Type 1 Hyper on low carb :(

[deborabaratto]

Hello everyone! I'm a type 1 following low carb diet and physical exercise everyday. But Friday I ate more meat than usual (2 hamburgers, only with salad and guacamole) and my glycemia went from 4 (pre meal), to 6 (after 2h, and I had 0,3u of novorrapid) to 17 during the night and all morning.
I'm really upset because I didn't eat anything but meat and fat and veggies so I don't know what could have caused it.
First I thought it was a random thing but yesterday I made a cauliflower pizza, with cauliflower, 1egg and some parmesan and the same thing happened : 4 (pre meal), I had 0,3 UI at the time and a bolus of 0,5 for 4 hours just in case. This morning my BS was 14! (The topping was only cheese and a bit of pepperoni)



Can someone help me figure it what happened?

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[catapillar]

Did you bolus for the protein? Gluconogenesis is when the body turns the protein you eat into glucose to stor in your liver, and raise blood sugar. If you're eating carbs your body doesn't need to turn the protein into glucose because it has a much more easily accessible form of glucose in the carbs. If you aren't eating carbs, your body needs to get glucose from some where so it will perform gluconogenesis on the protein you eat. This is a process that can take a while tho, so protein might need a bolus for it 2 or 3 hours after eating.

The other thing would be to do some basal testing to check the hypers aren't related to a lack of basal insulin.

 

[Kristin251]

I bolus for half my protein as if they were carbs. I eat ultra lc and I gluconeogenis just as quickly ( though lower and slower) as if I ate carbs.

I prebolus 20 min before eating but I tested and tested to figure my bolus timing out. Humalog takes about 20 min to start working for me.

If I ate two burgers I would need to split my bolus. Some before and some an hour or so later and probably one more time for TWO burgers. Not sure as I could never eat two burgers in one sitting.

Meal size does matter with insulin and bg. I rarely eat more than three oz protein at a time or I would need to split my bolus to catch the tail end. I prefer a few small meals a day and a few nut snacks to avoid splitting and to keep very steady.

And with a very fatty meal ( especially animal fat) the peak is much longer, as in hours.

 

[Peppergirl]

I have this issue as I low carb too. When I eat meals with small carbs (bit of cauli or bran crackers so no more than 15g carbs), protein and high fat (cheese/fatty meat like lamb) I split bolus before and then another 4 hours after the meal as my BG will start to increase. I also found that late evening/early morning my BG will start to rise again so I bolus then too. It always happens when I eat meals with high fat (tends to be big meals too). When I eat fish/veg/salad of an evening, no such issues. Basal is fine so it's the fat and protein + liver starts to kick off in the early morning.

I eat hotdogs sometimes too which have deceptive carbs. I've found some frankfurters with have a 'trace' of carbs. Not really eating sausages either due to carb content. The extra meat you ate may be a factor in the BG increase. Also I was surprised at the amount of carbs in avocado...

 

[Kristin251]

I have this issue as I low carb too. When I eat meals with small carbs (bit of cauli or bran crackers so no more than 15g carbs), protein and high fat (cheese/fatty meat like lamb) I split bolus before and then another 4 hours after the meal as my BG will start to increase. I also found that late evening/early morning my BG will start to rise again so I bolus then too. It always happens when I eat meals with high fat (tends to be big meals too). When I eat fish/veg/salad of an evening, no such issues. Basal is fine so it's the fat and protein + liver starts to kick off in the early morning.

I eat hotdogs sometimes too which have deceptive carbs. I've found some frankfurters with have a 'trace' of carbs. Not really eating sausages either due to carb content. The extra meat you ate may be a factor in the BG increase. Also I was surprised at the amount of carbs in avocado...

I eat an avocado a day. They are high carb but very high fiber and fat. I find they stop the dips and the peaks. Kind of a bridge between insulin and bf. I have 1/3 with each meal.

Fatty meals that are plant fats do very little to my bg. Like avo, olive oil, mayo, macadamia nuts. But fatty meats and dairy are very different.

I start rising around 6 am no matter what I eat so if I wake up I do take a small bolus. If I don't wake up I correct it when I do get up.

I love lamb and often have lamb chops but I cut the meat off the bone and all visible fat and eat in modest amounts. Then it doesn't effect me. But a fatty burger will. I buy 100% grass fed hot dogs that don't have a load of fat and they work well too. Fatty regular ones probably wouldn't. I also buy grass fed organic deli beef slices that are very lean. I smash avo in ktnand put it on a lettuce wrap. Sometimes with mayo and mustard for a change.

Generally bf is a thin slice of turkey or chicken on a lettuce wrap with avo smashed in. Lunch and dinner are more avo with 2 oz protein and some type of veg. Lots of times asparagus or salad.

Keeping portions small helps me tremendously. I eat 4 small meals a day. Bf, then I make my lunch and eat half at noon and half at 3. Then at 5 a small cheese snack then dinner around 6:30. A few nuts or olives in between.

I only take 1-2 units lantus so basal is gone by morning and I use humalog during the day. Usually 1/2 unit 4 times with food and an extra 1/2 an hour after bf to stop the morning get going rise. I sedon't m to need a small bolus every three hours as there's no basal left and I will just keep climbing.

This probably won't work for a lot of people but it does for me. With those small units I fear no hypos and stay very steady. It's my version of the pump.

 

[azure]

@deborabaratto The thread below might help as it discusses a similar problem :

http://www.diabetes.co.uk/forum/threads/low-carb-but-high-sugars-advice-please.123659/

.

 

[deborabaratto]

Did you bolus for the protein? Gluconogenesis is when the body turns the protein you eat into glucose to stor in your liver, and raise blood sugar. If you're eating carbs your body doesn't need to turn the protein into glucose because it has a much more easily accessible form of glucose in the carbs. If you aren't eating carbs, your body needs to get glucose from some where so it will perform gluconogenesis on the protein you eat. This is a process that can take a while tho, so protein might need a bolus for it 2 or 3 hours after eating.

The other thing would be to do some basal testing to check the hypers aren't related to a lack of basal insulin.

I only had 0,4ui of novoRapid, because usually I don't take more than that for my meals - but in this case I had the double of meat, so taking more insulin makes sense.
And to figure it out how much protein increases my BS do you have any advice?

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[deborabaratto]

I bolus for half my protein as if they were carbs. I eat ultra lc and I gluconeogenis just as quickly ( though lower and slower) as if I ate carbs.

I prebolus 20 min before eating but I tested and tested to figure my bolus timing out. Humalog takes about 20 min to start working for me.

If I ate two burgers I would need to split my bolus. Some before and some an hour or so later and probably one more time for TWO burgers. Not sure as I could never eat two burgers in one sitting.

Meal size does matter with insulin and bg. I rarely eat more than three oz protein at a time or I would need to split my bolus to catch the tail end. I prefer a few small meals a day and a few nut snacks to avoid splitting and to keep very steady.

And with a very fatty meal ( especially animal fat) the peak is much longer, as in hours.

That was a great advice, thanks!
And yes, it was very difficult to eat two hamburgers but they were so tasty hahaha
I'm gonna try to stick with the same amount of protein as well, it's a lot safer.

Thanks a lot )

Sent from my XT1033 using Diabetes.co.uk Forum mobile app

 

[deborabaratto]

I have this issue as I low carb too. When I eat meals with small carbs (bit of cauli or bran crackers so no more than 15g carbs), protein and high fat (cheese/fatty meat like lamb) I split bolus before and then another 4 hours after the meal as my BG will start to increase. I also found that late evening/early morning my BG will start to rise again so I bolus then too. It always happens when I eat meals with high fat (tends to be big meals too). When I eat fish/veg/salad of an evening, no such issues. Basal is fine so it's the fat and protein + liver starts to kick off in the early morning.

I eat hotdogs sometimes too which have deceptive carbs. I've found some frankfurters with have a 'trace' of carbs. Not really eating sausages either due to carb content. The extra meat you ate may be a factor in the BG increase. Also I was surprised at the amount of carbs in avocado...

Hmmmmm interesting.
I'm gonna pay more attention to It (eating more fat and protein) and try to use the multiwave bolus!
Really? I thought that avocado was a low carb fruit

Oh well, but thanks for the advice, I appreciate it

Sent from my XT1033 using Diabetes.co.uk Forum mobile app

 

[deborabaratto]

I eat an avocado a day. They are high carb but very high fiber and fat. I find they stop the dips and the peaks. Kind of a bridge between insulin and bf. I have 1/3 with each meal.

Fatty meals that are plant fats do very little to my bg. Like avo, olive oil, mayo, macadamia nuts. But fatty meats and dairy are very different.

I start rising around 6 am no matter what I eat so if I wake up I do take a small bolus. If I don't wake up I correct it when I do get up.

I love lamb and often have lamb chops but I cut the meat off the bone and all visible fat and eat in modest amounts. Then it doesn't effect me. But a fatty burger will. I buy 100% grass fed hot dogs that don't have a load of fat and they work well too. Fatty regular ones probably wouldn't. I also buy grass fed organic deli beef slices that are very lean. I smash avo in ktnand put it on a lettuce wrap. Sometimes with mayo and mustard for a change.

Generally bf is a thin slice of turkey or chicken on a lettuce wrap with avo smashed in. Lunch and dinner are more avo with 2 oz protein and some type of veg. Lots of times asparagus or salad.

Keeping portions small helps me tremendously. I eat 4 small meals a day. Bf, then I make my lunch and eat half at noon and half at 3. Then at 5 a small cheese snack then dinner around 6:30. A few nuts or olives in between.

I only take 1-2 units lantus so basal is gone by morning and I use humalog during the day. Usually 1/2 unit 4 times with food and an extra 1/2 an hour after bf to stop the morning get going rise. I sedon't m to need a small bolus every three hours as there's no basal left and I will just keep climbing.

This probably won't work for a lot of people but it does for me. With those small units I fear no hypos and stay very steady. It's my version of the pump.

That's awesome advice! I usually try to eat always some fat as well, like olive oil on my eggs in the morning and at the salad during lunch and it works great. I love avocado, so I'll try your ideia as well thanks!
For these big portions of meat, I thought they were harmless, but either I'm taking now a different bolus or not eating that much (a much better idea)

Thanks a lot for showing me how you do it

Sent from my XT1033 using Diabetes.co.uk Forum mobile app

 

[Kristin251]

That's awesome advice! I usually try to eat always some fat as well, like olive oil on my eggs in the morning and at the salad during lunch and it works great. I love avocado, so I'll try your ideia as well thanks!
For these big portions of meat, I thought they were harmless, but either I'm taking now a different bolus or not eating that much (a much better idea)

Thanks a lot for showing me how you do it

Sent from my XT1033 using Diabetes.co.uk Forum mobile app

Anytime!!! My typos didn't make sense haha
The avo with all its healthy fat and fiber seem to bridge the gap between insulin coming in too early or too late from my food and it just keeps me steady with no dips or peaks. Without it I would either dip or rise. I think the fat and fiber slow food and insulin so they meet in the middle.

I hadn't realized how much protein effected me either. Then it became obvious. I don't like feeling full/ stuffed so I tend to not over eat. I spent too many years bloated. In the event I do over eat I have to continuously take small boluses to avoid dropping and try to match the timing of the food digesting. I also know if I over eat protein my bs will run a bit higher for a few DAYS! I have to watch protein almost as much as carbs. And in keto land I need to keep glycogen stores near empty and protein fills those up as well. Then it takes a few days to empty them until bg returns to normal.

So after loads and loads of testing, trying to calculate, time things and questioning how much insulin blah blah blah, I basically landed on eating the same TYPE meal at the same times everyday. ( this through Bernstein) Then I found my dose for each one and I'm on autopilot now. It took the fears out of hypos and the anxiety of counting, measuring, thinking.
7:30 am Bf is a piece of deli meat and 1/3 avo smashed in it on a lettuce wrap. I bolus at 7:30 wait 20 min and eat. Then an hour later another small bolus with no food. Bf insulin can vary a bit depending on fasting.

Lunch is split into 2 meals and is 1/3 avo, 2 oz protein either on lettuce, salad or a few asparagus spears. 1/2 unit noon and three

5:00 ounce of cheese and a cocktail. No bolus

6:30 dinner. 1/2 unit. 2 oz protein 1/3 avo and more of the same veg.

A few Macs or pumpkin seeds in between and before bed ( they help me sleep)

I use mayo or olive oil where desired without hesitation.

This is what works for me and 95% of the time I'm between 80-100.
I did LOADS of testing to find this routine. I don't like my life revolving around food and calculating. I precook lots of protein in bulk and freeze in two ounce portions. Then I have loads of options everyday and everymeal.

Good luck!! I love keto