That one meal that starts the rollercoaster...

[Applenerd81]

I've been (pretty much) consistently following lchf to keto way of eating since Jan 2015 with amazing results in both body fat loss and blood glucose stability, reduced hba1c - obvious right?

My major issue though however is those meals/days when I just think I'll take a break, have some homemade food at a relatives house, have a couple of - the fuse is lit and what follows is day's of high blood sugars, even being back on lchf/ and even fasting. My (liver/body) seems to freely dump sugar into my blood and seems resistant to any insulin provided. This is all from a day of eating perhaps 80-150g carbs. My DP seems to come back instantly and last 2-3 days before settling, a nightmare for the bg averages!

Short of never deliberately eating carbs again (yes that's obvious!).

How do you manage those once a while/week/month meals? Double basal for a few days? Fasting? Regular monitoring with corrections (me currently)?

 

[GrantGam]

I've been (pretty much) consistently following lchf to keto way of eating since Jan 2015 with amazing results in both body fat loss and blood glucose stability, reduced hba1c - obvious right?

My major issue though however is those meals/days when I just think I'll take a break, have some homemade food at a relatives house, have a couple of - the fuse is lit and what follows is day's of high blood sugars, even being back on lchf/ and even fasting. My (liver/body) seems to freely dump sugar into my blood and seems resistant to any insulin provided. This is all from a day of eating perhaps 80-150g carbs. My DP seems to come back instantly and last 2-3 days before settling, a nightmare for the bg averages!

Short of never deliberately eating carbs again (yes that's obvious!).

How do you manage those once a while/week/month meals? Double basal for a few days? Fasting? Regular monitoring with corrections (me currently)?

Hello,

I'd guess it's fairly easy to kick yourself out of ketosis and get the unwanted liver dumps after having a "cheat" day.

I remember your post a wee while back about basal requirements, fasting, etc. You reduced your basal needs significantly whilst fasting/LCHF/keto dieting. If you've scaled your basal right back to run in a state of ketosis, then when you have your wee carb binges - there won't be enough basal insulin in your system to cope with the extra glucose.

As basal insulin's purpose is to combat the release of stored glycogen from the liver. When you're in ketosis, your liver should be effectively empty and therefore not putting much sugars into your blood stream at all. When you have your wee carb blow out, your liver will be storing all that glucose and then releasing it shortly after in a steady trickle. If you haven't adjusted your basal dose back up to what it is normally (when you're not in ketosis) this would explain your high BG readings the following day(s).

I'm not sure what the best approach would be to counter these higher BG readings. I think the effect of the increased basal would be too slow acting to be of any use. The bolus correction method you're using would be the quickest but it's also the most restrictive and awkward.

I'm not sure there's really an answer for this as it's hard to accommodate steady BG with irregular states of ketosis and random higher carb intakes. Especially with MDI.

I hope someone can answer this though, I'm very interested

Grant

 

[Applenerd81]

It's really tricky, if the effect was only for a day I wouldn't mind so much, but it literally takes days and energy levels are sapped to say the least! BGs sit at around 7-8 all day (with 1-2iu correction boluses throughout!).

It may be enough to get me back to using my pump!

 

[Brunneria]

Yes.
As a non insulin user, I don't have to juggle that kind of thing, but the diet, the cravings, the weight gain/water retention, the DP, the wangy blood glucose levels, the fatigue and hunger... am familiar with all of them, after eating increased carbs.

After years of this (years of lc with the odd bad day), I've developed a few coping mechanisms that seem to help me. No idea if they will help anyone else!

The apathy and low energy levels are (for me) due to increased insulin resistance, and either Fasting or exercise are the quickest way past them. A good brisk dog walk where all the main muscle groups get warm and glowing will deal with that. But the IR will rise again, after a few hours, so it is a case of being more active (if you can force yourself into it). A few flights of stairs can bring it down again, if you feel that leaden limbed feeling developing again. This also helps to burn up the glycogen, but it will replenish, especially if you eat a lot of protein. This is a bummer, because protein is nicely satiating, when you want to feel full after all those carbs.

My cravings always give way to fat. So now when I get a craving, I just have a coffee with cream, and they vaporise.

You may have drifted out of ketosis, but you will still be 'fat adapted', which makes it easier to drift back into ketosis again. Personally, I don't rate ketosis over being fat adapted, since one is running on fat, and the other is running dual fuel. I like the dual fuel idea a lot, especially when I want to deplete my glycogen reserves.

 

[Kristin251]

I always say one bad meal equals 3 bad blood sugar days. Corrections don't seem to do much and it becomes correction after correction. Even if it does come down it pops back up. This is why I don't 'cheat' often. And my cheat meals don't even mean more carbs! Just more food in general. Or too much saturated fat ( like a big a*s burger with cheese and bacon)
Most times it's not worth the 3 day penalty. All that correction insulin makes me feel awful. Low energy, weepy

 

[Applenerd81]

I always say one bad meal equals 3 bad blood sugar days. Corrections don't seem to do much and it becomes correction after correction. Even if it does come down it pops back up. This is why I don't 'cheat' often. And my cheat meals don't even mean more carbs! Just more food in general. Or too much saturated fat ( like a big a*s burger with cheese and bacon)
Most times it's not worth the 3 day penalty. All that correction insulin makes me feel awful. Low energy, weepy

Sounds like a very sensible ethos, it's never worth a 3 day penalty. Just can't get over how one "bad" meal can cause 3 days of chaos!

 

[Kristin251]

Sounds like a very sensible ethos, it's never worth a 3 day penalty. Just can't get over how one "bad" meal can cause 3 days of chaos!

I completely agree but it happens consistently. Like I said, I'm not even eating carbs!! Once it was some huge BBQ chicken legs WITHOUT the skin and sauce. That took 4 days but it was a LOT of protein compaired from what I usually eat. But still, give me a break!!! IT WAS CHICKEN! LOL.

And exercise doesn't help my bs. I just go up even more. Perhaps it reduces some glycogen but it doesn't lower my bs, I need insulin for exercise.

 

[Larissima]

I'm also not on insulin, but have developed similar strategies to @Brunneria . Firstly, I eat carbage very, very rarely. When I do eat it, it's not for the whole meal - just for a single course, and not a full portion at that (usually dessert, but last month I ate some home-made spaghetti in a divine Roquefort and cream sauce, all on top of a veal steak). The next day I fast till dinner, with lots of black coffee and some MCT oil in the meantime. My meals in the following few days will contain lots of fat, to reduce any cravings. However, I am fully in ketosis most of the time, which works really well for me - no cravings, ease of fasting, and continuing fat loss and body recomposition.

 

[ickihun]

I've been (pretty much) consistently following lchf to keto wintery of eating since Jan 2015 with amazing results in both body fat loss and blood glucose stability, reduced hba1c - obvious right?

My major issue though however is those meals/days when I just think I'll take a break, have some homemade food at a relatives house, have a couple of - the fuse is lit and what follows is day's of high blood sugars, even being back on lchf/ and even fasting. My (liver/body) seems to freely dump sugar into my blood and seems resistant to any insulin provided. This is all from a day of eating perhaps 80-150g carbs. My DP seems to come back instantly and last 2-3 days before settling, a nightmare for the bg averages!

Short of never deliberately eating carbs again (yes that's obvious!).

How do you manage those once a while/week/month meals? Double basal for a few days? Fasting? Regular monitoring with corrections (me currently)?

When was your liver enzymes last tested? Sounds like your liver over working. A liver detox needed?
My metformin and carbs were interferring with my liver so had to refrain for 12mths.

 

[Applenerd81]

I completely agree but it happens consistently. Like I said, I'm not even eating carbs!! Once it was some huge BBQ chicken legs WITHOUT the skin and sauce. That took 4 days but it was a LOT of protein compaired from what I usually eat. But still, give me a break!!! IT WAS CHICKEN! LOL.

And exercise doesn't help my bs. I just go up even more. Perhaps it reduces some glycogen but it doesn't lower my bs, I need insulin for exercise.

Yikes!

Similarly for me exercise causes my bg to spike, 1-2iu 20 mins before any activity usually does the trick and levels always come down quickly too. Least it's not day's of highs.

 

[Applenerd81]

When was your liver enzymes last tested? Sounds like your liver over working. A liver detox needed?
My metformin and carbs were interferring with my liver so had to refrain for 12mths.

Well assuming it's a normal test - probably in the last 6 months... will have to ask at my annual mot which is coming up soon!

 

[Kristin251]

I also want to mention fasting for BF made everything MUCH worse. I in advertently fasted a few weeks ago. Not on purpose. I wanted to see when my insulin started dropping me. I NEVER did. I took a full days dose in 3 hours after testing every ten min. I never went down until I ate. For me, there is no answer other than time. I've tried everything. Fat only, low protein, no carbs, fasting ( worst) smaller meals. Nothing's but time. Not worth it.