Tiredness

[susieg]

I'm in my third week of low carbing now but I feel very tired. Is this normal? I've been cutting down on bread,pasta,rice,potatoes etc... all processed carbs. My diet has consisted mainly of eggs, cheese, salads, veggies and plain yogurt with some berries. I do miss my muesli for breakfast and my occasional slice of toast.

Everyone says that low carbs make them feel more energetic, I feel somewhat deflated. but on the other hand it does keep my glucose levels more on an even keel.

 

[nigelho]

Hi Susieg,
How are you getting on these days on your low carb diet? I've been a type 1 for 3 years and have finally got myself off, with difficulty, all analogue and human insulins. I'm now on porcine insulins which, at date, my system is accepting. My tiredness/fatigue, and drugged up feelings have all but gone, after 3 years of hell.

What type of diabetic are you. I too understand that low carbs help enourmously in keeping our BSs under control. Remember it the carbs on lables we need to look at. I still eat most things but in moderation. I'm going to try Burgen Bread which has about 12 carbs per slice as I do like a piece of toast. Don't let the deiabets beat us. As I inject I can adjust the dose to what I eat but if I go silly with carbs then I end up with a high reading. My job is quite physical..heavy lifting and driving..home shopping driver..so I feel that I need some carbs as my sugar levels tend to drop quite rapidly during my shift. For me, that seems to be NORMAL as sometimes cutting the grass with an electric mower can send me into hypo or doing some light DIY.

 

[susieg]

Hi Susieg,
How are you getting on these days on your low carb diet? I've been a type 1 for 3 years and have finally got myself off, with difficulty, all analogue and human insulins. I'm now on porcine insulins which, at date, my system is accepting. My tiredness/fatigue, and drugged up feelings have all but gone, after 3 years of hell.

What type of diabetic are you. I too understand that low carbs help enormously in keeping our BSs under control. Remember it the carbs on lables we need to look at. I still eat most things but in moderation. I'm going to try Burgen Bread which has about 12 carbs per slice as I do like a piece of toast. Don't let the diabets beat us. As I inject I can adjust the dose to what I eat but if I go silly with carbs then I end up with a high reading. My job is quite physical..heavy lifting and driving..home shopping driver..so I feel that I need some carbs as my sugar levels tend to drop quite rapidly during my shift. For me, that seems to be NORMAL as sometimes cutting the grass with an electric mower can send me into hypo or doing some light DIY.

Hi, I am type 1, have been now for 19months. I am not getting on too well with the low carbing, I really was at a loss as what to eat after a while and I hated the tired feeling. I am now at a half-way house, eating no more potatoes/pasta/rice, but having bread and rolls which I just missed too much before. I find it suits me better like this. so I just have meat/salads/omelettes etc. but I still find it a tad boring, but as for the insulin, I'm not sure. I don't really understand about the different types as yet, but I am in line next month to do a dafne course, so i'll ask a lot of questions there. thanks for your reply.
p.s. I get hypo's when I mow the lawn or clean my car too!!

 

[cteld]

Hi, about the low energy - were you sure to get enough fat in your diet? When you go low carb, you generally want to replace the carbs you gave up with extra fat - so plenty of high-fat foods like butter, tallow, lard, cheese, nuts, seeds, coconut oil, olives, avocado, cream.... It's a total about-face with the standard "healthy" diet and most people who have been trained that a healthy diet means low-fat have a hard time with this part. But it seems that a sustainable low-carb way of eating means high fat. Having enough dietary fat is especially critical to not being hungry or getting carb cravings or feeling deprived, or so my own experience has taught me. But that doesn't work for everyone, of course....

 

[susieg]

Hi, about the low energy - were you sure to get enough fat in your diet? When you go low carb, you generally want to replace the carbs you gave up with extra fat - so plenty of high-fat foods like butter, tallow, lard, cheese, nuts, seeds, coconut oil, olives, avocado, cream.... It's a total about-face with the standard "healthy" diet and most people who have been trained that a healthy diet means low-fat have a hard time with this part. But it seems that a sustainable low-carb way of eating means high fat. Having enough dietary fat is especially critical to not being hungry or getting carb cravings or feeling deprived, or so my own experience has taught me. But that doesn't work for everyone, of course....

Yes Cteld, I did have more fats, cheese, cream, greek yogurt, butter (mmm) I always eat olives anyway, so I don't think it was that, I felt a little odd though, as I have high cholesterol too, and am on statins, so It played a little with my conscience. I don't know what's going on with me right now, I'm a little confused to say the least, my BG is a bit up in the air at the moment, I don't know whether it's me changing back to a few more carbs or what, but yesterday I woke up with 14.1 reading and this morning a 9 ! I think it might be my basal not being right, I suppose I ought to do the fasting test thing, but I can't imagine not eating for a whole day!! :?

 

[dawnmc]

Have you had a look at statin side effects? Cholesterol isnt as dangerous as the medical profession would have us believe. They can do funny things to the brain, my partner had panic attacks when he took them. Others get joint pain etc.

 

[hanadr]

susie
If you can get hold of a copy, read Dr. Bernstein's Diabetes Solution.
He's an american doctor, aT1 himself and believes that diabetics have a right to Normal blood glucose, He's kept to a low carb, low dose insulin regime for many years. The only reference I have found in his book on fatigue, is that it's due to high blood glucose .
You have reduced your carbs, but how is your blood sugar doing? Bernstein quotes 85mg/dl as the normal level. that equates to 4.7mmol/l So if you are not yet near there, you could still be feeling the weightt of sugar.
I agree 4.7 is difficult to get to and keep, so I try to keep around 5 and i do notice tiredness if I creep up near to 6
Hana
PS I've been low carb and minimal medication for several years and it's definitely been worth the effort of getting used to it

 

[susieg]

susie
If you can get hold of a copy, read Dr. Bernstein's Diabetes Solution.
He's an american doctor, aT1 himself and believes that diabetics have a right to Normal blood glucose, He's kept to a low carb, low dose insulin regime for many years. The only reference I have found in his book on fatigue, is that it's due to high blood glucose .
You have reduced your carbs, but how is your blood sugar doing? Bernstein quotes 85mg/dl as the normal level. that equates to 4.7mmol/l So if you are not yet near there, you could still be feeling the weightt of sugar.
I agree 4.7 is difficult to get to and keep, so I try to keep around 5 and i do notice tiredness if I creep up near to 6
Hana
PS I've been low carb and minimal medication for several years and it's definitely been worth the effort of getting used to it

I've read the book, I actually bought it, but found it somewhat extreme, I just ran out of things to eat, basically, I like my food and I don't particularly like meat, so it's a bit of a chore for me to keep to such a low carb diet. I eat salads, veggies and eggs/cheese/ etc as much as I can, cut out potatoes, rice and pasta, but my bloods still seemed to rise, no matter what. I'm off to see the nurse on tuesday as they want to see me regarding a rise in my hba1c. I think, personally it's all down to the honeymoon period, my BS were brilliant the first year, then they seems to go all over the place. I am trying to establish a good basal rate now, it's creeping up more and more. I started with 12u at night now I'm on 16. and counting....
To tell you the truth I am really fed up with trying to suss it all out. they say type 1 can eat normally if you get the insulin right!! so DAFNE in 2 weeks has a lot of explaining to do!

 

[susieg]

Have you had a look at statin side effects? Cholesterol isnt as dangerous as the medical profession would have us believe. They can do funny things to the brain, my partner had panic attacks when he took them. Others get joint pain etc.

Yes Dawnmc, I have, I was on simvastatin when I was first dx, and it gave me terrible leg cramps, so I stopped taking it, after 6months they asked to reconsider as my cholesterol had risen quite a bit, I argued til I was black and blue the reasons why I didn't want to take it, The dr.offered me a much much lower dose statin and a different make. I agreed to a 3m trial, My cholesterol is now down to an acceptable level , no side effects and I am still taking them. I won't forever though, just till they are satisfied I'm not going to keel over with a heart attack (I have lots of heart problems in my family)

 

[hanadr]

Susie
I'm T2 with a T1 husband, who is supposed to adjust his dose of insulin, but has never been offered DAFNE in well over 30 years. I've got his carbs and insulin down by following Bernstein. I agree the book's not easy, but it is comprehensive. Ioften dip in to my copy
I'm sorry to have to say that your aalternatives as a T1 are:
low carb/low insulin OR Norma[high carb]/high dose insulin.and increased risk of hypos.
I know it can be frustrating and it takes a while to get used to it. For myself, I prefer to keep medication to a minimum.
It's even harder if you don't eat meat, but you say you don't much like meat, not that you are a vegetarian, so now might be a time to try different meat recipes.
Hana

 

[susieg]

Susie
I'm T2 with a T1 husband, who is supposed to adjust his dose of insulin, but has never been offered DAFNE in well over 30 years. I've got his carbs and insulin down by following Bernstein. I agree the book's not easy, but it is comprehensive. Ioften dip in to my copy
I'm sorry to have to say that your aalternatives as a T1 are:
low carb/low insulin OR Norma[high carb]/high dose insulin.and increased risk of hypos.
I know it can be frustrating and it takes a while to get used to it. For myself, I prefer to keep medication to a minimum.
It's even harder if you don't eat meat, but you say you don't much like meat, not that you are a vegetarian, so now might be a time to try different meat recipes.
Hana

Hi Hana,
I was offered the DAFNE course by my GP, I didn't ask, he just offered it! I think we're all eligible to go and he should just ask.
Re low carbs, I'd love to try it, I just don't understand all the stuff in Bernsteins biook, it just sounds so radical. I dont use a lot of insulin really, about 3-7 u for each meal, I think once I get my basal right I'll be more on an even keel, I hope so. I just can' see how to get my boluses any lower other than living on salad. which I almost do now. but I do love my food, as I said, I eat a lot of chicken, and sausages, that's about the only meats I do like. Oh, and ham (with salad)

I hope after a few more years it won't seem so baffling, 30yrs is a long time to get things sorted. I don't think I'll have that long anyway lol.

 

[nigelho]

Hi Susieg,
There is a good chance that the insulins you're on isn't working for you. What insulins are you taking? I used to be on novorapid and levemir then lantus which was HELL for me..Tiredness, foggy headed, fatigue and even had to reduce my hours of work..I still eat whatever I want ....in moderation, but I find cereals give me a high unless I increase my insulin..I'm now on porcine neutral and porcine isophane. My blood pressure is highish and vit D deficient. Thankfully, the tiredness, foggy headed etc have all gone and my strength in returning. I can now walk without having to drag my legs.

Remember that your insulin dose depends on what(CARBS) you eat, so on a low carb diet (don't go silly as food is energy)

you'll need less insulin. I just look on the amount of carbs per say 30grams. If you carb count you can then work out how much insulin to inject. Failing that, look at what you eat then make sure you're checking your BGs before and 2 hours after meals, You can then adjust the BGs , if you're high, by doing a correction dose..see your DSN if you're unsure. This is just s simple guide to carbs, but LOOK at the carb details on the packets. If I'm going to do any DIY I just have a light 'carb snack' before doing the DIY.

For me I aim for BGs around 6-9, I've tried to aim for lower but I tend to go into hypo if I start to do ANYTHING. It seems that's how my body work. I'm still learning what doses to use especially when I'm at work as it's physical. On my days off I have to use MORE insulin for the 'same' meal otherwise I end up high.

Just a thought for porcine neutral users, I find that I need to test up to 3 hours instead of the usual 2 hours after a meal. Maybe, that's ME...

Having gone through 3 years of needless hell on the wrong insulins..analogue and human insulins...check that the insulins are OK for you. Many diabetes teams try and get everyone on analogue and don't like people saying that it's giving you the 'side effects'.

 

[susieg]

Hi Nigelho
I'm on Humalog and Lantus. I had no side effects with both of these up until I started trying to cut down on the carbs, that's what made me think it was that. Last night I succumbed to rice (just 100g) and chicken Korma curry!! Heaven!! but I needed more insulin, but It was worth it, as a special treat. This morning I woke up at a decent 4.6! yet the other day, having just a veggie omelette I woke up at 14 !! I can't reason with it at all!!
Well, I'll ask all my questions when I get to do this course , regarding insulins and carbs. I'd better take a hefty notebook, coz I'm bound to forget it all if I don't.

 

[nigelho]

Hi Susieg,
I haven't used Humalog but I did use humulin S and I for a short while before going onto porcine. I found that I needed almost 3 times more humulin S than when I used novorapid. With the porcine neutral I take approx 2 - 3 times the dose, depending on what I'm eating than when I used novorapid. A good example is a 30g bowl of cornflakes with semi skimmed milk..approx 10 units novorapid but I need approx 30 units of porcine neutral. My ratios with porcine is 1 to 1 but with novorapid I used 4units to 1 carb. It getting to know what works for you.

I'm still trying various doses with the porcine isophane at night. I've split the doses and at present I seem to need 3 injections of the isophane as it only seems to last 8-9 hours before my BSs start to rise quite quickly. It's not that I 'hit' hypo and my liver has kicked in. I've checked my readings twice during the night and have had readings between 5 to 7 which is great but when I get up around 6.00am my readings have been 13 to 15. Since I been infecting 3 times with the isophane it hasn't been too bad. I've also tried different times during the evenings and am settling on injecting between 9 to 10pm. When I used to be knackered I used to be going to bed around 7.00pm but I'm retraining myself to go to bed later.

At breakfast, 6.15am I inject 12 units, around 2 pm I inject 6 units and around 9pm I inject 16 units. I also trying to have a 'lighter' carb meal for my tea. This morning my BSs were 6.4..it's been around 13.5s lately.

All the best on your carb course. 100g grams is approx 32 grams then there's the korma sauce. I would use approx 30 units porcine neutral for that meal, but if it works and you get the insulin dose correct then usually there's no problems..unless you're trying to lose weight. I'm about 5'9" and 74 kgs.

 

[susieg]

Nigelho

I notice, after today, being out all day walking with the dog, and generally enjoying the sunshine, my readings were really good, 4.7 this morning 6.0 at lunchtime, and 7.0 before evening meal, that exercise makes all the difference. I walked for miles today and had to have a few snacks in between meals to keep going, last week, rain and not going out much, high readings.
It just confirms my theory that being a diabetic is like being on a rollercoaster !
btw I am 5'7" and 70kg so I don't worry too much about weight.

 

[nigelho]

Hi Susieg,
How are things working out now? I've now been on the porcine for 2 month and feeling so much better now that I'm off analogue insulins. I still working on my doses of the neutral and isophane, it's up and down. I have to use LESS neutral when I eat while at work as it's quite heavy work and my BGs drop quite quickly. My morning BGs are not good as I'm not sure how the isophane is working. I've split it into 3 doses, approx 10units at breakfast, 4units at lunch and 16units at tea around 5.00pm. At the monent, after a hard days work I've gone into hypo half hour after injecting (tea time) so I'm not going to inject 20 minutes before eating, I'll just do it prior to eating, like when you use novorapid, as I've gone into hypo 3 days running...It's so much trial and error. However, I'll get it right soon.