Type 1 Ketosis problems!

[haza1988]

Hi... im type 1 have been for 4 yrs. Iv been eating 'keto' for 3 months, i say eating keto because i havent actualy been in ketosis yet!! Im grinded down ... my nhs dietician has no idea how to help other than stick to low carb (15-20g p/d)...
Iv found out that i need to try keep my insulin dose down as too much will affect adaptation. My doses are 25-30mmols basal. And 0 bolus!!
Can anyone who has done keto or is in ketosis and type 1 share there experience with me as im all alone with this 1 could do with help!!

 

[robert72]

hi @haza1988

What is your protein and fat intake?

 

[haza1988]

hi @haza1988

What is your protein and fat intake?

Hi.... thanks for repling,


Macros are 80 fat 15 pro 5 carb... im on my fitness pal so can keep a close eye on it. i have 2300kcals pd... works out to pro 87g carb 29g fat 206g.... most of the 29g carbs is fibre.... i weigh 12.12lb... sorry so detailed :/

 

[robert72]

Hi.... thanks for repling,


Macros are 80 fat 15 pro 5 carb... im on my fitness pal so can keep a close eye on it. i have 2300kcals pd... works out to pro 87g carb 29g fat 206g.... most of the 29g carbs is fibre.... i weigh 12.12lb... sorry so detailed :/

No, that's good detail. Same macros as me, yet I am usually in ketosis between 1 and 3 mmol. One thing I find that helps to get into ketosis is to have coconut oil or MTC oil.

 

[Robbity]

Just a thought, but how are you measuring your ketone levels? If you use Ketostix (testing urine) it may be that you are in ketosis, and your body's now using ketones efficiently, so you no longer see any surplus ones being flushed out in your wee. Which is what happened to me. (I'm type 2)

Robbity

 

[haza1988]

No, that's good detail. Same macros as me, yet I am usually in ketosis between 1 and 3 mmol. One thing I find that helps to get into ketosis is to have coconut oil or MTC oil.

U mean when you measure for ketones? (1-3) ye thats optimal ketosis if thats what u mean... and i have coconut oil every day at brek 30g... so how long till you showed ketones? And what was your insulin doses like?

 

[haza1988]

Hi @Robbity i use a blood meter alot more accurate! i drink alot of water and have come to know that more water dilutes ketones therefore givin inaccurate readings...

 

[robert72]

U mean when you measure for ketones? (1-3) ye thats optimal ketosis if thats what u mean... and i have coconut oil every day at brek 30g... so how long till you showed ketones? And what was your insulin doses like?

I can't really think of much else to try. I have been low-carb for almost 3 years now and I think it took a few months to get really keto adapted. My Insulin levels are currently 16u basal and 2 x 7u bolus

 

[haza1988]

Right ok thanks for advice speak soon

 

[tim2000s]

@haza1988 You haven't mentioned your blood glucose levels at all throughout this discussion. You don't need to reduce your insulin levels on order to get into ketosis, but you also don't want your blood glucose levels getting too high while you are doing it as that indicates that you don't have enough insulin on board.

 

[haza1988]

Sorry bout that thats because its been the norm to me too have normal bloods after all thats the most important thing before anything... yes there normal infact excellent... im well aware high blood sugars and lack of insulin will result in keacidosis! So to confirm my basal dose is at a level which my body requires my bs to be normal

 

[tim2000s]

Sorry bout that thats because its been the norm to me too have normal bloods after all thats the most important thing before anything... yes there normal infact excellent... im well aware high blood sugars and lack of insulin will result in keacidosis! So to confirm my basal dose is at a level which my body requires my bs to be normal

That's not really what I was concerned about. You say that you've been doing no bolusing - what do your bg levels look like before, one hour and two hours after a meal?

When you are very low carb, eating protein can and does induce a glucagon reaction, as can, say salad, so you may need to be taking insulin with meals, as the spikes could be occurring and raising your levels enough post-prandially to stop ketosis.

 

[haza1988]

Ye i understand what ur sayin before a meal it ranges from 4 to 6... after 7-8 because im on the go most of the day i leave bolus out as even 1 unit would send me low and id have to eat glucose which i dont want to do... as for the glucagon my protein intake has been droped too 89g p/d... i do go gym and exercise so majority id like to think would be used in amino uptake... i may decide to go even lower it in future if becomes more of a struggle to adapt... as for salads and veg has very little effect whats so ever...

 

[haza1988]

I also intermitant fast and exercise to increase my insulin sensitivity... which is workin as day to day my basal dose is going down hopefully making adapting more possible

 

[tim2000s]

So here's the thing. You are eating <20g carbs per day, you are not taking very much insulin, your bloods are in range and you do loads of exercise, and yet, you aren't seeing ketones in your blood testing for them.

You also aren't eating a great deal of protein. Can you post a day's diet so we can see if there is anything in there that may be causing the issue?

 

[haza1988]

So here's the thing. You are eating <20g carbs per day, you are not taking very much insulin, your bloods are in range and you do loads of exercise, and yet, you aren't seeing ketones in your blood testing for them.

You also aren't eating a great deal of protein. Can you post a day's diet so we can see if there is anything in there that may be causing the issue?

I spoken with my dietician on friday and made some tweaks and changes but this is what my diet looks like from monday just gone. My brek and lunch remain the same dinner varies i tend to check how many macros i have left and make summat to suit....

Breakfast. (Omerlette).
2 whole eggs.
1 egg yolk.
10g of cheese.
30g coconut oil.
30g peanuts. (Dry roasted).

Lunch.
2 pork sausages.
125g cucumber.
Since yestaday i was havin an avacado but droped it cs found out it was 9g carb.
25g brasil nuts.
25g walnuts.

Then dinner will be any meat or fish/fat to make up my macros of 80%fat
15%pro 5% carb.
I eat veg with dinner broccali/sprouts...
And i do count the carbs in them and put them to total...

Snacks may inc dark 85% choc but ill try not to go over my calories 2220kcal (i lowered it as weighed same 2 days in row).

Also a question?? do i have to count the carbs in green leafy veg or broccalli/ sprouts as i no you dont have to include the fibre so eg... if my carb intake is 50g total with veg etc fibre is 25g total therefore my NET carb intake is 25g for day??

 

[tim2000s]

I spoken with my dietician on friday and made some tweaks and changes but this is what my diet looks like from monday just gone. My brek and lunch remain the same dinner varies i tend to check how many macros i have left and make summat to suit....

Breakfast. (Omerlette).
2 whole eggs.
1 egg yolk.
10g of cheese.
30g coconut oil.
30g peanuts. (Dry roasted).

Lunch.
2 pork sausages.
125g cucumber.
Since yestaday i was havin an avacado but droped it cs found out it was 9g carb.
25g brasil nuts.
25g walnuts.

Then dinner will be any meat or fish/fat to make up my macros of 80%fat
15%pro 5% carb.
I eat veg with dinner broccali/sprouts...
And i do count the carbs in them and put them to total...

Snacks may inc dark 85% choc but ill try not to go over my calories 2220kcal (i lowered it as weighed same 2 days in row).

Also a question?? do i have to count the carbs in green leafy veg or broccalli/ sprouts as i no you dont have to include the fibre so eg... if my carb intake is 50g total with veg etc fibre is 25g total therefore my NET carb intake is 25g for day??

So I've worked my way through this, and there is something I notice. Based on timing of your posts, I am assuming you are in the UK. In the foods you've listed for breakfast and lunch, I come out at 20g carbs in the day already (so I don't think you are likely to be eating less than 20g per day)and 34.5g of protein. If you are doing Low Carb, you should absolutely be including carbs from vegetables - for most people they count on this way of eating.

UK carb counts are already net of fibre, so if using a UK measure, do not deduct the fibre from the carb values as you'll end up with the wrong information.

What many people also find if you are hugely reducing carbs (and it's something I noticed on this way of eating) is that even small amounts of protein increase bg levels, but not necessarily when you'd expect. Given the macros in the foods you've shown, and that you're not using rapid acting insulin at all, you will, I'm guessing, be consuming around 50g of protein in the evening. If I was to do that, I would see a blood glucose rise about 3-5 hours post eating that protein, and it would be a few mmol/l.. This is likely to be when you are in bed. Have you checked your glucose levels overnight to see whether this is having an effect?

 

[haza1988]

Im in uk yes. Ill look closely into the carb intake i wasnt aware of the fibre been included... back to the drawin board... when i awake my bs are normally 1-2mmols higher if not the same dosent have much affect... anything u suggest on getting lower carbs even my sausages have carbs! And cucumber this is hard!!

 

[tim2000s]

Im in uk yes. Ill look closely into the carb intake i wasnt aware of the fibre been included... back to the drawin board... when i awake my bs are normally 1-2mmols higher if not the same dosent have much affect... anything u suggest on getting lower carbs even my sausages have carbs! And cucumber this is hard!!

Yes, it is! What do you consider a normal blood glucose range?

 

[haza1988]

Yes it is?5-7