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Low carb diet and bedtime bg readings

elation80

elation80

Newbie
Messages
1
Location
Stockport
Type of diabetes
Type 1
Treatment type
Insulin
Hello everyone,

I was hoping some kind soul could help me.

I was diagnosed with t1 towards the end of last year following hospital admission.

Following my diagnosis I was determined to get good control of my bg levels from the outset, I purchased a number of books including How To Think Like A Pancreas, as well as getting the Freestyle Libre. I recently got my first HbA1c result which seemed ok (45/6.3%), however as I was trying to tightly control my levels with insulin I was suffering frequent hypos, sometimes 3-4 a day and often quite low (2 - 2.5 mmol).

I typically enjoyed a high carbohydrate diet (I am half Italian after all!) and very recently made the (difficult) decision to move to a ketogenic diet after researching the potential benefits (including watching lots of Dr Bernsteins' videos) . The change in my levels is quite astounding, as my carbohydrate intake is now very low I have not needed to bolus. My Libre now shows a lovely straight(ish) line throughout the day around 4-5.5 mmol however, my bedtime levels (circa 5 mmol) are lower than what the general recommendations are. I am naturally concerned about the prospect of nocturnal hypos, should I be having a snack before bed to raise my levels to 6.5-7 mmol? If so what type of snack should I be having when I am trying to stay in ketosis?

Thank you in advance, this forum in particular has been such a great resource and I have found it very comforting reading other peoples experiences following my diagnosis.
 
Hi @elation80 and welcome to the forum!
You are doing so well, but I can understand your concern about night hypos. I think Dr Bernstein favours the use of a glucose tablet to correct blood sugar upwards before bed - but I hope someone will correct me if I'm wrong! - he also hints that Type Ones may need to check their blood sugar during the night - easier said than done. Keep some glucose tablets to hand at night.
 
Hi @elation80 - as you have a libre you can see what your glucose levels are doing overnight. I would be guided by this rather than taking the guidance necessarily as gospel. There is nothing wrong with going to bed at 5mmol/l if your levels remain flat at that level overnight. What do you generally see?

If you are concerned about going low overnight, you can always set alarms to wake you up so you can test in the night to reassure yourself that you aren't going low whilst you get used to the idea.
 
Hello @elation80 and welcome to the forum. @daisy1 will be along shortly with some general D info.

Whilst I was getting my sugars down early on, I found an oatcake or two with a bit of cheese for supper would give me that slight rise I wanted to avoid night-time hypos.
There's no one fix which suits us all - it's a case of try and see with D.

Now I have great control, I no longer need the oatcake and DP will give me a rise to get me started in the morning (though sometimes I wish it wouldn't!).

Have a good look around and enjoy the forum - you'll find some very knowledgeable folk on here
 
@elation80

Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask questions when you want and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:
  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.
  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
elation80 said:
Hello everyone,

I was hoping some kind soul could help me.

I was diagnosed with t1 towards the end of last year following hospital admission.

Following my diagnosis I was determined to get good control of my bg levels from the outset, I purchased a number of books including How To Think Like A Pancreas, as well as getting the Freestyle Libre. I recently got my first HbA1c result which seemed ok (45/6.3%), however as I was trying to tightly control my levels with insulin I was suffering frequent hypos, sometimes 3-4 a day and often quite low (2 - 2.5 mmol).

I typically enjoyed a high carbohydrate diet (I am half Italian after all!) and very recently made the (difficult) decision to move to a ketogenic diet after researching the potential benefits (including watching lots of Dr Bernsteins' videos) . The change in my levels is quite astounding, as my carbohydrate intake is now very low I have not needed to bolus. My Libre now shows a lovely straight(ish) line throughout the day around 4-5.5 mmol however, my bedtime levels (circa 5 mmol) are lower than what the general recommendations are. I am naturally concerned about the prospect of nocturnal hypos, should I be having a snack before bed to raise my levels to 6.5-7 mmol? If so what type of snack should I be having when I am trying to stay in ketosis?

Thank you in advance, this forum in particular has been such a great resource and I have found it very comforting reading other peoples experiences following my diagnosis.
Click to expand...
@robert72 is a notable T1 who follows a ketosis diet, I'm sure he could offer some excellent first hand advice:)

There is absolutely no need to opt for a ketosis style diet in order to gain good control and reduce hypos. I only say this because you have used the term "difficult" with regards to shifting to this dietary approach. Personally, I eat 150-180g of carbs per day, which I would deem moderate, and also have a HbA1c of 45. It was 39 but DP has been causing me some issues...

I wouldn't be overly concerned about going to bed with a BG of 5mmol/l. Providing your basal insulin is set correctly, there should be no concerns with nocturnal hypos. Have you done a basal rate test? I'd imagine you required significant adjustments to your insulin doses when going from high carb to keto?

If you wanted to raise your BG in the evening though, you could always try eating some protein instead of carbs? When I eat a low amount of carbs (such as that on a keto diet) I need to bolus for protein, because it raises my BG. If you're the same, then you could always try having some ham or the like before bed to raise your BGL?
 
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Hi @elation80 & well done on all you've done. I agree with @tim2000s as the Freestyle gives a clear picture of night time. Mine showed I was dipping low so I adjusted my basal & it's now okay. I often check mine around 3am to 'double check' which has been helpful. Hope you're getting on okay.
 
hi @elation80

I would agree with others, if the Libre is showing that you're in range overnight then I wouldn't worry about it, otherwise a low GI snack or some protein before bed might do the trick.
 
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