Keto - More insulin required?

Mflannagan

Newbie
Messages
3
Type of diabetes
Type 1
Treatment type
Insulin
Hi, I'm pretty new to the forum. Started keto a few weeks ago and finding that I'm actually requiring more insulin. Had bacon and eggs yesterday for lunch cooked in butter with some dry roasted peanuts. Total of about 15g of carbs, and I need 4 units, then 2 additional units. My levels on only steadily rise but then don't seem to come down without a correction dose. Is it the protein, is it my body adapting?

All that in mind my levels are far better and I don't see the same spikes.
 

In Response

Well-Known Member
Messages
3,706
Type of diabetes
Type 1
Treatment type
Pump
I find, in the absence of carbs, I need insulin for protein. Protein is converted to glucose slower, so the insulin is taken later. I also found that the insulin to protein ratio varies a lot depending upon the type of protein. I gave up trying to remember the different ratios needed for eggs, nuts, salmon, etc. and went back to eating carbs.
The other thing I have read (but did not continue the diet to experience it myself) is that a low/no carb diet increases insulin resistance so you may be more basal.
 
Last edited:
  • Agree
Reactions: filly and EllieM

HSSS

Moderator
Staff Member
Moderator
Messages
7,566
Type of diabetes
Type 2
Treatment type
Diet only
The other thing I have read (but did not continue the diet to experience it myself) is that a low/no carb diet increases insulin resistance so you may be more basal.
The insulin resistance you mention may well be adaptive glucose sparing (physiological resistance rather than pathological). To be noted it goes away within days of reintroducing carbs. I would guess for a type 1 insulin dosing purposes the difference between different types of IR is immaterial.

Where it does matter is in type 2 where pathological IR is our main issue. This specific temporary form of IR doesn’t cause damage in the way the more typical one does and is done to preserve the essential small amounts of glucose, the brain and a few other processes absolutely require, in the absence of all but minimal carbs. It can mean slightly raised fasted readings but maintains good responses to keto meals and a flatter line all day resulting in fewer peaks and troughs and better hba1 ultimately

edited for clarity
 
Last edited:

EllieM

Moderator
Staff Member
Moderator
Messages
9,595
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
hypos and forum bugs
My dietician told me that I would need higher insulin ratios for a low (less than 100g) diet. I believe (possibly incorrectly) that my total insulin dose is less than I would need for a higher carb diet.

Still not counting protein but possibly I should?

I have a differet insulin ratio for mornings when I eat breakfast and mornings when I don't...
 

Mflannagan

Newbie
Messages
3
Type of diabetes
Type 1
Treatment type
Insulin
Interesting, I've definitely noticed the protein takes longer to absorb, which makes it much easier to control. I just can't understand why I'm needing the same dose that I would for a normal carb meal.
Im hoping that the diet doesn't cause insulin resistance. In theory it shouldn't given the way fat is absorbed into the body, maybe just takes time for body to start actually burning this for fuel. I'm not quite 2 weeks in so I'll need to give it longer. Cheers for the reply.
My dietician told me that I would need higher insulin ratios for a low (less than 100g) diet. I believe (possibly incorrectly) that my total insulin dose is less than I would need for a higher carb diet.

Still not counting protein but possibly I should?

I have a differet insulin ratio for mornings when I eat breakfast and mornings when I don't...
Interesting. As it's only been a few weeks I need to give it time. Definitely much better control already, I just assumed I'd need hardly any short acting fiasp as I'm eating very few carbs.
How's the low carb diet working for you overall?
 

Melgar

Moderator
Staff Member
Moderator
Messages
871
Type of diabetes
Other
Treatment type
Tablets (oral)
The insulin resistance you mention may well be adaptive glucose sparing (physiological resistance rather than pathological). To be noted it goes away within days of reintroducing carbs. I would guess for a type 1 insulin dosing purposes the difference between different types of IR is immaterial.

Where it does matter is in type 2 where pathological IR is our main issue. This specific temporary form of IR doesn’t cause damage in the way the more typical one does and is done to preserve the essential small amounts of glucose, the brain and a few other processes absolutely require, in the absence of all but minimal carbs. It can mean slightly raised fasted readings but maintains good responses to keto meals and a flatter line all day resulting in fewer peaks and troughs and better hba1 ultimately

edited for clarity
Health line.com discusses their keto diet findings (although they do not cite their sources for this) on mice. I quote “They found that keto diets don’t allow the body to properly use insulin, so blood sugar isn’t properly controlled. That leads to insulin resistance” ……… Which I’m guessing is what you are saying @HSSS .

@Mflannagan have you been diagnosed T1 late onset? If you have then LADA is known to have some similarities with may T2. Insulin resistance maybe present.
 

JAT1

Well-Known Member
Messages
570
Type of diabetes
Type 1
Treatment type
Insulin
I'm type 1 doing low carb. It works very well for me, keeping me in a tighter blood sugar range, without the spikes and drops. I take one unit more of basal than when I was on a higher carb diet and actually my fast-acting insulin to carb ratio has improved. It used to be 1:10 and now it's 1:15. I don't factor protein into my calculation of how much fast-acting to inject and I believe the extra basal is covering for it.
 

HSSS

Moderator
Staff Member
Moderator
Messages
7,566
Type of diabetes
Type 2
Treatment type
Diet only
Health line.com discusses their keto diet findings (although they do not cite their sources for this) on mice. I quote “They found that keto diets don’t allow the body to properly use insulin, so blood sugar isn’t properly controlled. That leads to insulin resistance” ……… Which I’m guessing is what you are saying @HSSS .

@Mflannagan have you been diagnosed T1 late onset? If you have then LADA is known to have some similarities with may T2. Insulin resistance maybe present.
I’m not saying glucose isn’t properly controlled. I’m saying glucose gets used differently than the accepted “norm on a carb heavy diet”. Insulin resistance comes in different ”flavours”, not all are problematic. I’m not a mouse. Perhaps it depends on the definition of “properly”
 
  • Like
Reactions: Melgar

Melgar

Moderator
Staff Member
Moderator
Messages
871
Type of diabetes
Other
Treatment type
Tablets (oral)
I’m not saying glucose isn’t properly controlled. I’m saying glucose gets used differently than the accepted “norm on a carb heavy diet”. Insulin resistance comes in different ”flavours”, not all are problematic. I’m not a mouse. Perhaps it depends on the definition of “properly”
Ha, no you are not a mouse @HSSS , not as far as I’m aware!
 

Melgar

Moderator
Staff Member
Moderator
Messages
871
Type of diabetes
Other
Treatment type
Tablets (oral)
@HSSS thanks for the mention about IR coming in ‘different flavours’. I found this piece on IR

‘Insulin resistance in an energy-centered perspective’, Ping Wang, Edwin C M Mariman, 2008.

I couldn't attach the link as I’m not at home.
I had no idea there are positives associated with IR .

ed - spelling
 

HSSS

Moderator
Staff Member
Moderator
Messages
7,566
Type of diabetes
Type 2
Treatment type
Diet only
@HSSS thanks for the mention about IR coming in ‘different flavours’. I found this piece on IR

‘Insulin resistance in an energy-centered perspective’, Ping Wang, Edwin C M Mariman, 2008.

I couldn't attach the link as I’m not at home.
I had no idea there are positives associated with IR .

ed - spelling
This one ? https://pubmed.ncbi.nlm.nih.gov/18054972/
 
  • Like
Reactions: Melgar