T1/Low Carb help please

johen said:

I have started to follow a low carb diet cutting carbs down from needing about 20 novorapid per day, down to about 8 units. However my readings are not coming down much though the graphs are not having as many spikes. My blood sugars seem to want to stay between 10-12mmol even though I do corrections doses. When I have a carb free meal (just meat and steamed veg) it still goes up to 14-15. I know there's a small amount of carbs in carrots, peas and broccoli so I have about 2-3 units but there is still a marked rise and the correction dose does not seem to be bringing it down to the 6-8mmol region. Does anyone have any guidelines to how much insulin I should be taking when I'm not having any major carbs?

Click to expand...

Hi Johen,

I have tried keto and very low card too and experienced elevated bg's many hours after the meal or snack. For me it appeared to be that eating low carb and in comparison higher protein, the protein influenced my bg's very much. Maybe that is what happening too in your situation. There are some 'rules' to manage that, like bolusing 50 percent for the grams of protein that you would do otherwise for that same amount of carbs. For as the protein is being digested slower than carbs you would need a later bolus for them or a temporary higher basal. But it is very very personal and you would need to explore it for yourself. And of course there can be other reasons for what you experience, but maybe it is at some point of help.
Good luck, it's great that you are so motivated taking good care of yourself!

I have been very low carb high fat for around 6 years now, and will be for the rest of my life. I feel much better for it, fitter, stronger and healthier. I take 3 or 4 units for each meal. Protein definitely has an affect, often 4 hours after a meal, not within 2 hours, so sometimes have to have another unit to correct it, but long lasting insulin is often the better choice. Peas and carrot are quite carby, I avoid them. Keep at it, you will get there I am sure, but even now I sometimes get it a little wrong and end up a little high or low, and that’s with just 4 units. It’s not an exact science, slight stress, exercise, hydration etc all can make a difference.

johen said:

If you take 5units for 50 carbs on a "normal" diet, no one mentions the effect that protein has.

Click to expand...

My understanding is that protein only really tends to have a measurable glucose footprint in the absence of dietary carbohydrate. Put another way, when the diet contains plenty of glucose, there is no requirement for the liver to try to manufacture the remaining balance. When the diet is deficient of glucose, it may turn to using protein to manufacture it.

This will largely depend on the level of dietary fat, and the level of stored fat. Essentially, if you remain a glucose burner (outside of ketosis) then the protein may well be used to make glucose, whereas this would not have been necessary on the "normal" diet. Hope I'm explaining clearly.

johen said:

I wonder if by upping my long acting insulin I could make it a less bumpy ride?

Click to expand...

Don't do this, you'd be eating to the insulin and not the other way around. The best insulin to use for protein is regular or short-acting, it peaks later and follows the slower glucose release.

Dr Bernstein's Diabetes Solution is the book to read if you're looking for info on insulin and a low carb diet. It goes through the basics and from there it's trial and error to find out what works well for you. Good luck!

johen said:

I have started to follow a low carb diet cutting carbs down from needing about 20 novorapid per day, down to about 8 units. However my readings are not coming down much though the graphs are not having as many spikes. My blood sugars seem to want to stay between 10-12mmol even though I do corrections doses. When I have a carb free meal (just meat and steamed veg) it still goes up to 14-15. I know there's a small amount of carbs in carrots, peas and broccoli so I have about 2-3 units but there is still a marked rise and the correction dose does not seem to be bringing it down to the 6-8mmol region. Does anyone have any guidelines to how much insulin I should be taking when I'm not having any major carbs?

Click to expand...

Hi, I will tag @LooperCat as this member is low carb so may be able to advise and help.

johen said:

Hi thanks to you both for your replies. Now you have pointed it out, I am finding a rise about 3 hours after a meal when I was most expecting it to go down; that makes total sense. However after 30 years of dumbing down by the medical profession who have not really helped me, I am aiming to be more proactive in my care. If you take 5units for 50 carbs on a "normal" diet, no one mentions the effect that protein has. Also I was told not to count any veg apart from sweetcorn so I was thinking most veg apart from those were "free". Unsure I could go without peas and carrots though as they are my favourite vegetables (after roast potatoes!! ) I wonder if by upping my long acting insulin I could make it a less bumpy ride?

Click to expand...

Glad to be of help! Indeed many of us have been informed incorrectly/poorly in the past by our care takers. I am afraid they did not know better either. Good that you are selfeducating .
I am on an insulin pump which may make things a bit easier. After trying keto and very low carb, I also missed the carby veggies. I love peppers, carrots, beets etc. And an apple once in a while also feels like a great treat. I decided to go for a midway and am now using approx. 100 to 120 grams of carbs a day. My bgs are pretty good and my latest HbA1c in December was even slightly better than ever. So it is good to consider all aspects and find out what way of eating and treatment feels best for you, gives you the best quality of life.
For me the influence of protein depends on the ratio of the macro nutrients (carbs, protein, fat) per meal or snack, not per day, week or for the diet in total/general.
And upping the long acting insulin would indeed, as mentioned already by somebody, lead to having to eat in between too often.
Good luck!

johen said:

I have started to follow a low carb diet cutting carbs down from needing about 20 novorapid per day, down to about 8 units. However my readings are not coming down much though the graphs are not having as many spikes. My blood sugars seem to want to stay between 10-12mmol even though I do corrections doses. When I have a carb free meal (just meat and steamed veg) it still goes up to 14-15. I know there's a small amount of carbs in carrots, peas and broccoli so I have about 2-3 units but there is still a marked rise and the correction dose does not seem to be bringing it down to the 6-8mmol region. Does anyone have any guidelines to how much insulin I should be taking when I'm not having any major carbs?

Click to expand...

Because I'd done carb counting courses I had always thought that 0 carbs = 0 insulin but it turns out that I need half my usual bolus and the same basal.
I am not ultra low carb because I like green veggies, carrots and tomatoes. How many carbs do you take in?
I have also read that because we take exogenous insulin our alpha cells are not inhibited as they would be if making own insulin still which is why we continue to need insulin and especially if a burst of exercise has occurred (high energy demand) or we're ill and fighting it!
Going low carb is great for reducing the carb counting but there are still a few other variables and it is frustrating that most of my learning comes from this forum or podcasts rather than my consultants. | That isn't their fault because there is little research on type 1s and keto which would help with 'rules'.

@NicoleC1971 it's my understanding that exogenously administered insulin is also less effective than endogenous because it's not delivered directly to the liver via the portal vein.

Increase your correction dosage slightly and wait for effects. ( be patient) our bodies follow a habit with everything good control breeds good control and bad control breeds bad control etc. Only you can break this habit.

I know that the question is put by a type one, but I suspect that the basic diet for a Human has been subverted by those selling food for some time, and really needs revising whilst there is still time.
For me, diet controlled type two, I start off by considering the fats and proteins I need - I would not eat a low fat meal as that pushes me into breaking down protein to make glucose, which I really do not want. Eating low fat and high carb cost me a lot of muscle strength and stamina over the decades - I used to run over mountains in my youth...
I know that ketosis is an alarming work for a type one, but with low blood glucose is is not a bad situation to be in - I certainly feel the difference if I overdo the carbs.
Carrots are high carb - and I can't really cope with legumes. There are a lot of low carb options though, and I do roast a carrot or parsnip once in a whole, I usually stick to turnip or swede or celeriac also roasted, and do stirfries - also a lot of salad stuff.
Sweetcorn is not a vegetable but a grain.
I realize that types one and two are treated very differently - but do forgive my wry laughter at the idea of a carb free meal which involves steamed veges.