How many carbs are enough?

[Bluemarine Josephine]

Good day! I hope that you are all doing very very well.

About a month ago, I concluded the DAFNE course. During the course, with the help of my educators I made several adjustments with regards to my background insulin, my ratios and my carbs intake.

I am still in the process of adjusting my background insulin and my Novorapid ratios so, please, disregard the blood glucose levels that I am about to mention (this is still a work in progress) because, the idea behind this post refers to nutrition and carbohydrates.

Prior DAFNE, I was on an ultra low carbs diet, consisting only of green vegetables and protein (no eggs though).

During my DAFNE course, my nutritionist insisted that I eat at least 30 grams of carbs per meal (which is 90 grams overall per day) referring only to carbs such as bread, yogurt, milk, cereal etc without considering the “hidden carbs” in green vegetables or protein or subtracting dietary fiber.

For the time being, my ratios are 2:1.
I am very slim, former athlete, and my BMI is at the lower side of the healthy range.
On a basis of 2:1 ratio, I need 6u of Novorapid to cover my meal.
If my calculation is correct, each correction unit lowers me by 2 mmols.
Therefore, if I want to have a meal which consists of 30 grams of carbs + 2 units of adjustments then, I need overall 8 units of Novorapid…
Now… that sounds like a lot of insulin to me…

I do it but, I am not happy about it.

So, today morning, I decided to do a basal test because I suspect that my background insulin isn’t enough.
My fasting was 10.8
Pre-lunch was 14.8
It seems to me that my morning Levemir needs adjustment.
If I eat 30 grs carbs for lunch on a 2:1 ratio = 6u
and if each adjustive unit lowers me by 2 mmols, I need some 4 additional units.
A total of 10 u of Novo....and I am not confident to do that... I just cant...

However, (and here is the point of this long post) during the basal test this morning, I realized how much I have missed the benefits of a low carbs diet. For the first time after about a month, I didn’t feel the stress deriving from the possibility of over-injecting, of making a mistake, of the ‘what-if’s in my head…

My God, I had missed that freedom!!

I felt more confident to drive and work and run to the banks without constantly thinking “I wonder what is my Novo doing now” and “why did I just have that dizzy spell? Am I dropping more than I calculated?” and “Did I walk too much? Was the walk too brisk maybe?”

My nutritionist insists that, for the brain, in order to function properly, we need, at least 130 grams of carbs per day. I was on a next-to-nothing carbs since I was diagnosed 3 years ago and my brain was working alright (or so I believe, at least.) I am not advocating that I do not see the nutritional benefits of a greek yogurt or an apple or a glass of milk but, do all these carbs have to be altogether in each meal every single time?

Please, share your thoughts with me and also, please guide me, how many carbs are enough or too many?
Thank you
Josephine.

 

[urbanracer]

Good day! I hope that you are all doing very very well.

About a month ago, I concluded the DAFNE course. During the course, with the help of my educators I made several adjustments with regards to my background insulin, my ratios and my carbs intake.

I am still in the process of adjusting my background insulin and my Novorapid ratios so, please, disregard the blood glucose levels that I am about to mention (this is still a work in progress) because, the idea behind this post refers to nutrition and carbohydrates.

Prior DAFNE, I was on an ultra low carbs diet, consisting only of green vegetables and protein (no eggs though).

During my DAFNE course, my nutritionist insisted that I eat at least 30 grams of carbs per meal (which is 90 grams overall per day) referring only to carbs such as bread, yogurt, milk, cereal etc without considering the “hidden carbs” in green vegetables or protein or subtracting dietary fiber.

For the time being, my ratios are 2:1.
I am very slim, former athlete, and my BMI is at the lower side of the healthy range.
On a basis of 2:1 ratio, I need 6u of Novorapid to cover my meal.
If my calculation is correct, each correction unit lowers me by 2 mmols.
Therefore, if I want to have a meal which consists of 30 grams of carbs + 2 units of adjustments then, I need overall 8 units of Novorapid…
Now… that sounds like a lot of insulin to me…

I do it but, I am not happy about it.

So, today morning, I decided to do a basal test because I suspect that my background insulin isn’t enough.
My fasting was 10.8
Pre-lunch was 14.8
It seems to me that my morning Levemir needs adjustment.
If I eat 30 grs carbs for lunch on a 2:1 ratio = 6u
and if each adjustive unit lowers me by 2 mmols, I need some 4 additional units.
A total of 10 u of Novo....and I am not confident to do that... I just cant...

However, (and here is the point of this long post) during the basal test this morning, I realized how much I have missed the benefits of a low carbs diet. For the first time after about a month, I didn’t feel the stress deriving from the possibility of over-injecting, of making a mistake, of the ‘what-if’s in my head…

My God, I had missed that freedom!!

I felt more confident to drive and work and run to the banks without constantly thinking “I wonder what is my Novo doing now” and “why did I just have that dizzy spell? Am I dropping more than I calculated?” and “Did I walk too much? Was the walk too brisk maybe?”

My nutritionist insists that, for the brain, in order to function properly, we need, at least 130 grams of carbs per day. I was on a next-to-nothing carbs since I was diagnosed 3 years ago and my brain was working alright (or so I believe, at least.) I am not advocating that I do not see the nutritional benefits of a greek yogurt or an apple or a glass of milk but, do all these carbs have to be altogether in each meal every single time?

Please, share your thoughts with me and also, please guide me, how many carbs are enough or too many?
Thank you
Josephine.

Hi, not sure if it will help but I take about 120g per day. But some people on this site are taking below 50g.

Your nutritionist is not correct, you can get your energy from other food groups such as fat and proteins, but they take a bit longer to break down in the body. You have to decide on the right carb intake for your own needs and goals.

 

[Kristin251]

when I was 1st diagnosed they told me I had to eat 15-20 c per meal.. So I did (usually 3 oz sweet potato and a few carrots) and my BS was all over the place. I could not find a steady state. Ups and downs constantly. I also gained 20 #'s in 2 months which was fine at the time and I needed to (I was 97#'s / 5'8) . After that 2 months I slowly reduced carbs back to how I was eating as a T2. VLC (veggies only) moderate protein an d healthy fats. I have reduced insulin from 6-10 units per meal to 1-1.5 and have reduced basal from 5 to 2 or 3 and NEVER fear hypos anymore. Personally I believe eating carbs and taking insulin is sort of like Russian Roulette, you never know what you're going to get. Except fear. I have no idea how to time insulin to meals when eating carbs. I would drop 20 or 30 and then spike 40+ in an hour. Now I stay within 10 points usually and more often less than 10. I used to tell my husband when I would go to bed that if he woke up in the night to make sure I was alive. After going back to 20g C a day divided I have no fears of that. I eat guacamole for BF , 2 oz protein and veg lunch and 3 oz p and veggies/salad for dinner. I only eat low GI veggies for carbs, no more than 3 oz P per meal and all the fat I need to be satisfied.
Personally, I would do what is 'safe' before listening to any one else. If you prefer LC then do it but be very careful with insulin. You will need much much less.
Again the problem I have with carbs is getting insulin there at the same time. I think it's impossible and these educators that don't take insulin are only going by the 'carb counting ' theory. I doesn't actually work that simply.
Also I have been eating 20c a day for 25+ years an I am still functioning, brain is working, energy good etc. The body is an amazing thing. There are many who eat zero carbs and are still very much alive to talk about it

 

[tim2000s]

My nutritionist insists that, for the brain, in order to function properly, we need, at least 130 grams of carbs per day. I was on a next-to-nothing carbs since I was diagnosed 3 years ago and my brain was working alright (or so I believe, at least.) I am not advocating that I do not see the nutritional benefits of a greek yogurt or an apple or a glass of milk but, do all these carbs have to be altogether in each meal every single time?

Hi again Josephine. The "130g requirement for the brain to function properly" is a myth perpetuated by failure to understand how the body works and a lot of old data. You actually need to eat zero carbs for your brain to function properly. Your body will convert protein to glucose for the ~30g that it does need a day and it can also run directly off ketones. I'll have to try and find the post I wrote previously with all the references in it.

 

[tim2000s]

Here we go @Bluemarine Josephine , the requirement of 130g per day is a myth, and here are the reasons why. You can manage on zero carbs per day...

This paper describes an estimate of the glucose requirement for the brain to run exclusively on Glucose:http://books.nap.edu/openbook.php?record_id=10490&page=277

However, the key point of the paper in reference to this discussion is that it states that the brain runs perfectly efficiently on ketone bodies, glycerol, and protein-derived glucose.

This paper published in the FASEB Journal in October 2008 details research into the brain's use of Lactate as a primary energy source during strenuous exercise when muscles require glucose. http://www.fasebj.org/content/22/10/3443.full

Page 277 of this document: http://www.nal.usda.gov/fnic/DRI/DRI_Energy/energy_full_report.pdf discusses estimating carbohydrate requirements. It includes the statement:

In individuals fully adapted to starvation [or low carbohydrate diets], ketoacid oxidation can account for approximately 80 percent of the brain’s energy requirements (Cahill et al., 1973). Thus, only 22 to 28 g/d of glucose are required to fuel the brain. This is similar to the total glucose oxidation rate integrated over 24 hours determined by isotope-dilution studies in these starving individuals (Carlson et al., 1994; Owen et al., 1998).

Or in other words, even this study mentions that the 130g of glucose isn't actually necessary for brain functioning and that less than 30g will suffice.

When you put these (and other studies that can be found with a bit of googling), it becomes clear that:

a) The brain does not operate solely on a glucose metabolism
b) The brain does not require 130g of glucose per day to operate
c) The value of 130g is an estimate derived from a number of assumptions, the keymost being that the brain operates solely on a glucose metabolism
d) The majority of papers discussing the brain and glucose metabolism describe multiple sources from which the brain can obtain glucose including protein and fat derived glucose which means that the "130g of glucose required from an external source" is a myth.

 

[Bluemarine Josephine]

Thank you very much for your replies.
I think that nutritionists, including mine, are well aware that protein and fat convert into sugar as well but, for some reason (which I do not understand) they do not like this type of energy conversion... In the case of my nutritionist, she gives me the impression that she perceives as "good energy" the carbs/sugar conversion and "bad energy" the fat/protein conversion...
Theoretically, 45% of the meal should be carbs...
I dont understand what is their reason for promoting this idea...

I understand if a diabetic would like to indulge in a carb treat once every blue moon.
I also understand if we would like to have a carb nutritional choice (like a fruit) for all the vitamins and dietary fiber it offers.
But why should this be in every meal and in large quantities?
I dont understand the instructions that I am given...

 

[tim2000s]

Thank you very much for your replies.
I think that nutritionists, including mine, are well aware that protein and fat convert into sugar as well but, for some reason (which I do not understand) they do not like this type of energy conversion... In the case of my nutritionist, she gives me the impression that she perceives as "good energy" the carbs/sugar conversion and "bad energy" the fat.protein conversion...
Theoretically, 45% of the meal should be carbs...
I dont understand what is their reason for promoting this idea...

I understand if a diabetic would like to indulge in a carb treat once every blue moon.
I also understand if we would like to have a carb nutritional choice (like a fruit) for all the vitamins and dietary fiber it offers.
But why should this be in every meal and in large quantities? I dont understand nutritionists... they make no sense to me...

The issue is that many don't understand the "nutritional ketosis" approach and see obtaining energy from protein and fat as a starvation process, which obviously isn't so good. Tie that in with the myths about running the brain purely on glucose at 130g a day and you have a right old recipe for mess and confusion.

 

[Bluemarine Josephine]

The issue is that many don't understand the "nutritional ketosis" approach and see obtaining energy from protein and fat as a starvation process, which obviously isn't so good. Tie that in with the myths about running the brain purely on glucose at 130g a day and you have a right old recipe for mess and confusion.

Tim 2000s thanks ever so much.
I am thinking to, gradually, go back to my low carbs diet, which I followed prior DAFNE.
It was much less of a headache than what I am going through now...

 

[MellitusTrap]

I heard the brain runs better whilst your in ketosis.
Anyone else heard that?

 

[tim2000s]

I heard the brain runs better whilst your in ketosis.
Anyone else heard that?

@diamondnostril and I have both experienced that it runs differently when in ketosis. I'm not sure whether it is better...

 

[Kristin251]

Without a doubt I do better in ketosis. When I eat carbs other than veg I am bloated, tired, brain fog, fat etc. I am with steady energy in ketosis

 

[Daibell]

Hi. As you can gather from the various posts, there is a lot of ignorance out there amongst the experts. I think there is still confusion between ketosis and ketoacidosis and hence ketosis is thought to be bad or risky. The degree of advertising by the food lobby for sugary snacks for 'energy' has made society believe that we need carbs regularly for energy. BTW I don't understand your 2 units for corrective doses. You don't need any correction doses unless you have miscalculated the carbs in a meal or discover during the day that your blood sugar is way too high. Correction doses are not relevant to the normal bolus for a meal. Note that a bolus ratio of 2:1 is unusually high? Mine for example is 1.1:1.

 

[azure]

I think some people can tolerate carbs better than others, or maybe the exogenous insulin just works more predictably in some people?

I eat between 150 to 200g of carbs a day, probably the high end of that now or even higher as I'm breastfeeding. On occasions I do have lots of carbs at one meal, usually on special occasions or when I have a rare meal out. I do think that when you go above a certain amount of carbs at one time, you may need extra insulin. That's what I've found anyway. So generally I eat moderate carbs at meals. I do have carby snacks too.

I'm slim and active and I have a pretty fast metabolism so can lose weight easily. I find carbs help keep the weight on so that's one reason I eat them.

For me - and everybody and every body is different - I find eating carbs fine. No awful highs or lows normally. I use an insulin pump so I credit that with getting my basal right and giving me a firm foundation to build on.

 

[Brunneria]

I heard the brain runs better whilst your in ketosis.
Anyone else heard that?

I experience it, every day.

Am much less clear headed, focussed and more feak and weeble when glucose burning.

 

[noblehead]

However, (and here is the point of this long post) during the basal test this morning, I realized how much I have missed the benefits of a low carbs diet. For the first time after about a month, I didn’t feel the stress deriving from the possibility of over-injecting, of making a mistake, of the ‘what-if’s in my head…

My God, I had missed that freedom!!

I felt more confident to drive and work and run to the banks without constantly thinking “I wonder what is my Novo doing now” and “why did I just have that dizzy spell? Am I dropping more than I calculated?” and “Did I walk too much? Was the walk too brisk maybe?”

It's a no brainer in your case @Bluemarine Josephine, just go back to your low-carb diet if you feel you had less stress and managed your diabetes better, we all have to do what works best for us as individuals and not do as others do. Good luck.

 

[Amrit1712]

Don't know if this helps at all, but I've continued to eat the same amount of carbs as I had been before I was diagnosed a year ago (minus the carbs snacks otherwise I'd have to bolus). I tend to have around 200g a day and am managing just fine. In my opinion you should have as much or as little as you want, making sure that it doesn't effect your bg levels control. The fact that I'm a 16 year may explain why I seem to have a higher intake as I'm always hungry and growing

 

[PseudoBob77]

Don't know if this helps at all, but I've continued to eat the same amount of carbs as I had been before I was diagnosed a year ago (minus the carbs snacks otherwise I'd have to bolus). I tend to have around 200g a day and am managing just fine. In my opinion you should have as much or as little as you want, making sure that it doesn't effect your bg levels control. The fact that I'm a 16 year may explain why I seem to have a higher intake as I'm always hungry and growing

A low carb intake for me is between 100-150, my average sits at around 225, and the peak end I think I clocked about 580 one day in the last four months.

 

[Robbity]

I heard the brain runs better whilst your in ketosis.
Anyone else heard that?

My brain definitely runs better in ketosis. Before I went on a very low carb diet I'd ended up in a zonked our zombie like state for several years... Changing my brain fuel worked a little miracle for me, and few too many carbs will still sometimes knock me for six...

Robbity


PS Maybe try a Google search for epilepsy and ketosis, or Alzheimers and ketosis;and it seems too that brains occasionally can actually become insulin resistant...

 

[TorqPenderloin]

Your nutritionist is sadly mistaken. I'd love to have a conversation with her (using my partially functioning brain) and explain the basic differences between glycolysis and ketosis.

Even if there was a minimum carb intake needed to survive, I wonder why she thinks 130g carbs/day is the magic number.

Side note: based on the answers she gave you....you may want to ask if she's been eating less than 130g of carbs/day herself

 

[steve_p6]

My brain works much better with my HBA1c below 7 as opposed to when i was running up in the 9s.