a real concern. Changing your diet, whether trimming some of what you usually say out, or more radical, you must, must, in my view, have a supported plan of what you do if your blood sugars behave unexpectedly, or indeed trend up or down.

Your Endo wants those numbers down (and I bet you do too!), but if you do it too well and end up with badly mismatched insulin doses it could be uncomfortab, at best, and dangerous at worst.

I urge you to discuss learning to use your insulin more flexibly. That will involve carb counting and dosing accordingly. Then, decide which tactic you want to adopt, then discuss that with your health care team too, so that you feel supported and have adequate supplies to hand. By that I'm thinking about test strips. If you are changing what you eat, you will likely end to up your testing significantly to learn what's actually going on here.
 

mortigger1968

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Thanks everyone im seeing my endo again on the 3rd july he seems to think cutting my insulin and lowering carbs and highering fat will help..it isnt ill write down all your suggestions
 
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mortigger1968

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@mortigger1968 - as you can see you've started quite a lively debate here.

There is often more than one way to skin a cat, but your issue is a bit tricky, is say. Nobody has, so far, asked if you are healthy, aside from your T2? Do you have any other health conditions that could be impacting things? Some conditions, and some medications can affect blood glucose numbers.

Moving on.

You are on fixed doses of insulin, and that is a real concern. Changing your diet, whether trimming some of what you usually say out, or more radical, you must, must, in my view, have a supported plan of what you do if your blood sugars behave unexpectedly, or indeed trend up or down.

Your Endo wants those numbers down (and I bet you do too!), but if you do it too well and end up with badly mismatched insulin doses it could be uncomfortab, at best, and dangerous at worst.

I urge you to discuss learning to use your insulin more flexibly. That will involve carb counting and dosing accordingly. Then, decide which tactic you want to adopt, then discuss that with your health care team too, so that you feel supported and have adequate supplies to hand. By that I'm thinking about test strips. If you are changing what you eat, you will likely end to up your testing significantly to learn what's actually going on here.


Hi i di test regulary my endo just wanted me to do lchf and lower my insulin.. i do have pcos but no other illnesses and no other medication .cholestrol is good my doctor said apart from the diabetes im one of his healtiest patients ....
 
M

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Thanks everyone im seeing my endo again on the 3rd july he seems to think cutting my insulin and lowering carbs and highering fat will help..it isnt ill write down all your suggestions

That sounds like the best strategy to me. Seems as though your endo is switched-on and fully understands insulin resistance. Surprisingly rare in this business!

I definitely feel that you should try to get away from fixed insulin dosing, as this will empower you with far greater flexibility to experiment and take maximum advantage of any dietary choices.
 

DCUKMod

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Hi i di test regulary my endo just wanted me to do lchf and lower my insulin.. i do have pcos but no other illnesses and no other medication .cholestrol is good my doctor said apart from the diabetes im one of his healtiest patients ....

That's good to know. Please don't think I was suggesting you don't test, but those using insulin report when changing their way of being (whether it be eating less, changing insulin, up or down, or even starting a new job), they need to focus quite hard to get a decent picture.

If your Endo wants to you LC and use less insulin, but isn't supporting you by telling you how to make adjustments to it along the way, that doesn't feel too helpful. Have you discussed having a Libre for a while, so that you can see the track of your blood sugar, rather than a few tests a day?

Just one final question from me (I tend to do a lot of questions), where are you on the menopause track? If your hormones are getting a bit disrupted, especially with pre-existing PCOS, that could also be impacting your numbers. Just a thought.
 
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MeiChanski

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Hello, I think you also need to ask to either see a dietitian about carb counting and dose adjustments or ask to be referred to a carb counting course, that way it will help with your consultant's suggest of LC diet. So you can reduce doses without the risk of hypos compared to fixed doses.
 

kitedoc

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I remain unclear on how many carbs you eating per day @mortigger1968 ?
Once that is known it may be easier to see what is happening.
And are you on any other medications? If so, what are they please?
 
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Brunneria

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Hi @mortigger1968

I appreciate that you are in a very uncomfortable situation, and I wholeheartedly agree with those who say that fasting while on (fixed) insulin is not advisable until you have more help and advice from your healthcare team.

Also wanted to say that with PCOS you will have a different experience of insulin resistance than most - so please do not assume that fasting would have a major impact on it. The higher insulin resistance we have (speaking as a PCOSer myself), then the longer and harder we need to fast to see any benefit. Combining that with your current insulin regime could get dangerous. Some people are so insulin resistant that fasting does not significantly lower it. I have seen people (e.g. one of the founders of the ketodudes ketogenic forum) who have combined fasting with a significant exercise regime but seen no weight loss until max dose Metformin was added - because even when fasting, insulin resistance stayed high. The hormonal disruptions that make up PCOS are much more complex than most people experience, and that insulin resistance will also be more resistant. PCOSers typically have far more trouble losing weight, making it a longer, slower, harder road than most people.

I’m sorry, i appreciate no one wants to be in that situation! Going low carb is usually great for PCOSers, but the benefits are usually slower and smaller than for nonPCOSers, and this is (unfortunately) rarely recognised by docs, endocrinologists or even people who find that LC works well for them. Sad but true.

I really feel for you, but I urge you not to make any significant changes until you have the knowledge to adjust your insulin to your carb intake, and your basal has been tested and fine tuned.

Good luck with the appointment.
Please let us know how it goes?
 

Hotpepper20000

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I also have PCOS and agree with what @Brunneria has said.
I lost 60 pound in the first year of LCHF but haven’t have lost anything in the two years since. I still have about 50 to go. My BG is in non diabetic range.
I would also like to add that it's not just how many carbs but where they come from that make a difference.
Any grains no matter how little spike my BG.
So no rice, barley, oats, wheat and such.
Green leafy vegetables are the best sources for carbs.
 
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