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Type1. I have a question.

SandyDee

SandyDee

Well-Known Member
Messages
130
Location
Slough
Type of diabetes
Type 1
Treatment type
Pump
I have been low-carbing for several months now and I wonder if anyone has found it more difficult to treat hypos? I am definately having less hypos, but they seem much harder to treat. I used to just have 1/3 glass of full fat coke to get it up and then carbs to keep it up. Now I am having a whole bottle of coke with no effect, then some sweets or a sugary tea and sometimes it's still not back to a 'normal' level.
 
this may be happening due to your basal dose not being correct, or slightly off anyway.....

because you have cut the carbs right out and hence reducing your bolus dosing, this may now be exposing a surplus in basal, which may have been hidden by small inaccuracies of the bolus, if you know what I mean....

all just speculation though....lol.....:)

when are the hypos occurring currently? Is there pattern?
 
Having low-carbed for over 2 years I find it much easier to treat lows - a single dextro tab raises me by 1mmol.

I agree that it sounds more like a basal hypo if it's that persistent.
 
My speculation: you have depleted glycogen reserves (the result of ketosis) and the Coke addresses that first and your blood sugar second.

It's my understanding that our bodies can retain about 2000 calories worth of glycogen storage, but only 250-500 can be stored in your liver (the rest is primarily stored in your skeletal muscle).

Considering that a can of Coke (side note: what is a "full fat" Coke?) only has about 170-200 calories, that would certainly explain why you need more to correct a hypo.
 
Follow-up: someone who low carbs, but isn't necessarily in ketosis may not have completely diminished glycogen reserves, and even those in ketosis may still have some glycogen reserves.

That would explain why some low-carbers can correct a hypo easier than others as excess carbohydrates would be converted into glucose and dispersed about your body through your blood stream.

(Or at least that's my understanding,lol)
 
Hi,

I'm not familiar with this I'm afraid. I would have thought that the opposite would have happened as you are taking smaller boluses and the bolus is the normal 'source' of the hypo.

So, try the famed basal test to make sure that you don't need to drop that.

I've noticed that my daily fluctuations in blood sugars are much more noticeable on a low-carb approach and so have been able to fine tune my basal to match them.

I would also try and use pure glucose to treat hypos instead of coke; you can get glucose gel in little sachets (aimed at runners) or the old dextrose tablets. Certainly do that if this seems persistent.

Are there any patterns to your hypos?

Best

Dillinger
 
Invariably if you lower your carbs then you wiil also need skightly less basal aa well as less bolus.

Eg if you were on basis of your bolus and basal working out to be pn a 50/50 ratio ie just an example of 10 units bolus and 10 units basal
Each day. The impacy of having less carbs may knock you down to only needing 5 units of bolus.. This then knocks your 50/50 ratio out of the window... So it would be likely as well that you are needing less basal.

The need to be gulping down extra hypo stopping drinks etc is because your insulin is plummeting.. Very little to do with less carbs but prob just showing how incorrect that insulin is...

I low carb... My favourite is stilll milk and sugar from a tommee tippee mug. Depending upon the level of my bg would depend whether I give two or three teasoons of sugar. The milk although peoplle say the fat slows down the sugar absorption actually keeps me raised enough without needing to add on any other long carb afterwards.

I certainly don't need to shovel extra glucose stoppers. I think thats just showing how much the insulin is plummeting by and how far out the qty of insulin is.
 
I think SandyDee would have had to significantly (300g+ reduction)reduce her carb intake for her basal to cause "plummeting" blood sugar drops. Presumably, she is carb counting and has reduced her bolus insulin appropriately. Had she not, I'm sure she'd be having SIGNIFICANT issues with hypos on a daily basis.

Obviously, too much basal can cause a hypo, but I can't see a situation where it would cause a rapidly onset hypo that also requires significantly higher carb/sugar requirements to correct. If it did, it would basically defeat the purpose of a basal/bolus insulin approach.

Again, I'm not suggesting it's impossible, but there would have to be some extreme miscalculations made for that to occur.
 
Thanks for all the replies - I have reduced my basal levels since low carbing and do regular fasts to check and they are fine. The hypos are at different times, after different foods and I can see no pattern. The depleted glycogen reserves is an interesting idea, I shall have to investigate further.
 
Different foods do have such different affects... Thats why some people like the pump so much because it enables you to give varying amounts and timings of bolus to suit the foods eaten.... Ie if grazing two hours over a buffet some may do an extended bolus.. If eating say puzza some may do a multiwave bolus.
Great to hear you have also adjusted basals and doing fasting tests.
On MDI..it is possible to do similarish actions but it does take figuring out... I've had to recently have to figure out just how a fish n 10chips and curry sauce from takeaway would affect me... It is so rare that I have to get a takeaway-only when moving or re doing kitchens!! - but I had my normal calculated bolus when eating which was 7pm. I knew the takeaway affect would occur with me from 2am onward so at 10pm when I did my basal I gave 50% extra which would kick in when I needed it.
Food is trial and error. I have very limited food due to other problems but once again back to MDI there is the option of making better choices or trying to adapt to the choices by altering the way we dose....
 
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