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LCHF - hypo danger ?

Spiker said:
The carbs swings seem harder to control when they happen in the middle of a low carb diet.
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If you were me, and type 2, I would say that the low carb high fat has 'rested' my pancreas, and introducing carbs causes an over-reaction, and over-release of insulin. You will know all the technical terms, but I don't.

Since you are type 1, that wont apply. Could it be decreased insulin resistance? Caused by the low carb diet?
 
zand said:
I have lost more weight this week....5 lbs. I think I will be doing lots more walking before eating in the future.
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Congratulations that's fantastic. In his book 'The 4-hour Body ...' Timothy Ferriss has these cheat days where the participants eat as much carbohydrate as they want - not even implying that we should do it - he has a strategy on how to eliminate the damage.

Not sure how some of the recommendations would affect us but scroll down to section III and he talks about the pre meal exercise that work for him

http://www.4hourlife.com/2011/03/09/damage-control-and-the-slow-carb-diet-binge-day-cheat-sheet/

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I always worry about diets that suggest such things - I can't imagine carb binges can be healthy for diabetics, no matter how well the diet may work for non-diabetics, a diabetic's body will really struggle to handle a huge influx of glucose and resultant insulin spikes. Remembering how my body used to react to such things prior to diagnosis, I wouldn't willingly put myself through such an experience again for any diet!
 

I agree with you. The carb binge is not for us.

But what was interesting and perhaps pertinent to diabetics was his strategy employed on reducing the impact - fat gain etc - of the carbo binge.

I've used section III the intense exercise before eating to 'prime' the muscle receptors to accept the nutrients.

I think it works in my case as I've put on more muscle and gained very little fat - some around the stomach - much like walking before the meals.

In the past it was always suggested to do exercise after the meal to lower BG.


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more likely your pancreas can produce enough insulin for the smaller amount of carbs in the LCHF diet
What I do is prime the muscles with a good bout of exercise in the morning - seems to set them up for the day by emptying their gylcogen stores and then I do a small amount of exercise after lunch and dinner (about 10 mins is all that is needed about an hour after eating) and my blood sugars are normalise.
 
IanD said:
What is YOUR experience? Do YOU get hypos with LCHF ?
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Thanks for this starting this thread. You have motivated me to start an experiment on myself. I will let you know if I ever get a hypo! For 3 years I was fairly successful in keeping my BG's at an acceptable level by 'eating to meter'. Now I have learnt to recognise hunger properly I am going to switch to 'eating to hunger' alongside 'exercising to meter'. This morning my fasting BG was 6.7. I did have breakfast - 2 rashers of fried bacon (with fat cut off because unfortunately I hate the taste) , 6 walnut halves and a cup of tea .

I went out for a walk. I have been starting to increase the distance I can walk and also add a few slopes. ( I had a heart problem - AF- for a few years, so slopes have always been difficult.) Today I decided to walk a little further than usual and include part of a hill. When I got there I changed my mind and did the whole hill, not sure about the gradient, but it's definitely a hill not a slope! Total distance walked was 3.5 miles . My BG now is 5.9.


thanks for this. I have read most of your posts and found them interesting but I have never seen how they could apply to me . Now I do. It will be a long time before I can do those exercises properly! But I can try. Thank you
 
runner2009 said:
In his book 'The 4-hour Body ...' Timothy Ferriss has these cheat days where the participants eat as much carbohydrate as they want - not even implying that we should do it - he has a strategy on how to eliminate the damage.
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I use something a little similar to this.

I use a Ketogenic diet, taking less than 10g carbs per day. This keeps my blood-sugars under control.

Every second weekend I take a break from the diet, and indulge in a Sunday afternoon of chocolate eating. (Not suggesting this is right for other people; just something that I do.)

Interesting for me has been the result this has had for my experience of "Hypos", and I think this relates to what others have said on this thread:

borofergie said:
If you are in ketosis and not taking insulin or any other insulin promoting drug, then you should be more or less immune to hypoglycemia. That's what ketosis is (a defense against hypoglycemia).
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Brunneria said:
I never hypo in ketosis, or on a LCHF diet, but I can hypo on low carb, low fat, or if I have to eat carbs for a few meals, and then can't eat when I need to. Fat is the key. It is like a buffer.
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When I am in Ketosis (12 days out of each 14) my blood-sugars can go extremely low without any loss of brain function. I do not get any warning signs, but then I do not get any loss of brain function either.

When I am out of Ketosis (2 days out of each 14), my warning signs for low blood-sugar are there (sweating, shaking), and if untreated this proceeds to loss of brain function (confusion, loss of balance, double-vision).

I investigated how/why this might happen and found several published medical studies that concluded that Ketosis is protective against the normally dangerous effects of low blood-sugars. I found this really fascinating.

I am a T1 Diabetic living on my own, and I use this knowledge to help manage my Diabetes. I shoot for blood-sugars in the non-diabetic range, and with this protection that Ketosis offers I am really not scared to do so. If I make a mistake with the injected Insulin and my levels go low, I have the extra protection of Ketosis to fall back on.

I think that the Ketogenic/LCHF diet is an inherently safe way to manage T1 Diabetes. All T1 Diabetics are fighting on (at least) 2 fronts - for me it has been brilliant to discover a diet that simultaneously eliminates high blood-sugars and protects against the dangerous effects of low blood-sugars.

I suspect that as LCHF becomes more accepted and more popular, there will be more T1 Diabetics that start to report this phenomenon of being able to tolerate lower blood-sugar levels without loss of brain function, when in Ketosis. Only time will tell, I guess.

Regards,
Antony

(I know that this issue of low blood-sugars and what exactly constitutes a "Hypo" can be an extremely sensitive one! To be clear, I don't suggest that people shoot for low blood-sugars, and I don't suggest that low blood-sugars are nothing to worry about. DVLA, safety of self, safety of others, I know it. I only report my own experience that being in Ketosis - being fuelled by Ketones - changes the game).
 
Thanks for the various replies.

Just tried another experiment - a morning's tennis after my usual nut porridge b'fast - about 7 g carbs .

Overnight - 5.8
1 hour after b'fast - 6.8
10:30 before play - 5.9
12:00 after 3 sets - 6.8
1:00 after shower, before lunch - 7.8
No sign of a hypo - & no running out of energy.

I play hard - my resting pulse is about 60, but gets up to about 150 during a rally, dropping to about 120 at end changes. It was 113 when we finished.
My BP at 1:30 was 127/67, pulse 82.

It is very clear that the adage "sugar for energy" is not valid.
 
From the Diabetes UK "Position Statement on Low carb."
Diabetes UK recommends that:

  • A range of approaches to weight loss should be considered with the overall aim of energy intake being less than energy expenditure; and that the most appropriate method to achieve this is identified between the person with diabetes and their dietitian.
  • When considering a low-carbohydrate diet as an option for weight loss, people with diabetes should be made aware of possible side effects such as the risk of hypoglycaemia, head-aches, lack of concentration and constipation.
  • Diabetes control should be considered and blood glucose levels need to be closely monitored with adjustments to medications as required.
  • Nutritional adequacy should be considered ensuring that optimal amounts of vitamins, minerals and fibre are supplied by the diet.

  • The amount of carbohydrate to be restricted should be agreed between the person with diabetes and their dietitian.
Note DUK speaks of low carb for weight loss rather than BG control. In six years, NONE of those possible side effects have affected me. The health improvement has been massive.
 
When considering a low-carbohydrate diet as an option for weight loss, people with diabetes should be made aware of possible side effects such as the risk of hypoglycaemia, head-aches, lack of concentration and constipation.

Why don;t they even consider it for diet and exercise regime to start with instead of drug peddling at the first opportunity. I understand their worry about drugs and risk of hypo but then tailor the dose... Even 150g carb level is better than what they peddle although more difficult for weight loss as quantity and hunger kicks in before of the calorific value of 150g carbohydrate.
 
It may be worth pointing out that no one gets to a low/ketogenically low carb diet without a few iffy moments. And therefore warning people about the hypo risks of moving to a low carb diet makes sense. I just wish they also told people that you come out the other side.

Often it is very hard to change the mindset from widely the accepted 'fat is evil', to the low carb idea that 'carbs are evil' and fat is good. It is a really hard transition for some people especially if doctor, nurse, family and friends are all opposed.

And of course, it is during that transition period that the risk of hypos is at its greatest - which reinforces their argument!

Additionally, most people come to low carb wanting to lose weight, so they are reluctant to eat fats because of the calories, and by cutting down on carbs too, they teeter on the edge of the hypo-zone.

This is why, whenever I get the chance, I suggest to new low-carbers that they eat lots for the first few days. Meat, fish, eggs, cheese, butter, cream, pate... As high fat as possible. It is only for a few days, but it helps them until the glucose levels drop, the cravings fade, and they come out the other side of the hypo risk.
 

This is good advice.

As always with this discussion, we need to be careful by what we mean by "hypo".
If you mean "a temporary blood dip that takes your BG down below 4mmol/l and then quickly recovers" then I agree.
If you mean a T1 "BG gets low and doesn't recover" then I don't agree.

Strictly speaking "hypos" are a symptom of medication, not of diet. You shouldn't really get proper hypos on a low-carb diet (unless you are taking insulin or some medication that promotes insulin production).

Even if you starve yourself for a few days (no carbs, no fat, no protein) you don't typically go hypoglycemic (because of ketosis).
 

This is one of the biggest challenges for me in low carbing. I experience hypos as I switch over. The hypo fear response and carb eating reaction is so ingrained after 20 years of being diabetic (and it's instinctive in humans anyway). It is a great effort of will to imagine the "other side" that Brunneria mentions, and instead of having a "carb panic", just take a very small measured dose of carbs and a small reduction in insulin going forward. It takes a lot of belief and discipline to get through to the other side. And, every time you "carb panic", you are pushed back to the beginning, to square one.
 

You are perfectly right. And I should have expressed myself better.

By 'coming out the other side' I was referring to going through the glucose fluctuations that disappear when you reach very low carb/ketosis.

Didn't mean to imply that you can tough your way through a type 1 hypo!!!
 
Now my understanding is type 2 's should not be vulnerable to severe hypos as the are able to still produce glucagon which has the opposite effect to insulin. As well as being unable to make insulin most type 1's are also unable to make glucagon. Therefore they have to balance insulin injection and food intake to keep there blood sugars in a safe range whereas type 2's livers will dump sugar into the blood under the influence of glucagon no matter what the diet is. It is this pathway which metformin probably interferes with. A low card diet will stop post meal spicks though
 
Also type 2s can quickly reduce or stop their own production of insulin in response to falling blood sugar.

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Spiker said:
Also type 2s can quickly reduce or stop their own production of insulin in response to falling blood sugar.

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The problem comes down to what type of diabetic are you. It is my understanding of that Type 1 is fairly clear cut but Type 2 has not homogenous but a large variable disease who's symptoms and disease can be viewed on a semantical scale - and can change over time

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That's a fair point, over time T2s can lose that insulin function.

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