Keto Diet and no Fast Acting Insulin

JoeT1

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Hi,

So over the last two or three days, I have gone ultra low carb. To the point where it's no more than 5g carbs per meal. Cauliflower rice, cabbage rice, keto bread etc. I have done this originally to see about losing a little it of excess weight. I think I have lost a couple of pounds this week doing this, but I have noticed something else.

Although it's still a low amount of carbs, I am not needing to take any fast acting insulin at all with my food. Even needing to lower the amount of Basal I am taking as it sends me near hypo, to the point I need a couple squares of chocolate last night, although I had put a lot of exercising in.

Has anyone experience of this sort of thing happening? I have read that keto can make you more sensitive to insulin and less insulin resistant. I really didn't expect that I wouldn't need any fast acting insulin though.

I'm under no illusion that this will stop, but just something to note and interesting. At the very least it's saved me from 6 extra injections over the weekend...
 

LooperCat

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I’m finding the same, started low carb about ten days ago, and some days I’ve not needed any Novorapid at all. Glad it’s not just me!
 
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Peppergirl

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I eat low carb for year and a half now. It took some time to work out basal rate (I'm on MDI) and carb ratios, I also bolus for protein (liver dump in morning is usually an issue). I have to bolus for protein. Maybe as you're starting out your rates need a tweak. My basal dose has lowered due to weight loss and maybe R-ALA I'm taking. I take tresiba and make small adjustments every now and again. Definitely lower amounts of insulin now which suits me (16u tresiba and average 10u novorapid a day - recently tried 12u of tresiba which worked for a bit but after a few days this was a bit too low). Hardly any hypos, no significant hypos at all, occasionally high 3's and low 4's. Some weeks I'm 98% in target range according to the libre, hardly ever above 7.5 after eating.

Starting low carb, I made small changes to my insulin while I worked out what foods I wanted, what spiked me, how long to leave it between meals, fasting etc. It's all work, it never ends :) Good luck
 
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NoKindOfSusie

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I find the less I eat the easier it is, but on the other hand I have people telling me to eat normally and just cover it. I wouldn't dare actually do that but I think there is a bit of wishful thinking in this whole normal eating thing.
 

JoeT1

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I find the less I eat the easier it is, but on the other hand I have people telling me to eat normally and just cover it. I wouldn't dare actually do that but I think there is a bit of wishful thinking in this whole normal eating thing.

I eat plenty of food when going keto, enough to fill me and more. I am only going low carb/keto really to shed just a few pounds to get to a weight i'm more comfortable at. My control has been just as good when eating more carbs, but no more really than 30g per meal for now, but i'll certainly work towards higher in the future, it's one step at a time really.

I also managed a gym session yesterday where I was a lot stronger than just a few weeks ago, and then played a game of astro turf last night where I covered a lot of ground. 2 Jelly Babies when I got home to cover the drop from an initial high (9mmol during the game due to adrenaline) and I was just fine. I'm beginning to feel so much healthier.
 

JoeT1

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Day 4 now and still no fast acting insulin needed. In fact, I have had to drop my Basal down quite a chunk in order to not go low.

It may not be long term, and may not be sustainable at all. Currently though I am feeling a tonne better and it's giving my injection sites a nice break.
 
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LooperCat

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Unless you know exactly how quickly and how much specific foods raise your sugars, and exactly how quickly a shot of insulin will start to work, (and factor in the precise effects of your stress levels, heat, hormones, and a million other vague things) it is next to impossible to eat normally without either spiking your blood sugar or having a hypo. It’s not just the dose, it’s the timing as well. I’m finding it much easier just to eat low carb.
 

Kristin251

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Unless you know exactly how quickly and how much specific foods raise your sugars, and exactly how quickly a shot of insulin will start to work, (and factor in the precise effects of your stress levels, heat, hormones, and a million other vague things) it is next to impossible to eat normally without either spiking your blood sugar or having a hypo. It’s not just the dose, it’s the timing as well. I’m finding it much easier just to eat low carb.
It’s the only way that works for me
And I agree, timing of the dose matters even low carb.
 
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to the point I need a couple squares of chocolate last night, although I had put a lot of exercising in.
Due to the fat in chocolate a couple of squares of chocolate would have a very delated affect in terms of avoiding a hypo.
However, depending on the type, intensity and length of exercise you did, this could easily reduce your insulin requirements as it can significantly increase your insulin efficiency and reduce your glycogen reserves (increasing your chances of hypo for the next 48 hours). I do not follow a ketonic (or low carb) diet but always reduce my basal insulin by 20 to 30% after high intensity exercise.
 

JoeT1

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Hi @JoeT1 - I watched this last night


The speaker is T1 GP, who is T1, using a keto diet.

http://type1keto.com/


Excellent, thanks for sharing. It just reinforces my belief that going down this route will be hugely beneficial in my control. I will see in the next month or two how my HBA1C is and that will give me an idea. I guess being my first HBA1C post diagnosis, I won't have a measurement against the higher carb diet, but I can see from my graphs at least what's been going on.

Again, I won't force this on people, they are completely free to do as they wish, and i'll certainly have a day or two every now and again where I eat more carbs, but 80% of the time, I think under 20g carbs a day is the way forward for me.

Update....took 1 unit of insulin last night as adrenaline of a training session brought me up to 7mmol. So that's 1 unit since Friday.
 
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DCUKMod

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Excellent, thanks for sharing. It just reinforces my belief that going down this route will be hugely beneficial in my control. I will see in the next month or two how my HBA1C is and that will give me an idea. I guess being my first HBA1C post diagnosis, I won't have a measurement against the higher carb diet, but I can see from my graphs at least what's been going on.

Again, I won't force this on people, they are completely free to do as they wish, and i'll certainly have a day or two every now and again where I eat more carbs, but 80% of the time, I think under 20g carbs a day is the way forward for me.

Update....took 1 unit of insulin last night as adrenaline of a training session brought me up to 7mmol. So that's 1 unit since Friday.

Joe - I met the presenter at a conference just before Christmas and we had a good old chat. He also showed me his CGM handset which demonstrated a pretty impressively flat line. He's on MDI with no desire to pump.

Good luck with it all.
 

JoeT1

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Joe - I met the presenter at a conference just before Christmas and we had a good old chat. He also showed me his CGM handset which demonstrated a pretty impressively flat line. He's on MDI with no desire to pump.

Good luck with it all.


Sounds great. At the moment, I actually don't think I have a desire to pump either, perhaps due to seemingly (fingers crossed) being able to avoid big spikes and having a relatively flat line a lot of the time. I sometimes wonder if a jump for no reason of maybe 1mmol, before coming back down, is the same for non diabetics, but am willing to take that any day of the week.

Thank you.
 

bulkbiker

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Hi @JoeT1 Not sure if you have seen Dr Lake's website but its here
http://type1keto.com
I had the pleasure of meeting him when he gave the talk linked to above and can confirm he's a charming guy.
 

DCUKMod

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Sounds great. At the moment, I actually don't think I have a desire to pump either, perhaps due to seemingly (fingers crossed) being able to avoid big spikes and having a relatively flat line a lot of the time. I sometimes wonder if a jump for no reason of maybe 1mmol, before coming back down, is the same for non diabetics, but am willing to take that any day of the week.

Thank you.

Joe - I'm not T1, so my body works a bit differently to yours, but I have been running my HbA1c at 33 or under for a few years now. OK, I'm not a person who has never had diabetes, but my body seems to have recovered pretty well.

Anyway, enough of all that jibber jabber.

When I have used Libres I have watched my 24 hour traces for weeks and weeks worth of data. So many things make our blood glucose move up or down, in a minor way. Examples of that would be the usual exercise, an adrenaline response, excitement and so on, but even bonkers things like visiting the loo can lead to a little blip-ette. Of course that's way TMI, but just trying to demo that our bloods wobble a bit, if we micromanage it deeply enough.

As you are finding, we all just have to find our own way to create our individual comfort zone we can sustain. I respect that for T1s that's a much bigger job than for someone like me who had a relatively easy trip with my diabetes.
 

becca59

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Just watched the clip, found it interesting and downloaded Bernstein’s book to my Kindle to find out more. Four years in, I have always been relatively low carb, but following what appears to be the end of a very protracted honeymoon period, my meagre insulin levels have taken somewhat of a hike. Have already progressed to cauliflower rice and courgetti and actually love them. Baby steps, but hey you have to start somewhere.
 

JoeT1

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Hi @JoeT1 Not sure if you have seen Dr Lake's website but its here
http://type1keto.com
I had the pleasure of meeting him when he gave the talk linked to above and can confirm he's a charming guy.

Hey,

Thank you. Yes, had a good read through it. Some great information in there. One thing I am a little confused about is the type of Doctor Dr Lake is?