Ketonauts, how forgiving are your meal doses?

[mentat]

I've been in ketosis for nearly three weeks (ketones over 1.5) and I'm not finding dosing to be as forgiving as I expected.

My mealtimes NovoRapid doses are about 3 or 4 units but it seems that being too low by 1 unit can mean a drop of 5mmol/L and too high by 1 unit can mean a rise of 5mmol/L. Because of this I'm running my sugars at 9 or so, so that I can prevent hypos without eating carbs (e.g. black coffee.)

I think my basals are good... when I'm fasting sugars are very stable and when I "get a meal dose right" it's very stable too.

What are other people in keto finding?

 

[Juicyj]

Hello @mentat I am not a keto as such as will eat carbs as and when I know I can tolerate them, but have noticed if I do eat low carb that my tolerance to carbs get's much worse and I need to take more insulin than usual to cope with them when I do have them.

 

[NicoleC1971]

I'd agree that it isn't straightforward re dosing. I am a ktonaut too except on Fridays.
I find my blood sugars to be much more responsive to protein when I am eating very low carb and I have to do half the dose I would do for the carbs ideally taken before I eat as once I have spiked it is harder to get blood sugars into range.
I think the great Doctor B says to eat consistent amounts and at consistent times across your day but that's easier said than done!
I am sure others will be along soon who get great results (Not me currently).

 

[Antje77]

I'm not eating keto, so those are just some random thoughts.
Would a half unit pen be of help? The novopen echo is used for novorapid and does half units.
I'm also curious as to why you're aiming for ketosis. If the goal is to have healthier bg it may not be ideal if it forces you to aim for around 9.
Yope you'll find a way that suits you!

 

[JAT1]

My mealtimes NovoRapid doses are about 3 or 4 units but it seems that being too low by 1 unit can mean a drop of 5mmol/L and too high by 1 unit can mean a rise of 5mmol/L.

Please explain further. It sounds like your blood sugar drops when you take less NovoRapid and goes higher when you take more NovoRapid.

 

[michita]

I eat around 50g of carbs a day in 2 meals. I normally inject 2 units for a meal (so for 25g carbs) and stay relatively stable. Luckily I don’t see any noticeable rise from protein.

How much carbs/protein do you have in a meal and at what stage do you see the 5 mmol rise/drop?

I also think it’s more important to keep good bs level than be in ketosis. Maybe you can experiment with higher carbs if you think proteins are giving this problem. I hope you can find a good balance

 

[mentat]

Please explain further. It sounds like your blood sugar drops when you take less NovoRapid and goes higher when you take more NovoRapid.

Whoops I got that backwards! More insulin = sugar drop lol.

Would a half unit pen be of help?

I use syringes and do half-unit dosing.

If the goal is to have healthier bg it may not be ideal if it forces you to aim for around 9.

Actually it's already better than any other diet I've tried. I normally aim for around 7 (due to other health conditions) but since using carbs for hypos will screw up ketosis I'm aiming for 9 right now. Due to much more stable sugars my average has already gone down by 0.5 to 1 mmol/L.

How much carbs/protein do you have in a meal and at what stage do you see the 5 mmol rise/drop?

E.g. 40g protein and zero carbs... the rise tends to gradually ramp up from the start while a drop can be more sudden after say an hour. Although sometimes lots of fat and sometimes not. Maybe that's a big factor...

I also think it’s more important to keep good bs level than be in ketosis. Maybe you can experiment with higher carbs if you think proteins are giving this problem. I hope you can find a good balance

Had similar problems with low-carb. But I could treat hypos at least.

 

[JAT1]

E.g. 40g protein and zero carbs... the rise tends to gradually ramp up from the start while a drop can be more sudden after say an hour. Although sometimes lots of fat and sometimes not. Maybe that's a big factor...

For me, the ratio of fat to protein matters regarding how much the protein affects my blood sugar. There is always a delay before the protein raises my blood sugar, but lean meats send it up, whereas, fatty meats are hardly noticeable. For example, chicken breast will put my blood sugar up, whereas chicken legs don't seem to.