Lowering Basal drastically with Keto/More Exercise

[JoeT1]

Hi All,

So I am aware that the more exercise you do, the less insulin really should be required. It seems like my needs though are dropping drastically, and i'm wondering whether it could be a timing issue, rather than dosage.

Before more walking/activity
Levimir 8.30am 9u
Levimir 8.30pm 13u

Now
Levimir 8.30am 5u (as of today, now looks like i'll need to drop it to 4u)
Levimir 8.30pm 7u (may even need to drop further)

The added exercise has only really been an extra 3-5,000 steps a day, mostly during the day and not a whole pile in the evening. I'm very low carb, with most of the carbs now actually coming from the hypo treatment I need to take. Has this happened to anyone? I am not taking any fast acting insulin during the day as i'm on keto, and find my levels generally in the 5's, to 7.1 as the highest last night after some adrenaline.

Diagnosed in October. Wondering if it could be a case of timing these injections better, or continue to lower until I find the balance.

 

[Deleted Account]

Exercise is an odd one. The affect on BG (and, hence, insulin needs) depends on things like timing, intensity, type of exercise, your fitness at that exercise, whether you have any insulin on board...
And the affect, as you are finding, is likely to last longer than when you are doing exercise because exercise will reduce your glucose supplies in your liver so could affect your insulin needs for 24 to 48 hours.

However, there are a few things going on with you: you are new diagnosed so likely to be going through the honeymoon period which make cause your insulin needs to fluctuate and you have changed your diet to keto which will also reduce your insulin needs.

 

[SueJB]

Hi All,

So I am aware that the more exercise you do, the less insulin really should be required. It seems like my needs though are dropping drastically, and i'm wondering whether it could be a timing issue, rather than dosage.

Before more walking/activity
Levimir 8.30am 9u
Levimir 8.30pm 13u

Now
Levimir 8.30am 5u (as of today, now looks like i'll need to drop it to 4u)
Levimir 8.30pm 7u (may even need to drop further)

The added exercise has only really been an extra 3-5,000 steps a day, mostly during the day and not a whole pile in the evening. I'm very low carb, with most of the carbs now actually coming from the hypo treatment I need to take. Has this happened to anyone? I am not taking any fast acting insulin during the day as i'm on keto, and find my levels generally in the 5's, to 7.1 as the highest last night after some adrenaline.

Diagnosed in October. Wondering if it could be a case of timing these injections better, or continue to lower until I find the balance.

Very similar to me.
I was diagnosed in August. Started on very low dose of levemir 5 units. I wasn't told i could adjust my basal but I have anyway. I've now dropped the dose for the same reasons and am now on 3 units morning and evening
I'd actually like to stop totally and will run it past the consultant in March. Good luck with yours

 

[JoeT1]

Very similar to me.
I was diagnosed in August. Started on very low dose of levemir 5 units. I wasn't told i could adjust my basal but I have anyway. I've now dropped the dose for the same reasons and am now on 3 units morning and evening
I'd actually like to stop totally and will run it past the consultant in March. Good luck with yours

Yeah, that's where i'm going with this really. I don't expect to ever STOP completely, but if I am not in my honeymoon period, and it's a case that while eating this way, I can drop my Basal to extremely low quantities, the benefits would be a lot more for me. No real weight gain, less stress through injections and so on.

I'm working very slowly on lowering dosages, I don't mind getting the walks and exercise in, in the long run, it's really good for me both mentally and physically as well.

 

[Biggles2]

I don't expect to ever STOP completely, but if I am not in my honeymoon period, and it's a case that while eating this way, I can drop my Basal to extremely low quantities, the benefits would be a lot more for me. No real weight gain, less stress through injections and so on.

@JoeT1, if you have not already read this article you might be interested in doing so. It was written by 2 engineer parents and is about their scientific approach to managing their daughter's Type 1 with LC (and ultimately less insulin). It's very well written - they certainly did their research. Obviously, a CGM would be an essential piece of kit for anyone looking to try this approach. It may be helpful to you:
https://www.lowcarbusa.org/low-carb-diet-for-type-1-diabetes/

 

[Deleted Account]

I can drop my Basal to extremely low quantities, the benefits would be a lot more for me. No real weight gain, less stress through injections and so on.

My understanding is that weight gain with insulin is related to insulin resistance which is usually associated with type 2.
With type 1, insulin should not cause weight gain.
I have had type 1 diabetes for nearly 15 years. I have not adopted a low carb diet: I eat the same as I did before I had diabetes and take insulin with every meal. I exercise about the same as I did before I had diabetes.
Despite doing nothing to lose/maintain/gain weight, I weigh the same as I did before diabetes and have good control (hBA1C of around 4.8).

There are incidents of people withholding insulin in order to lose weight. This is caused by the body reacting to high BG and is not advised. This is sometimes called diabulimia.

My point is choosing a lifestyle (diet and exercise) is great if that is what you want but it is not necessary to reduce insulin or avoid you weight gain.

 

[JoeT1]

My understanding is that weight gain with insulin is related to insulin resistance which is usually associated with type 2.
With type 1, insulin should not cause weight gain.
I have had type 1 diabetes for nearly 15 years. I have not adopted a low carb diet: I eat the same as I did before I had diabetes and take insulin with every meal. I exercise about the same as I did before I had diabetes.
Despite doing nothing to lose/maintain/gain weight, I weigh the same as I did before diabetes and have good control (hBA1C of around 4.8).

There are incidents of people withholding insulin in order to lose weight. This is caused by the body reacting to high BG and is not advised. This is sometimes called diabulimia.

My point is choosing a lifestyle (diet and exercise) is great if that is what you want but it is not necessary to reduce insulin or avoid you weight gain.

Absolutely, but the main MAIN reason for choosing this way of eating at the moment is I have what seems like great control with regards to not going high, no big swings and less injections. It's not all down to weight at all, my health comes first. I would not be against eating carbs, i'm not saying they are the devil etc, it's just my control is exceptionally better when I don't have them.

 

[NoKindOfSusie]

God I'd love to do this. The problem is that my level of exercise has dropped from walking 2-3 miles every day and running at least 3km three times a week this time last year, to essentially zero because I just can't. The thing that worries me about it is that because I have lost all my fitness and am now totally out of shape, I will need more and more drugs just to stay alive. Is that also a thing, if you stop being so fit?

 

[SueJB]

God I'd love to do this. The problem is that my level of exercise has dropped from walking 2-3 miles every day and running at least 3km three times a week this time last year, to essentially zero because I just can't. The thing that worries me about it is that because I have lost all my fitness and am now totally out of shape, I will need more and more drugs just to stay alive. Is that also a thing, if you stop being so fit?

When diagnosed, I didn't do that much exercise but worked in my garden. Contrary to what @helensaramay understanding, I put on weight and so decided to do something about it. I started very small, touching toes while waiting for my egg to boil, a tiny run on the spot waiting for the kettle. Last week, I bought a Pingko, muck cheap which has given me a little nudge forward. I'm still touching toes and don't expect I'll be running ever, not even for a bus. But like you, I don't want to have to take more and more insulin and like JoeT1 I've got better control on low carbs and doing the jiggling that I call exercise is starting to have an impact. I lost 0.1k last week.hahahahaha breathe hahahaha. I refuse to give in or let anything get the better of me. Live here now