LCHF - Basal - Dawn Phenomenon - Fixed??? :)

[Applenerd81]

Quick search but nothings popped up:

Have recently started Low Carb High Fat (LCHF), so far so good but with the occasional hypo. I have a flat basal profile except for 4-5 hrs in the morning where I am at around 200% normal rate to cover DP and reduced sensitivity at breakfast. This elevated rate is now causing hypos, dropped from 4.5 at waking to 2.8 just before leaving for work 30 mins later.

How do you manage DP when on LCHF? Are there any hard and fast rules for basal adjustment? Does DP stop when in ketosis?

Thanks in advance

*****Update August 2015, 8 months of LCHF in....***********

Hi all, just an update, I've been offline for a while with whole load going on at work.
I'm still living the LCHF lifestyle and am still having fantastic results with both bodyweight and diabetes control.
In the past 2 months my body has improved even further having noticed I was getting serious hypos at waking, I have tweaked my basal rate further and low and behold my pesky DP issues are no more! My basal profile is flat as pancake (0.75iu per hour) and my BGs are more stable than ever.
I don't understand the physiology behind how this has happened but am ecstatic at the results, happy days

 

[CarbsRok]

Quick search but nothings popped up:

Have recently started Low Carb High Fat (LCHF), so far so good but with the occasional hypo. I have a flat basal profile except for 4-5 hrs in the morning where I am at around 200% normal rate to cover DP and reduced sensitivity at breakfast. This elevated rate is now causing hypos, dropped from 4.5 at waking to 2.8 just before leaving for work 30 mins later.

How do you manage DP when on LCHF? Are there any hard and fast rules for basal adjustment? Does DP stop when in ketosis?

Thanks in advance

Simple solution is do a basal test and adjust according to the results

 

[novorapidboi26]

being low carb its should just be as simple as testing overnight and fine tuning your basal rates.............

you can usually get different rates in every half hour with most pumps........

I have two different rates overnight......

 

[Applenerd81]

Thanks but as a heads up; generally do basal rates drop and do the profiles (peaks and troughs) change by much?

BGs have been great thus far, all my hypos have been around the morning. Pre meals are in around 5-7 mark (am topping up with some fruit to maintain BG)

Having read what I've written I think I've answered my own question!

 

[Applenerd81]

Do your insulin to carb ratios change?

 

[novorapidboi26]

do basal rates drop..........? well, yeah, they can go up and down to suit whatever your liver is doing.......

peaks and troughs......? with the basal delivery there wont be a peak and trough, or not ones you need to factor in.....

you shouldn't need to eat anything to maintain blood sugar levels....especially on the pump...

insulin/carb ratios change also, again, as and when you need it..........

did you receive any carb counting/dose adjustment training prior to going on the pump......?

 

[CarbsRok]

Sounds to me as if you need to invest in the book pumping insulin by John Walsh (Amazon)

 

[Applenerd81]

do basal rates drop..........? well, yeah, they can go up and down to suit whatever your liver is doing.......

peaks and troughs......? with the basal delivery there wont be a peak and trough, or not ones you need to factor in.....

you shouldn't need to eat anything to maintain blood sugar levels....especially on the pump...

insulin/carb ratios change also, again, as and when you need it..........

did you receive any carb counting/dose adjustment training prior to going on the pump......?

Thanks, I don't think my question was worded properly - does going on LCHF change the (shape) of an existing basal profile?

I agree I shouldn't need to "top up" adjusting once I confirm the pattern.

With the I to C ratio I am wondering if LCHF increases overall sensitivity.

I need to get my new basals right (back to basal testing), so far I've only read Think Like a Pancreas which has been enlightening, 20 years of carb counting (and the help of plenty of apps) has helped my carb counting. Not had any official advice on LCHF...

 

[novorapidboi26]

I see,

you may find your basal needs [profile] will fluctuate and settle to something different on a LCHF diet as opposed to a normal carb diet, maybe down to the way the body is processing the food you eat to maximize the fuel extracted from it............the liver may well have to adjust its output to compensate for these changes.......

ultimately though, as with a normal diet, you need to constantly check your basal and adjust it throughout life, regardless of diet etc...

I am unsure myself what a low carb diet does to insulin sensitivity..........generally my understand is that insulin sensitivity depends on how well the cells of your body take up the glucose/insulin, which is helped the more active you are......

 

[robert72]

Do your insulin to carb ratios change?

Yes, depending on how low carb you have gone. What's you current daily carb intake?

 

[tim2000s]

I've found that my I:C ratio has been the same on LCHF, however I do have to bolus for protein, and that's at roughly 50% of I:C ratio.

 

[Applenerd81]

Currently about 30-50g per day, previously around 200-300 per day, Christmas was worse!

 

[robert72]

I've found that my I:C ratio has been the same on LCHF, however I do have to bolus for protein, and that's at roughly 50% of I:C ratio.

Agree but I wouldn't need to bolus for protein if I wasn't very low carb

 

[novorapidboi26]

WOW, you must be starving......lol...............

test and record, test and record.........

 

[robert72]

Currently about 30-50g per day, previously around 200-300 per day, Christmas was worse!

Then you will probably need to account for protein at 50% I:C ratio, but it raises BG more slowly so may be a delayed bolus for the protein (I'm not a pumper though)

 

[robert72]

Start with basal tests (I need quite a bit less on lchf) then work on your ratios as suggested above.

 

[Applenerd81]

Agree but I wouldn't need to bolus for protein if I wasn't very low carb

I find if a meal is high protein low carb/fat then BG can creep up (requiring small correction), but if the same meal has added fat the impact on sugars is negligible.

 

[Applenerd81]

WOW, you must be starving......lol...............

test and record, test and record.........

Honestly, it's been the easiest "diet" I've done, the fat (olive oil, cheese, double cream) seems to prolong hunger better than carbs/fibre.

BG have been awesome too, under 7.8 all day

 

[Applenerd81]

2 days results

 

[Spiker]

If you are seeing lows after waking up my guess is that your 200% DP basal was wrong and was being used to cover a carby breakfast that is now missing because you are low carbing. In other words I think that your morning basal was too high and instead you should have used a higher IC ratio at breakfast. And my further guess is that if you change to those settings now, your problem will go away, and stay away even if you stop low carbing.

For protein by the way when low carbing I dose 1/3 of normal IC for the same amount of carbs. So I dose for 60g of protein like it was 20g of carbs. If I dose 50% I consistently go hypo. I use a 2 hr delayed bolus, ie delivery spread over 2 hours rather than immediate.