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Pump: Help, can't seem to bring BG levels down.

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Pattipickle

Member
Messages
9
Type of diabetes
Type 1
hi anybody , I have been on a Medtronic pump for 8 months. BG never brilliant until about 4 months ago when I started a keto diet .For about 2 months BG ' s were brilliant then things started to go wrong. Without eating carbs ( much), sugars rose and I couldn't control them. For days now I am constantly high ( over 14), and when I take loads of insulin and they eventually come down to 12 or so and I feel able to eat , regardless of wether it's carbs (with insulin) or low carb (with less insulin) ,it shoots back up again. All I have eaten today is an apple, some nuts, chicken and cheese , I'm on a temporary basal rate of 120% and have had countless Bolus Wizard corrections. Don't know what to do now?
 
Have you done a basal test since you changed your diet?

Do you think maybe your insulin to carb ratios might need checking? There is some discussion about whether a very low carb diet can make you insulin resistant, so that migh mean you need to increase your I:C and correction factor.

Do you do anything to bolus for protein?

From what you say you've eaten today I'm not sure if you're eating very low carb or just not really eating. Could there be some kind of dawn phenomenon at play if you aren't eating a lot?
 
@Pattipickle A very low carb diet can cause insulin resistance (which is one reason why I avoid it). Some Type 1s find they need a fair bit more insulin when they eat very low carb. That sounds totally counter-intuitive, but it's true for some people.

I suggest doing a basal test to see if that's ok first, then starting one meal at a time and checking your meal ratios.

You could also check its not dodgy sets or dodgy sites, as that can be another cause of highs.
 
Firstly check your cannulas to make sure no problems there.
Secondly do some basal testing as that's your first priority.
Thirdly you do def need to bolus for protein. You will possibly need more than double your normal insulin requirements if only eating fat and protein.
 
Catapillar -
One thing you might be able to help me with is your point about bonus for protein? I have never heard of this and I am keen to learn more. Thank you.
 
TheNeedles said:
Catapillar -
One thing you might be able to help me with is your point about bonus for protein? I have never heard of this and I am keen to learn more. Thank you.
Click to expand...

@TheNeedles Tagging @catapillar for,you :)

Bolusing for protein is covered by something often referred to as the Polish Method. You'll find threads about it in Type 1.

Bolusing for protein mainly becomes an issue when there is a very tiny amount of carbs in your meal. If you're eating the common Type 1 diet of moderate carbs (as I do) then you might not even have to think about it. If you're eating minimal carbs, then it will be something you'd be wise to look into.

If you have particular questions, then either find an appropriate thread in Type 1 or simply start your own thread in Type 1 :)
 
TheNeedles said:
Catapillar -
One thing you might be able to help me with is your point about bonus for protein? I have never heard of this and I am keen to learn more. Thank you.
Click to expand...

Well if you are eating a keto diet you body is going to find other sources of glucose - it will do gluconogenesis on protein, so eating protein can cause a rise in blood sugar, albeit a little while after eating. I do bolus for protein when eating low carb meals - I work out how many grams of carbs in my meal (e.g. 7g) and how many grams of protein (e.g. 42g) I half the protein amount (21) and tell my pump I'm having half protein + all carbs as the sum of carbs I'm eating (e.g. 28) and I want the carb bolus now and the carb bolus over two hours (so I'd chose an extended bolus with 25% upfront and the rest over 2 hours in that example).

That's just what works for me. I'm very aware that protein does push me up if I don't bolus for it. You have do a bit of trial nd error to figure out if there is a need to do this in your case and the how best to do it.
 
Usually, if I eat about 10g carb, I will just bolus for the carb and ignore the protein and fat, but if I eat just protein in a meal along with no carb veg, I add up the protein content of the food and then divide that by 4 and just bolus for that amount so 16g of protein becomes 4g carb. Whether a delayed carb bolus is needed depends on how fast the food is digested and the action of the bolus, so a far bit of bg testing using trial and error usually finds the way.
 
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