• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Switched to very low carb, why am I needing more insulin?

Lauramc

Lauramc

Newbie
Messages
1
Hi, hoping someone can shed some light on to what’s happening with me at the moment.
I’m type one. I’ve recently switched to a low carb/Keto style diet. I wasn’t on a high carb diet before but I would still have bread and rice sometimes etc with meals (not every meal).

Today for example I had Greek yogurt for breakfast with a coffee. I took a small amount of fast acting insulin for the milk in my coffee because I’m sensitive to blood sugar changes in the mornings anyway (dawn phenomena). Blood sugar shot up from 6.4mmol to 12mmol an hour or so after. Took a correction dose.. then had two boiled eggs for lunch. Again, my blood sugar shot up to 15mmol!

This has happened the last few days eating similar low or no carb foods. I’m so confused.. why is my blood sugar going high? I take levemir as my background insulin and haven’t changed that amount at all. Even through the night if I have something like chicken and veg For my evening meal I’m going high through the night. Obviously I take into account the carbs in any veg I have.
 
Last edited:
Lauramc said:
Hi, hoping someone can shed some light on to what’s happening with me at the moment.
I’m type one. I’ve recently switched to a low carb/Keto style diet. I wasn’t on a high carb diet before but I would still have bread and rice sometimes etc with meals (not every meal).

Today for example I had Greek yogurt for breakfast with a coffee. I took a small amount of fast acting insulin for the milk in my coffee because I’m sensitive to blood sugar changes in the mornings anyway (dawn phenomena). Blood sugar shot up from 6.4mmol to 12mmol an hour or so after. Took a correction dose.. then had two boiled eggs for lunch. Again, my blood sugar shot up to 15mmol!

This has happened the last few days eating similar low or no carb foods. I’m so confused.. why is my blood sugar going high? I take levemir as my background insulin and haven’t changed that amount at all. Even through the night if I have something like chicken and veg For my evening meal I’m going high through the night. Obviously I take into account the carbs in any veg I have.
Click to expand...

Hi there, this is very interesting. I am NO expert but I wonder whether your body got used to a certain level of carbs (ie sugar) and therefore glucose numbers, which it was suddenly denied. In a panic (or over panic) it drops its stored glucose to bring the levels up to what it is used to but over compensates and leaves you higher than ever? How long have you been low carb, if it's only a matter of days it may be that a few more days/weeks are required for your body to accept that it's ok and happy on lower glucose levels. This might be complete rubbish I know but it sort of makes sense to me, any abrupt changes in habits always takes a while to settle down and adjust (ie, changes in insulin doses) so why not food changes? I wonder if your background insulin may need adjusting too?, my understanding is that it works in conjunction with your fast acting so if you are taking less bolus, you may need extra basal? One more observation, I was on a recent course and they said try to resist taking a correction after only one hour as this can have the opposite effect, your body panics as it goes lower very quickly and 'helpfully' releases more glucose. x
 
Last edited:
Lauramc said:
Hi, hoping someone can shed some light on to what’s happening with me at the moment.
I’m type one. I’ve recently switched to a low carb/Keto style diet. I wasn’t on a high carb diet before but I would still have bread and rice sometimes etc with meals (not every meal).

Today for example I had Greek yogurt for breakfast with a coffee. I took a small amount of fast acting insulin for the milk in my coffee because I’m sensitive to blood sugar changes in the mornings anyway (dawn phenomena). Blood sugar shot up from 6.4mmol to 12mmol an hour or so after. Took a correction dose.. then had two boiled eggs for lunch. Again, my blood sugar shot up to 15mmol!

This has happened the last few days eating similar low or no carb foods. I’m so confused.. why is my blood sugar going high? I take levemir as my background insulin and haven’t changed that amount at all. Even through the night if I have something like chicken and veg For my evening meal I’m going high through the night. Obviously I take into account the carbs in any veg I have.
Click to expand...

What were your numbers like before, Laura? Were they similar, or are these completely new and left field to you?

(I'm not T1, but will ask anyway, is you fast acting OK? Have you maybe tried a new pen/cartridge/vial?)
 
Hi, I have heard of some type 1s on the keto diet who need to inject a small proportion for the protein in their diet. I think there are threads on here about it, but I'm not on a keto diet so can't help further, sorry.

Have your activity levels changed at all recently? Even just a bit? Might be a combination of the diet change/activity levels/stress/hormones/illness (list goes on as I'm sure you're aware!). Just a thought that it might be a combination so even just one thing settling might again change your insulin demands back to how they used to be.

My DSN also warns about corrections and stacking insulin. But also that it is more important to have basal insulin doses right, otherwise if they're too low you'll end up injecting more fast acting to compensate, which can result in an overall higher amount of total injected insulin, making weight loss harder. Not that I know what your goals are, but I thought I'd mention it!
 
Hi. I switched to low carb too but have always had spikes. I assume that this is just my glucagon activating my liver into chucking out glucose because I have failed to switch into fat burning mode due ot my weekly chocolate habit. That and I also do exercise !
I have also read that glucagon is NOT turned off by the insulin we inject whereas it is by natural insulin!
On the other hand there seem to be a fair few people who do get much smoother blood sugars on keto.
I would give it time to settle down and perhaps do a basal test day in which you eat fat only or nothing but black coffee just to see how smooth things are then?
Once back on real food I'd try to keep to similar amounts of food at similar times to regularise your metabolism and truly see what your new bolus/protein doses might be. Personally if I ate nothing but butter and coffee and stayed in bed all day I would have stunning control!
 
I found for me that a meal with a small amount of carbohydrates needs less insulin than a solely protein based meal. As I am not on a pump I find myself playing catch-up with insulin to cover the rise protein gives. So ultimately not worth it.
 
I found the same thing as becca59, but from a type two angle.
If I had no carbs at all with my first meal my BG levels continued rising until I suddenly began to drop rapidly and felt woosy.
When I ate as small an amount as 10 gm of carbs with my meal the BG level would be perhaps 0.5mmol/l higher after eating and then sink very gently down again for the rest of the day.
 
Interestingly yesterday I had a carb fest and ate things I don’t normally touch. My insulin needs were not much more than the previous day and I’ve been steady as she goes for about 15 hours. You couldn’t make it up. Pic on Type 1’stars R Us thread.
 
I dont know if its right but I know that your liver can give off more glucose for energy. So if your body isn't getting energy through food which you can control then your liver can give it off. So maybe that's why its going higher
 
Fat delays absorption of any carbs too. So if you took it for the carbs, it might have worn off by the time the carbs finished hitting. If I have a high fat meal I have to do an extended bolus for my carbs a half to one hour later. But higher fats have a tendency to make you more sensitive to any carbs you eat so you might have a higher insulin to carb ratio.

I ended up getting a high protein/low carb drink as a snack thinking I wouldn't have to bolus much for it and my blood sugar went through the roof. A lot of low carb people have to start bolusing for the protein and even some fats . (Not at the same ratio) I do not low carb.
 
Last edited:
Transition into low carb should be gradual as your body is adjusting to a different level of carbs. When I was first diagnosed with type 1, I was in hospital 4 days with ketones at 3.2 and my blood sugars wouldn’t go down despite eating only like half of my food and drinking plenty of water and avoiding high carb foods like potatoes. My theory was that my body was so used to burning fat that it rejected glucose as an energy source .

Why don’t you gradually transition? Also bear in mind being too low carb is not good for your body as producing energy from fat and protein takes longer and your body needs some immediate form of energy. You might want to start off with 150-200g of carbs then decrease it 10g at a time per week. I would advice at least 20g of carbs per meal but it’s up to you. As long as you have some carbs and the relevant nutrients I don’t see a problem
 
What I notice is energy from fat and protein takes longer (so definitely not suitable as a hypo remedy) but it lasts longer and has more stable profile than carb energy. On low carb diet I can easily skip breakfast and go running without eating. I eat a lot though.
 
Back
Top