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Should I still take insulin if fasting?

Buttafli

Member
Messages
8
Type of diabetes
Type 2
Treatment type
I do not have diabetes
Why should I take insulin and metformin if I am going to fast? All insulin’s (Lantau, regular, byetta, etc) make my lower body swell to the point walking is difficult and metformin still causes GI distress after months of taking it (albeit for 1-2 weeks at a time before I forget again)I don’t know if this is the right place to post but looking for encouragement, support, and guidance from experienced folks. I havent started the new insulin yet (humlin 70/30). Filled Rx after last 5 A1C were between 11 and 12%. On metformin as well. My question is should I start the insulin with the fasting/keto and why? My blood sugars are very uncontrolled, the lowest it has been in the last year (manual checks) is 230. Complicating things is a mental health condition that makes consistency hard most days. (I am now on meds to help and that is why I am trying to really commit to keto/IF now) I have tried it before with keto and a 5 day fast and felt amazing but quit because my blood sugars didn’t get as low as I thought that should (I know more now). All of this is kind of appalling because I am a nurse and certified diabetes educator but when it comes to my own health there is this huge mental block and white space. I have been diagnosed since 2009 TD2 after gestational and honestly cycle through denial and acceptance and abject depressive overwhelm almost every month. Any responses, encouragement or cold hard logic would be appreciated
 
As a T1, I would skip my fast acting insulin and just take my long acting if I was fasting. But I am on a basal/bolus regime. Even fasting, I would go into diabetic ketoacidosis and die if I didn't inject, but that is because my body produces no insulin at all.

As a T2 you are presumably still producing insulin? (Some T2s wear out their insulin producing cells and eventually stop producing it, though most start out by over producing.) I wouldn't like to comment on your insulin needs when fasting because I don't know your insulin regime or how much insulin your body is making on its own. If your sugar levels are high because of lack of insulin rather than because of insulin resistance then skipping insulin could be deadly. And if you've been misdiagnosed as T2 when you're actually T1/LADA (not uncommon in the UK though I know you're not from there because of the units you are using for your blood sugar levels) then you 100% need insulin.

One of the main uses of the metformin is to suppress your liver's production of sugar. Most people who have gastro problems with it first try the slow release version and if that doesn't work get their doctor to prescribe something else.

Are you able to phone your doctor for advice. Your symptoms sound bad so I can understand your reluctance to take the medication but untreated diabetes can be lethal (quite quickly if ketones and blood sugars go high) so you need to be very very careful.
 
Hi there and welcome to the forum.

Sorry to hear you’re struggling so much. I have no experience of using insulin or diabetes medication of any type, but am I understanding correctly that you’ve been prescribed insulin but are not currently taking it?

If that is the case - prescribed but not taking - I see no reason why fasting/keto isn’t an option. You need to get those blood sugars down, and while there’s a danger of causing hypos by severely restricting carbs whilst already using insulin, if you’re not using it then that risk is removed.

You do need to get the blood sugars down and whichever route you take, consistency will be important, so I’d also see if you could get some help with the emotional/mental aspect of this too.

Do keep posting - lots of support here.
 
We learn something from making changes if we change only one thing at a time. Having diabetes means being on a never eding learning curve, which we move up by changing one thing at a time. I would continue with insulin and medication while starting keto/if, do regulat testing, and see what happens. I would only consider reducing insulin and medication if blood glucose drops too much.
 

Thank you very much for this thorough reply. Yes, I’ve talked with my MD and they advise to take what’s been prescribed. I am still producing insulin but couldn’t wrap my head around putting in more insulin when I am IR and trying to lower levels. thank you for the reminder to tread carefully.
 

Thank you for taking the time to reply-this was my thinking as well but I tend to rationalize things I want to do quite a bit. Have enlisted a few accountability partners to help me stay consistent and on goal-will try to fast to bring it down and then keto when I do eat. Will definitely keep posting and following these forums. Have been a lurker for awhile and it is so helpful. Appreciate it
 
Hi there, I would be very careful about advising you that it's ok not taking insulin that for some reason has been prescribed to you WITHOUT discussing it fully with your team. I know you are telling us you are a type 2 still producing insulin but none of us know that for certain so if you were a type 1 for example (maybe unknowingly) then not taking that insulin would be downright dangerous and potentially fatal. IF your team are saying without doubt it is type 2 then I guess that is another matter but anyone reading this thread should ensure that if they have been prescribed insulin and are thinking of stopping it, PLEASE talk to your medical team first. That's why we are told NOT to give medical advice because how can any of us know a person's true medical state? x
 

Thank you for your reply and note of caution. I am grateful for all the opinions received.
 

Thank you for sharing this wisdom and support. I tend to lean type A and “all or nothing”-it is good to remember that it is a process and a journey. I have seen my sugars drop quite a bit when I have focused on something simple like a good nights sleep. Thank you again.
 
Just wondering, how long were you doing keto? What does your daily diet look like? Are you expecting too much too soon?

I think I would have failed if I jumped into fasting right away. I’m 120 days into targeting zero carbs, now that I’m fat adapted, I’m just now dipping my toes into fasting, mostly because I have a lot of weight to lose.

IMHO 90 days aggressive carb cutting, and testing, you should be able to gather enough data to know if your medications need adjusting
 

Thank you for this suggestion and the 120 day timeline. I thought I could jump back into keto and then IF, that lasted less than 24 hours this attempt. The solid opinions that I am taking away is one thing at a time and that thing is going to be dirty keto-sacrificing the good for the perfect is a sure ticket to failure and disappointment for me.
 
i sometimes wonder if fasting can cause stress on the body
thus keeping numbers higher
its said that stress can make them higher
maybe thats why they stay high fasting
it may be that way for me
but im still learning
i hope you get it worked out
and get better numbers
 
From my own personal journey which I started 1/2/20 doing 1 meal a day and fasting for 23 hours each day I have gone from 80 units of humulin m3 now down to just 12 units some days none at all and have lost 3 stone.I think it's all about seeing what your body needs and lots of dosage adjustment to keep your levels correct , this is what I have done but would advise to contact your doctor of you intend to proceed down this path.
 
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