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not taking insulin with a no carb meal?

Discussion in 'Ask A Question' started by Nimster, Feb 10, 2013.

  1. Nimster

    Nimster Type 1 · Member

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    I was on the BERTIE (similar to DAFNE) course last july and one of the subjects was insulin and carbs. However we were told that you wouldn't have to take any insulin with a meal that has no carbs in them eg. Salad!

    I still don't really feel confident with what they said as I have always taken my insulin during my meals.

    If anyone can help me understand this or if anyone has been told similar i would be very much appreciated.

    Thanks :D
     
  2. mrman

    mrman Type 1 · Well-Known Member

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    Should be correct as when I eat I use my insulin to carb ratio to calculate how many units of qa I need. Eg eat 50 carbs with a 1 to 10 ratio I would use 5 units. If I ate 0 carbs I would not insulate. There are factors though which might require insulin for 0 carbs as when protein is eaten your body releases glycogen to break it down thus putting sugar in your blood. However this should have minimal impact. I would never insulate for a carb free meal unless it was to correct high sugar before my meal. Also of your base is out you might rise for a no carb meal un knowingly using qa to counter act. That is why it is important to now and again do daytime fasts to check base.

    Sent from my GT-S5360 using DCUK Forum mobile app
     
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  3. Nimster

    Nimster Type 1 · Member

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    Only recently that I've managed to get my insulin ratio back on track. At the moment I use a 1.5 to 10 ratio which works absolutely fine even though i do get the occasional low blood sugar (dietitian reminded me to change the ratio depending on the meal).

    Would the Lantus be of help because of it still being in the system and how it works throughout a 24 hour period?
     
  4. SamJB

    SamJB Type 1 · Well-Known Member

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    I dont eat starchy carbs and I need a regular 4u of Novorapid with each of my meals. Presumably because my liver is producing the glucose my body needs.

    Lots of food contains carbohydrates. A meal-sized portion of salad will have about 15g in. A pepper has around 8g, an onion around 5g, a garlic clove has 1g, a portion of peas have around 4g in, a tin of tomatoes has 12g in.
     
  5. mrman

    mrman Type 1 · Well-Known Member

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    Yeah the lantus is supposed to just keep you pretty level through a 24 hour period but not drop you unless you are exercising or just more active than usual. So if you was to have a zero carb meal you should stay within 1 to 2 mmol in your.blood levels. If you was to drop more it would indicate too much lantus but if you was to rise would indicate you might need more lantus. If any changes.are made to your lantus it can affect your qa ratios. Worth discussing any changes beforehand with your dsn.

    Sent from my GT-S5360 using DCUK Forum mobile app
     
  6. Nimster

    Nimster Type 1 · Member

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    i know i need to cut down on my carbs...i was diagnosed with diabetes 13 years ago and back then of course they always told you to eat carbs to keep the bloodsugars good and i was on actrapid insulin way before i had to start taking the novorapid and lantus insulins.

    I guess having vegetables would be a better source of carbs and maybe sticking with wholewheat based carbs too :D

    I think i feel a bit more relaxed about this now. Thank you so much for your help guys ^_^
     
  7. smidge

    smidge LADA · Well-Known Member

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    Hi Nimster!

    I eat a low-carb diet - about 50g a day, and very little starch carb. However, as Sam has said, I still have to take my rapid-acting to cover low-carb meals. For a chicken salad lunch (about 8g carb total), I will take 1.5 units Apidra. Salad, vegetables etc do have carb and do need to be jabbed for - calculate them and jab. It is a myth that carbs in these things require no insulin. It actually makes me very angry that nurses keep telling people this. If you are going to continue eating starch carb, wholemeal might release sugar slightly more slowly than white (although for me it is identical), but it will still release sugar and will need exactly the same amount of rapid-acting to cover it.

    Smidge
     
  8. ewelina

    ewelina Type 1 · Well-Known Member

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    One of the member here, Phoenix, gave me a good explanation to my question regarding protein and fat. I posted question in a wrong section so thought I can put it here.

    I do bolus to low carb meals. There are always some carbs and lots of protein or fat
     
  9. noblehead

    noblehead Type 1 · Guru
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    I need QA insulin to cover a meal containing just fat and protein, a typical example is bacon and eggs which I'd need 4 units of novorapid to cover it compared to my usual breakfast of jumbo oats which I need 5 units, personally I find eating a meal containing moderate amounts of carbs is much more manageable than one that contains none, I also need to split my insulin if I just eat a no carb meal which I loathe to do.
     
  10. AMBrennan

    AMBrennan · Well-Known Member

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    100g lettuce contains 0.5g fructose, 0.5g glucose and negligible starch, sucrose, maltose, etc so I am not sure that is correct.

    Those theoretical results about gluconeogenesis from protein are all very well, but at the end of the day it comes down to what your body does in response to eating food (whether low carb or not) - cf what Bernstein calls Chinese buffet effect iirc. The only way to know is to measure your BG after eating.
     
  11. SamJB

    SamJB Type 1 · Well-Known Member

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    Obviously it's an approximate amount as it depends what you put in the salad and it depends what a "meal-sized" portion is!
     
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  12. smidge

    smidge LADA · Well-Known Member

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    I've got a bag of Tesco 'garden salad' in front of me - it has 3.5g carb per 100g - an average lunch portion for me might be about 80g, so around 2.5g carb. A couple of small tomatoes - maybe 2.5g carb, a bit of red pepper - maybe 2g carb, some radish - maybe 0.5g carb - that's just a small basic salad and it comes to around 7.5g carb. (That's about a unit Apidra for me at 1:8 ratio), add in a bit for the protein in the chicken and I arrive at 1.5 units Apidra for a chicken salad. That 1.5 units might seem 'lost in the noise' to those of you on high carb diets and high doses of insulin, but it is the difference between BGs in the 5s and BGs in the 8s for me. So I would say add up the carb wherever it comes from and jab for it!

    Smidge
     
  13. angieG

    angieG Type 1 · Well-Known Member

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    Smidge,

    I totally agree with your reckoning, I can't eat salad without bolusing for it. Also depends what protein I have with it too, meat puts me up more than fish.

    I guess we are all different though and some may get away it but I know I can't.

    Angie
     
  14. Nimster

    Nimster Type 1 · Member

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    All i do stupidly worry about is that if i was to have a plain salad and not take insulin with it that my bloods would go haywire. It's like if i was to have a glass of orange juice with the salad (as sainsbury's orange juice has 18.4g carbs per 200ml) then would I have to take extra insulin?
     
  15. noblehead

    noblehead Type 1 · Guru
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    Why don't you just go without the insulin and see what your levels are like after eating the salad, the only way we learn what effect food has on us is by testing, you can always take a correction dose later if your bg does start to climb :)

    btw, orange juice with the salad would almost certainly require insulin!
     
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  16. diabolic sister

    diabolic sister LADA · Well-Known Member

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    I only had plain chicken for breakfast today, my DN advises no insulin for a totally protein meal, and my bg was 10mmol. So obviously that rule doesn't always apply. Diabetes is so full of variables.
     
  17. tim2000s

    tim2000s Type 1 · Expert
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    That's completely wrong advice unfortunately. Typically, you need about 50% of the insulin you would for the equivalent weight in carbs. Protein does cause your body to release glucagon which generates an associated BG rise.
     
  18. RuthW

    RuthW Type 1 · Well-Known Member

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    This is why I am completely unconvinced of the low carb diet for Type 1s. I do eat carbs and almost never take more than 4 units of insulin anyway. And I don't find it necessary to take insulin for protein or fat unless it is in huge amounts (in which case I assume my body desperately converts it to glucose instead of using it, more usefully, for maintaining body tissues such as muscle and bone).

    I only bolus for protein-only meals if they are huge. So, almost never. I can eat a few ounces of cheese between meals with no impact on my blood sugar. Same goes for avocados and some nuts (but some nuts seem to be quite carby according to my meter).
     
  19. tim2000s

    tim2000s Type 1 · Expert
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    Unfortunately that doesn't hold true for many of us. Sadly it's the usual what's good for the goose isn't necessarily good for the gander...
     
  20. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    You would definitely need Insulin for orange juice, fruit juices are high in carbs. I tried, a while ago now, eating scrambled egg and one piece of bacon for breakfast, supposably no crabs ? BS went over 13, was I shocked and irritated, yes I was :wideyed::arghh:
     
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