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Interested in trying low carb again but have concerns

B

boycat19

Member
Messages
14
Type of diabetes
Type 2
Hi
I am interested in going LCHF again after first trying it in September 2016. At that time I was taking Dapaglifluorizine (incorrect spelling no doubt) and Metrofmin and after 5 days on the keto diet I ended up with DKA secondary to sepsis and spent 5 days in hospital. It was there I was put on insulin. Since then my Diabetic Nurse has increased my insulin every few weeks whilst telling me not to worry about how many carbs I was eating. I believe this advice to be ridiculous and in following it, I have gained 2 stones in weight.
I am keen to try LCHF again but am now scared in case my blood ph drops due to high ketones and my BG rises too high and I end up with DKA.
However, I am assuming that because I am now injecting insulin DKA would be less likely to happen. My other concern is how much insulin to inject whilst eating low carbs. Last time I was having less than 20 grams of carbs per day, but this time I was thinking of between 100 and 150 grams per day.
I would love some advice from anyone who has some experience of this.
Many thanks
 
boycat19 said:
Hi
I am interested in going LCHF again after first trying it in September 2016. At that time I was taking Dapaglifluorizine (incorrect spelling no doubt) and Metrofmin and after 5 days on the keto diet I ended up with DKA secondary to sepsis and spent 5 days in hospital. It was there I was put on insulin. Since then my Diabetic Nurse has increased my insulin every few weeks whilst telling me not to worry about how many carbs I was eating. I believe this advice to be ridiculous and in following it, I have gained 2 stones in weight.
I am keen to try LCHF again but am now scared in case my blood ph drops due to high ketones and my BG rises too high and I end up with DKA.
However, I am assuming that because I am now injecting insulin DKA would be less likely to happen. My other concern is how much insulin to inject whilst eating low carbs. Last time I was having less than 20 grams of carbs per day, but this time I was thinking of between 100 and 150 grams per day.
I would love some advice from anyone who has some experience of this.
Many thanks
Click to expand...

It might be better posting this as a new question as I suspect it will get a bit lost under the heading of Hunger pangs. I don't know if a moderator can move it for you or whether you just need to start a whole new topic - sorry I don't have any advice on your diabetes issues
 
boycat19 said:
Hi
I am interested in going LCHF again after first trying it in September 2016. At that time I was taking Dapaglifluorizine (incorrect spelling no doubt) and Metrofmin and after 5 days on the keto diet I ended up with DKA secondary to sepsis and spent 5 days in hospital. It was there I was put on insulin. Since then my Diabetic Nurse has increased my insulin every few weeks whilst telling me not to worry about how many carbs I was eating. I believe this advice to be ridiculous and in following it, I have gained 2 stones in weight.
I am keen to try LCHF again but am now scared in case my blood ph drops due to high ketones and my BG rises too high and I end up with DKA.
However, I am assuming that because I am now injecting insulin DKA would be less likely to happen. My other concern is how much insulin to inject whilst eating low carbs. Last time I was having less than 20 grams of carbs per day, but this time I was thinking of between 100 and 150 grams per day.
I would love some advice from anyone who has some experience of this.
Many thanks
Click to expand...
My diabetic history is very similiar except I've become disabled after trying canagliflozin which is dapagliflozin's sister drug.
I've managed to reduce my mixed insulin and have just started to lose weight but I too had to reintroduce some carbs back in my diet to do it. I've dropped cheese, nuts and cream. Oh and veg. Veg was giving me loose tum, worse than a metformin tum.
I tired twice to drop insulin but failed twice but never lost weight lowering insulin anyway.
I initially only added half a stone on starting insulin but over a period and christmas I added with bad carbs.
I think too much fat was fattening for me. I guess because the carbs and protein combined were enough for me.
If I was a newee to diabetes I would have probables found success in lchf but insulin gives me the chance of a low calorie diet and weight loss.
 
Hi at @boycat19, what insulin are taking? You will need to get medical advice and help with adjustment if you are going to change your diet.
 
boycat19 said:
Hi
I am interested in going LCHF again after first trying it in September 2016. At that time I was taking Dapaglifluorizine (incorrect spelling no doubt) and Metrofmin and after 5 days on the keto diet I ended up with DKA secondary to sepsis and spent 5 days in hospital. It was there I was put on insulin. Since then my Diabetic Nurse has increased my insulin every few weeks whilst telling me not to worry about how many carbs I was eating. I believe this advice to be ridiculous and in following it, I have gained 2 stones in weight.
I am keen to try LCHF again but am now scared in case my blood ph drops due to high ketones and my BG rises too high and I end up with DKA.
However, I am assuming that because I am now injecting insulin DKA would be less likely to happen. My other concern is how much insulin to inject whilst eating low carbs. Last time I was having less than 20 grams of carbs per day, but this time I was thinking of between 100 and 150 grams per day.
I would love some advice from anyone who has some experience of this.
Many thanks
Click to expand...
Morning,

Dietary ketosis and DKA are two very different things. Although DKA in T2's is extremely rare, it can happen. However, it's typically caused by an underlying medical condition, combined with chronically high BG levels.

I think it's likely that you just coincidentally developed DKA whilst on the keto diet. What I find most probable is that having sepsis drove your sugars right up, and that combined with insufficient insulin production was the cause of your DKA.

You can always seek the advice of your dietician if you want to go down the LCHF route again, although it's unlikely that you'll find NHS staff that are happy to endorse something like LCHF...

Although I'm T1, I've followed the LCHF diet before and had no real issues whilst on insulin injections. Although LCHF isn't for me, I certainly had no problems with DKA.
 
ickihun said:
My diabetic history is very similiar except I've become disabled after trying canagliflozin which is dapagliflozin's sister drug.
I've managed to reduce my mixed insulin and have just started to lose weight but I too had to reintroduce some carbs back in my diet to do it. I've dropped cheese, nuts and cream. Oh and veg. Veg was giving me loose tum, worse than a metformin tum.
I tired twice to drop insulin but failed twice but never lost weight lowering insulin anyway.
I initially only added half a stone on starting insulin but over a period and christmas I added with bad carbs.
I think too much fat was fattening for me. I guess because the carbs and protein combined were enough for me.
If I was a newee to diabetes I would have probables found success in lchf but insulin gives me the chance of a low calorie diet and weight loss.
Click to expand...

Thank you for your reply.
I am beginning to think a low calorie diet is the best for me. My most successful weight loss was calorie counting 20 years ago, when I lost 5 stones. I don't think I could go down to 1,000 calories a day this time, but maybe 1,500 would be O.K. My BG levels although still too high are quite stabilised with the amount of insulin I am taking, and I have stopped putting on weight.
 
GrantGam said:
Morning,

Dietary ketosis and DKA are two very different things. Although DKA in T2's is extremely rare, it can happen. However, it's typically caused by an underlying medical condition, combined with chronically high BG levels.

I think it's likely that you just coincidentally developed DKA whilst on the keto diet. What I find most probable is that having sepsis drove your sugars right up, and that combined with insufficient insulin production was the cause of your DKA.

You can always seek the advice of your dietician if you want to go down the LCHF route again, although it's unlikely that you'll find NHS staff that are happy to endorse something like LCHF...

Although I'm T1, I've followed the LCHF diet before and had no real issues whilst on insulin injections. Although LCHF isn't for me, I certainly had no problems with DKA.
Click to expand...


Thank you for your reply.
I think what you said in your 2nd paragraph is probably true. It was an unfortunate coincidence.
As you say, the NHS are just not interested in LCHF. I was told to have 200 grams of carbs per day by the dietician.
I suffer with acid reflux so a high fat diet is not very good for me really. I think I need to go back to calorie counting whilst watching my carb intake.
 
boycat19 said:
Thank you for your reply.
I think what you said in your 2nd paragraph is probably true. It was an unfortunate coincidence.
As you say, the NHS are just not interested in LCHF. I was told to have 200 grams of carbs per day by the dietician.
I suffer with acid reflux so a high fat diet is not very good for me really. I think I need to go back to calorie counting whilst watching my carb intake.
Click to expand...

You don't have to overdo the fat to do a low carb diet. You just have to increase it a bit. The lower carb you go the higher fat is needed, but you can just try less fat but real fat, not low fat products. Real yogurt, butter, etc. Calorie count by all means, but to reduce your blood sugars you need to reduce the carbs.
 
Indy51 said:
The DKA was more likely a side effect of the canagliflozin - there is a warning thread about it elsewhere on the forum:

http://www.diabetes.co.uk/forum/thr...-on-the-risk-of-diabetic-ketoacidosis.104325/

That said, I recently heard some ketogenic diet experts saying that keto should never be recommended for anyone taking that class of drug.
Click to expand...

I found out afterwards, that anyone taking Dapagliflourizine should be told to look out for the symptoms of DKA! Pity my diabetic nurse forgot to mention that when she prescribed the Dapa. There is no mention of that in the leaflet accompanying the drug either! It makes me wonder if our healthcare professionals really know what they are doing and the side effects of the drugs they prescribe.
 
boycat19 said:
Thank you for your reply.
I am beginning to think a low calorie diet is the best for me. My most successful weight loss was calorie counting 20 years ago, when I lost 5 stones. I don't think I could go down to 1,000 calories a day this time, but maybe 1,500 would be O.K. My BG levels although still too high are quite stabilised with the amount of insulin I am taking, and I have stopped putting on weight.
Click to expand...
Give it a try. You must find what works for you.
I think my reintroduced metformin has just started to kick in too. Last time I lost 2 st on it but I'm low carb armed now so I'm hoping will give me a greater loss.
I'm just delighted to lose, for a change. I'm exercising relaxation too, which is a novelty to me.
Keep us updated on how you get on.
 
Alison Campbell said:
Hi at @boycat19, what insulin are taking? You will need to get medical advice and help with adjustment if you are going to change your diet.
Click to expand...


I am now prescribed 8 units Apidra at breakfast, 28 at lunch and 32 at tea time. With a 1 insulin unit adjustment per 1 mmol/L over 10 mmol/L's. I also have 55 units of Tresiba at night.
I have mentioned a LCHF diet to the dietitian but was told to eat a healthy balanced diet with around 200 grams of carbs per day. I think that is too many carbs to lose weight. I really don't feel I am being given any help by the diabetic team. They have no idea how many carbs I am currently eating to give me my current BG readings, not do they want to know!
I have a Freestyle Libre Monitor, so I can easily keep an eye on my BG levels and adjust my insulin.
 
boycat19414697 said:
Thank you for your reply.
I think what you said in your 2nd paragraph is probably true. It was an unfortunate coincidence.
As you say, the NHS are just not interested in LCHF. I was told to have 200 grams of carbs per day by the dietician.
I suffer with acid reflux so a high fat diet is not very good for me really. I think I need to go back to calorie counting whilst watching my carb intake.
Click to expand...
Just be aware the dietary reflux is from carbs not fat. If I have butter on bread, its the bread which is causing it. Have a watch even with low fat spread. To be honest I'm not going back to low fat spreads. Theres something not quite right about them. They never help me lose weight.
I'm doing a low carb (100g) healthy fats, watching calorie diet/regimen. With sufficient insulin and bareable metformin.
Not sure if I'll lose tomorrow as I've had a birthday treat.
Did your dn advise you to increase your insulin by 2 units at a time or 5 units at a time?
Give them a call for reduction advice with multiple hypo readings. Try and avoid shocking your system with fast reduction. Slowly reduce til hypos disappear. Always treat your hypo well. Take dn's guidance. Goodluck!
 
Just from my personal experience. my acid reflux and bloating all stopped after going very low carb.
Have you heard of Dr Jason Fung. He has had great success with Type 2's and reducing and in some cases stopping insulin for them. Maybe have a read on his website

https://intensivedietarymanagement.com

Some of the testimonials may be of interest..
 
ickihun said:
Just be aware the dietary reflux is from carbs not fat. If I have butter on bread, its the bread which is causing it. Have a watch even with low fat spread. To be honest I'm not going back to low fat spreads. Theres something not quite right about them. They never help me lose weight.
I'm doing a low carb (100g) healthy fats, watching calorie diet/regimen. With sufficient insulin and bareable metformin.
Not sure if I'll lose tomorrow as I've had a birthday treat.
Did your dn advise you to increase your insulin by 2 units at a time or 5 units at a time?
Give them a call for reduction advice with multiple hypo readings. Try and avoid shocking your system with fast reduction. Slowly reduce til hypos disappear. Always treat your hypo well. Take dn's guidance. Goodluck!
Click to expand...


I take daily medication - Nexium - and don't eat a lot of fat these days. I tend to suffer if I have pizza or proper chips (not very often), so I always thought the fat was to blame.

The DN's have increased my insulin by 2 units since I started on it in September. I call them every couple of weeks or so to give them my previous 5 days BG readings, and they make adjustments. I don't suffer hypos at the moment but am worried about them if I decrease carbs without reducing insulin - especially in the middle of the night. I will take it slowly in reducing the carbs and the insulin, and let the DN know. Thanks for your help.
 
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