How to get started? (Lowering Lantus)

[Tom30]

Hi all

After reading Dr Bernstein's excellent book the Diabetes Solution, I have decided to follow his recommendations and being low-carbing in order to try and both lose some weight and get my BG readings under tighter control.

I am currently 31 years old and have been diabetic since I was 7. I currently weigh just over 16 stone (which is mainly around my stomach area and face) although my optimum weight should be around 12-13 stone. I was put onto a basal (Lantus) bolus (Humalog lispro) insulin regime in 2002 following a few years of quite bad control and high HbA1C readings (around 8-9) as I was "rebelling" as a teenager by going out and drinking a lot and eating junk etc without checking my BG readings. My control is now fairly good (HbA1C is usually around 5-6) and while I sometimes get high readings on a morning, this is generally only if I have been drinking alcohol to excess the night before.

The main thing that I would like to do is to restrict my BG readings to the levels recommended by Dr B and I am prepared to go "hard routine" diet-wise to ensure this. I would also like to lose some weight however, and ideally get my weight down to around 12-13 stone. I have tried low-carbing before and although I didn't stick to it for very long, I noticed a weight loss of around 6-7lbs (overnight some days) although I invariably put it back on again, so my weight was always hovering around the 16 stone mark.

I only really started to put weight on (I was 13 stone in 2002) when I began the basal-bolus regime and so I am guessing that it is probably the Lantus which is responsible for this? I am currently on 50 units of Lantus which I take once a day (at the same time every day) and I am looking to reduce this without the adverse effects of high BG readings. Up until a few days ago, I was taking 58 units a day and experimentally I reduced this to 50 without noticing any significant effects on BG. For a meal with no (or low) carbs I have been taking around 3-4 units of Humalog, although this has resulted in a (fairly mild) hypo a couple of times which I've had to compensate for, so I need to avoid this if I can.

What I was wondering is if any of the other diabetics on this forum who have been on a similar regime to myself were able to reduce their insulin levels and how they did it? I don't particularly relish the idea of massively reducing my Lantus dose overnight and finding that I have raging high BG readings as a result of it!

Many thanks to anybody who replies Smiley

Tom

 

[stoney]

Hi Tom

Note sure if I can be of any help, but my son who is 14 has recently gone on the basal bolus regime (since Feb this year) and is carb counting with Novorapid and Lantus before bed. His ratios were 1:10g for breakfast, lunch and evening meal, but since we have noticed a pattern of low Bg's before evening meal, he is now on 1:15g for lunch. This has made a difference. Are you carb counting :?:

 

[mgibbon74]

Hi Tom

I am on exactly the same regime and insulin as yourself and am also looking to lose weight, any help that you have been given (ideas for low carbing etc) would be greatly appreciated, I have never tried low carbing before but a friend recommended it so thought I would give it a try

 

[jopar]

Bernstein isn't the easiest regime/diet to follow for many reasons..

To follow it you really do need to be using 3 different types of insulin..

Humalog for bernstein is normally too fast acting hence one of the reasons you are getting hypo's... Bernstein relies on the slowness of fat and protein to slow the adsorption of the limited carbs down... So you need to match this with a insulin soluable quick acting insulin such as Actrapid, humulin S etc so that the slower profile peak matches the adsorption profile better..

Then you humolog insulin really only comes in with tackling the need of giving a quick correction or a meal that is low in fat or protien..

Your background insulin, well the only way you are going to find out if that is at the correct levels is doing a fasting test to see what is happening, it may be that you might need to split lantus into two injecton..

Lantus though is know to increase weight as a side effect, so perhaps swapping over to levimer might help you out a bit, as this one doesn't seem to cause the weight gain so easily as the lantus..

If you are looking to do any diets, you really need to know your carb-insulin ratio's before hand so you can safely reduce the carbs and insulin together, plus also be very aware that has you lose weight your body may become less resistent to insulin so carb-insulin ratio's will need regular reviewing to ensure that they remian accuate..

Me I would look at what some of the other T1's are doing, their own version of low carbing with great success with verious different amounts of carbs..