Gastroparesis and diabetes

[rebrascora]

@Isma1123 What did you have to eat and did you inject bolus insulin for the food or was it so low carb that you didn't need anything? Do you inject for protein when you eat low carb? This is normally necessary because in the absence of enough carbs, the body breaks down about 40% of protein and about 10% of fat to produce glucose, however this takes longer to digest/release that carbs do, so you need to bolus for it later. I follow a low carb higher fat way of eating and it really suits me but something like a 2 egg omelette will need 2 units of insulin 2 hours after I have eaten it to deal with the protein release. If you also have Gastroparesis then it could just as easoly be food that has sat in your stomach from yesterday which has released it's glucose today. Perhaps if you had been walking, the exercise stimulated your digestive system and that is why it released.
Or perhaps you are coming down with something.....
3 weeks ago I went out for late lunch with a friend. I had a quiche with salad and half a portion of cake (it was her birthday, so I relaxed my low carb way of eating a bit) and I bolused for all the food I had before I ate it (a generous 9 units or so I thought) but it took another 19.5 units in 7 stacked corrections from 6pm until midnight to keep a lid on my levels. 2 days later I came down with Covid and I am pretty sure, that issue after the meal was my body starting to gear up to fight the virus and my liver releasing glucose to help my body to fight it, even though I had no symptoms then at all then. Whilst I had covid, the first week I needed about 50% more insulin perhaps a bit more and the second week I started hypoing and had to reduce my basal doses to the lowest they have been for 3years, to prevent the nocturnal hypos. So one week I was going high and the next week I was 15% in the red, despite daily reductions in my insulin. That is just diabetes for you and you have to adjust things as you go. Libre makes such a huge difference in helping us manage these situations though.

 

[Isma1123]

@Isma1123 What did you have to eat and did you inject bolus insulin for the food or was it so low carb that you didn't need anything? Do you inject for protein when you eat low carb? This is normally necessary because in the absence of enough carbs, the body breaks down about 40% of protein and about 10% of fat to produce glucose, however this takes longer to digest/release that carbs do, so you need to bolus for it later. I follow a low carb higher fat way of eating and it really suits me but something like a 2 egg omelette will need 2 units of insulin 2 hours after I have eaten it to deal with the protein release. If you also have Gastroparesis then it could just as easoly be food that has sat in your stomach from yesterday which has released it's glucose today. Perhaps if you had been walking, the exercise stimulated your digestive system and that is why it released.
Or perhaps you are coming down with something.....
3 weeks ago I went out for late lunch with a friend. I had a quiche with salad and half a portion of cake (it was her birthday, so I relaxed my low carb way of eating a bit) and I bolused for all the food I had before I ate it (a generous 9 units or so I thought) but it took another 19.5 units in 7 stacked corrections from 6pm until midnight to keep a lid on my levels. 2 days later I came down with Covid and I am pretty sure, that issue after the meal was my body starting to gear up to fight the virus and my liver releasing glucose to help my body to fight it, even though I had no symptoms then at all then. Whilst I had covid, the first week I needed about 50% more insulin perhaps a bit more and the second week I started hypoing and had to reduce my basal doses to the lowest they have been for 3years, to prevent the nocturnal hypos. So one week I was going high and the next week I was 15% in the red, despite daily reductions in my insulin. That is just diabetes for you and you have to adjust things as you go. Libre makes such a huge difference in helping us manage these situations though.

Hi there, I had 2 eggs with abit of avocado & I had done 3 units of insulin. Which seems enough and as you mentioned about the food from yesterday releasing it’s glucose, I managed to pass stools, three times yesterday & some in the morning, considering I don’t eat carbs , so I don’t know. I never inject insulin after, I’ve never been advised to do that, I’ve had a referral made to the hospital for a diabetes review, where they will help me in adjusting medication doses and help with my diet. I’ve stopped eating carbs, I have vegetables, fish mashed and mushrooms, which are zero carb and fibre, I also scrambled egg at times or tuna with eggs and some vegetables, aaah I understand what you mean also when you say that I’m eating protein but not carbs as carbs dosent longer to break down whereas protein does. I will do that next time, I will take a small dose two hours after, what carbs do you include in your diet and how much, so I can take note? Are you’re readings ok also, I’m just worried that these spikes are gonna lead to something serious. I understand what you mean also that the low carbs will help with the breakdown. Could you pls describe a few meals for me that you have, very much appreciated x

 

[rebrascora]

Why did you inject 3 units for 2 eggs and an avocado? There are no carbs in that so I don't understand how you come to calculate 3 units and by injecting them before you eat it, you risk going hypo, especially if you were on 5 and you went for a walk afterwards.
Do you carb count? Have you ever had a DAFNE course? (Dose Adjustment For Normal Eating)

I wonder if your basal (long acting insulin) dose is correct or if perhaps your basal is not enough and those 3 units were propping up your basal insulin.
Which basal insulin do you use and when do you inject it?
When was the last time you did a basal test, or perhaps you have never done a basal test.
How long is it since you adjusted your basal insulin dose?
Are you able to post a screen shot of your Libre graph?

I eat all sorts and I experiment more now with my diet than I ever did before diagnosis although the last few hays I have been living mostly on homemade soup until I tested neg for Covid, thankfully this afternoon, so I can go do some shopping and have something more interesting. I should say that I do not have gastroparesis but my menu is usually...

Breakfast:- Coffee with real double cream. Creamy Greek style natural yoghurt with a few mixed berries or other low carb fruit in season, mixed seeds cinnamon and a tiny sprinkle of nutty granola to give it extra texture. Possible a second cup of coffee with cream.

Lunch:- Half an apple with cheese or a pot of olives with cheese or some homemade soup or I might have a couple of slices of ham with some coleslaw or a 2 egg omellete with mushrooms and cheese and onion and any other veg I have that needs using up like peppers or courgettes or aubergines. Or I might have left over homemade curry from the day before. I have a great recipe for cauliflower, halloumi and chick pea curry with butternut squash.

Evening meal:- It depends, if I had a light lunch I might have high meat content sausages with broccoli and green beans and cauliflower mash or a cottage/shepherd's pie topped with cauliflower mash and lots of grated cheese, or I love ratatouille either with gammon or halloumi or chicken. If I am just wanting a light snack I might have feta stuffed peppadew peppers, or a pot of olives with cheese usually feta or Manchego, but I also get through a lot of cheddar and red Leicester. Cheese has become my new chocolate 🙄
I have half a square of minimum 70% dark choc with a spoon of peanut better as a treat every now and then and I do also enjoy roasted peanuts or mixed nuts.

As I said, I am low carb but for me that is about 70g carbs a day, not including any top up fast acting carbs I might need for hypos or near hypos.

Hopefully that gives you some ideas, but lots more things like steak and salad with coleslaw and celeriac chips or cabbage bhaji wich I absolutely love..... in fact I love cabbage cooked in all sorts of different ways and I serve my bolognaise sauce or chilli on a bed of shredded, cooked, buttered cabbage or there are stir fries of course.

 

[Isma1123]

Why did you inject 3 units for 2 eggs and an avocado? There are no carbs in that so I don't understand how you come to calculate 3 units and by injecting them before you eat it, you risk going hypo, especially if you were on 5 and you went for a walk afterwards.
Do you carb count? Have you ever had a DAFNE course? (Dose Adjustment For Normal Eating)

I wonder if your basal (long acting insulin) dose is correct or if perhaps your basal is not enough and those 3 units were propping up your basal insulin.
Which basal insulin do you use and when do you inject it?
When was the last time you did a basal test, or perhaps you have never done a basal test.
How long is it since you adjusted your basal insulin dose?
Are you able to post a screen shot of your Libre graph?

I eat all sorts and I experiment more now with my diet than I ever did before diagnosis although the last few hays I have been living mostly on homemade soup until I tested neg for Covid, thankfully this afternoon, so I can go do some shopping and have something more interesting. I should say that I do not have gastroparesis but my menu is usually...

Breakfast:- Coffee with real double cream. Creamy Greek style natural yoghurt with a few mixed berries or other low carb fruit in season, mixed seeds cinnamon and a tiny sprinkle of nutty granola to give it extra texture. Possible a second cup of coffee with cream.

Lunch:- Half an apple with cheese or a pot of olives with cheese or some homemade soup or I might have a couple of slices of ham with some coleslaw or a 2 egg omellete with mushrooms and cheese and onion and any other veg I have that needs using up like peppers or courgettes or aubergines. Or I might have left over homemade curry from the day before. I have a great recipe for cauliflower, halloumi and chick pea curry with butternut squash.

Evening meal:- It depends, if I had a light lunch I might have high meat content sausages with broccoli and green beans and cauliflower mash or a cottage/shepherd's pie topped with cauliflower mash and lots of grated cheese, or I love ratatouille either with gammon or halloumi or chicken. If I am just wanting a light snack I might have feta stuffed peppadew peppers, or a pot of olives with cheese usually feta or Manchego, but I also get through a lot of cheddar and red Leicester. Cheese has become my new chocolate 🙄
I have half a square of minimum 70% dark choc with a spoon of peanut better as a treat every now and then and I do also enjoy roasted peanuts or mixed nuts.

As I said, I am low carb but for me that is about 70g carbs a day, not including any top up fast acting carbs I might need for hypos or near hypos.

Hopefully that gives you some ideas, but lots more things like steak and salad with coleslaw and celeriac chips or cabbage bhaji wich I absolutely love..... in fact I love cabbage cooked in all sorts of different ways and I serve my bolognaise sauce or chilli on a bed of shredded, cooked, buttered cabbage or there are stir fries of course.

That’s the thing, I don’t get hypo easily, with the gastro, probably cos the food sits in your stomach, hence why, I’m not very familiar with carb counting and I’ve never been under the hospitals care for ages, I’ve not adjusted my nasal back up insulin for years, hopefully they may be able to do that when I go for my review. The things you have mentioned that you eat, some of them aggravate gastro, such as nearly all vegetables, cos of their high fibre & many vegetables have seeds, so that’s a no, stir fry’s haven’t helped me, broccoli, cauliflower, cabbage, lettuce, tomatoes, kale, cucumber, nearly all of them, plus with the meats you’ve mentioned, I do have meat but it has to be grounded, like minced and poultry like chicken has to be blended, not sure about pies, coleslaw has sugar and I’m sure is quite high in carbs, unless you meant eating in smaller portions. And isn’t cheese too high in fats,It may put a dramatic spike on my blood sugar & that’s what’s holding me back including carbs in my small meals, would you suggest abit of potatoe, would that be safe for me? Most of the vegetables are a no go for me unfortunately. How much carbs do you suggest I add in mu food. Also about the breakfast, should I only use one unit, I have actually read somewhere, that 10 grams of carb is equivalent to one unit of insulin. Reason why Im increasing the dosages slightly is, so I don’t end up with a sugar crash. Many soups are not gastro friendly, unless it doesn’t make a difference if the vegetables are thoroughly cooked. The only vegetables safe for me are carrots, courgettes, zucchini, aubergines, butternut squash and one or two others, cos they’re more softer and digestible. I’ve never attended a dafne course, I think i should. I’m on Novorapid and levermeir is my back up insulin. People have actually told others to consider getting the pump inserted which i think may help improve my overall health, or so I’ve heard, sorry I don’t have a libra graph to show you, I use the old blood glucose testing machine. One more thing, how often do you run on a high and how much is it and what do you do to lower it quickly, I take a teaspoon of cinnamon, or some bitter gourd, not sure I should be using it, if I have this.I always dread checking my blood sugars. I really appreciate you’re time and help. Do you think overall that I should be concerned about my readings? You seem like you know you’re stuff

 

[Leadinglights]

How about vegetables like broccoli and cauliflower cooked and made into soup with added stilton or brie, butternut squash and red pepper also makes a nice soup.

 

[Isma1123]

How about vegetables like broccoli and cauliflower cooked and made into soup with added stilton or brie, butternut squash and red pepper also makes a nice soup.

Yeah I suppose I can, it shouldn’t make a difference should it, still abit weary, because of their high fibre count. Tbh, I’ve never made soups, so I’m gonna consider giving them a go. Also, how much carbs exactly do you use for your meals, cos I was put off having carbs since finding out I have this condition, because of the delay of emptying. Advice would be much appreciated

 

[Leadinglights]

Yeah I suppose I can, it shouldn’t make a difference should it, still abit weary, because of their high fibre count. Tbh, I’ve never made soups, so I’m gonna consider giving them a go. Also, how much carbs exactly do you use for your meals, cos I was put off having carbs since finding out I have this condition, because of the delay of emptying. Advice would be much appreciated

Soups are really easy, I just boil the veg in a pan with a stock cube then blitz with a stick blender, add seasoning as needed usually black pepper. It's amazing how much soup just a few veg will make.
I am Type 2 so restrict my carbs to about 70g per day, say 15-20 for breakfast, same for lunch and 25g for dinner, but your situation is rather different being Type 1.

 

[rebrascora]

@Isma1123

Your knowledge of diabetes would really benefit from a DAFNE course, even if you are not able to eat "Normally" due to your Gastroparesis and it might get your foot in the door for a pump if the course educators think you would benefit from one.
The pump is not inserted in your body as such, it is applied externally, either via a cannula and tube to the pump which can be clipped to your belt or put in a pocket or a patch pump which incorporates the cannula and pump in one unit with no tubing and it sticks to the skin wherever you decide to place it. You do still have to tell the pump how many carbs you are going to eat or how much bolus insulin to deliver, even with the new hybrid closed loop systems which link to a sensor like Libre that samples your levels every few minutes and sends the readings to the pump for it to adjust your background insulin.

Is there a reason why you don't have a Libre sensor? All Type 1 diabetics should have them by now if they want them and it gives you a much better understanding of what is going on between finger pricks and particularly through the night. Plus they have high and low alarms, to warn you if levels are going low or high.

As regards going high, I have my Libre high alarm set at 9.2 and if the alarm goes off I either do some exercise (running up and down stairs 20 times will drop my levels by about 2mmols) or a good brisk 20 min walk or if appropriate, inject some more insulin. Much as I like cinnamon, eating a spoon of it or bitter gourd is not going to be pleasant or reduce your levels by any significant amount, if at all! Have you not been taught about doing correction doses with insulin? I am quite surprised that you have been diagnosed so long and not been taught carb counting and corrections. It is something you would need to learn to use a pump. And yes, they usually start you off with 10g carbs requires 1 unit of insulin but it varies from person to person as some are more sensitive to insulin and others less so. It can also vary with the time of day, plus if you are following a low carb way of eating, you have to factor in protein as I mentioned in a previous post. If you don't know how to do corrections when your levels are high and you are following a low carb way of eating, you are at risk of DKA, especially if you were to get ill.

It sounds like you have been left behind with current thinking and support in diabetes management and I think you should be pushing for a referral to a specialist diabetes clinic because your GP surgery is not knowledgeable enough to support you with Type 1 diabetes management and particularly now you have gastroparesis and unless you have some particular reason not to want it, you should have been getting Libre sensors on prescription for at least the last year. You should also have access to the specialist diabetes dietician for your gastroparesis.

Yes, cheese is a mixture of protein and fat (and so are eggs) and contains no fibre, so it is fine on a low carb diet with gastroparesis I would think. You have to get your energy from somewhere and just eating protein with very little carbs and very little fat and not much fibre is likely going to bung you up, so not only will your stomach be slow to empty but your gut will probably be really slow too.
No coleslaw doesn't contain sugar, at least the full fat ones don't or shouldn't, but they do contain cabbage which sounds like it is not good for you.

I really strongly feel that you have not been supported with your diabetes management as you should be and that you need specialized support from a diabetes clinic, especially now you have gastroparesis and an intensive education course like DAFNE would be beneficial.

 

[AJLang]

I'm too tired at the moment to type much but some great advice from @rebrascora. However, three points with regard to gastroparesis and what you've said @rebrascora that I feel I need to highlight. I agree with what you've said for Type 1 diabetes and I think in the above situation the basal needs looking at by a Diabetic Specialist nurse at the hospital AND Dafne is an excellent starting point BUT having gastroparesis throws all of the balls up in the air and changes what we normally understand to work.
a) The official guidance is that Gastroparesis should involve a diet that is both low fibre AND low fat due to both both causing delayed gastric emptying. However the individual needs to experiment with how this works for them and this is why a qualified dietician is so important.
b) I've not read anything that recommends low carbohydrate for gastroparesis and as the diet is low fibre and low fat my conclusion is that low carb as well would not give enough nutrition.
c) As the food is delayed in the stomach it does not match the normal process of bolus insulin working in relation to when we eat i.e. the food may not get digested in time causing a post meal hypo which is difficult (not impossible) to deal with because as the stomach still has food in it what we use for a hypo, even by chewing it for ages to absorb in gums, can take a long while to bring up the hypo this in turn leads to needing more hypo treatment than "usual" to get out of the hypo - sometimes in my experience taking two hours - as a result when both the meal food and hypo treatment(s) have finished digesting the blood sugar can go too high. Hence the difficulty in managing gastroparesis. BUT this can be managed by a) very small meals and b) using what is called an extended wave on the insulin pump which means that bolus insulin is delivered over a longer period and so works better as the meal digests. c) Using a temporary basal rate to reduce the amount of basal insulin being used if heading towards a hypo.
I've learnt through trial and error how to get this right and now just have mild hypos, not very often, that can be easily dealt with. But really it should be with the guidance of a diabetic specialist nurse experienced in gastroparesis i.e. almost certainly based at the hospital not in a GP practice. There's a lot more help and knowledge available now then when I was diagnosed with gastroparesis 14 years ago (after over 40 years ago of diabetes).

 

[AJLang]

Yeah I suppose I can, it shouldn’t make a difference should it, still abit weary, because of their high fibre count. Tbh, I’ve never made soups, so I’m gonna consider giving them a go. Also, how much carbs exactly do you use for your meals, cos I was put off having carbs since finding out I have this condition, because of the delay of emptying. Advice would be much appreciated

You can eat some fibre and fat, it depends upon how your gastroparesis tolerates it. One of the recommendations if gastroparesis worsens (which it doesn't necessarily do) is to eat pureed food and liquid food - this is in the later stages only if it progresses BUT does mean that you should easily be able to eat well cooked vegetables blended into a soup or a smoothie (or what the vegetable version of a smoothie is 🙂 I can eat a small amount of vegetables in small salads etc but I'm not sure how much of that I've been able to tolerate because of the medications that I'm on. But yes you right to avoid high fibre food in it's "natural" state due to the risk of it getting stuck in the stomach - obviously I can only speak for my experiences but I haven't had that happen.
Two questions
a) you say that the food takes two days to digest - how do you know that?
b) has your weight change since the gastroparesis "diagnosis"
I really hope that you're able to get the gastric emptying test so that it can properly be confirmed that it is gastroparesis and not something more simple causing your problems.

 

[Isma1123]

L

Soups are really easy, I just boil the veg in a pan with a stock cube then blitz with a stick blender, add seasoning as needed usually black pepper. It's amazing how much soup just a few veg will make.
I am Type 2 so restrict my carbs to about 70g per day, say 15-20 for breakfast, same for lunch and 25g for dinner, but your situation is rather different being Type 1.

Well I had included some carbs in my meal yesterday, about half a potatoe, so that equivalent to one unit of insulin, I’m sure it’s every 10 grams isn’t it for every 1 unit, so yeah I had half of a potatoe and when I checked my glucose levels after one hour, it fluctuated to 11, my post meal reading before was 4.3 followed by a small little hypo, so I slowly brought that up. Maybe carbs don’t work for me, hence why I think it’s best I eliminate them completely to avoid spikes. Majority of the times after meals I have a pretty good reading, cos of no carbs, also does missing a meal & I dot mean intentionally, it’s just abit difficult at times when having to run errands, can that spike your blood sugar post meal, I’ve been getting that a few times, and it’s always after I have had a few boiled eggs for breakfast with avocado, can you pls explain? Thank you

 

[Isma1123]

@Isma1123

Your knowledge of diabetes would really benefit from a DAFNE course, even if you are not able to eat "Normally" due to your Gastroparesis and it might get your foot in the door for a pump if the course educators think you would benefit from one.
The pump is not inserted in your body as such, it is applied externally, either via a cannula and tube to the pump which can be clipped to your belt or put in a pocket or a patch pump which incorporates the cannula and pump in one unit with no tubing and it sticks to the skin wherever you decide to place it. You do still have to tell the pump how many carbs you are going to eat or how much bolus insulin to deliver, even with the new hybrid closed loop systems which link to a sensor like Libre that samples your levels every few minutes and sends the readings to the pump for it to adjust your background insulin.

Is there a reason why you don't have a Libre sensor? All Type 1 diabetics should have them by now if they want them and it gives you a much better understanding of what is going on between finger pricks and particularly through the night. Plus they have high and low alarms, to warn you if levels are going low or high.

As regards going high, I have my Libre high alarm set at 9.2 and if the alarm goes off I either do some exercise (running up and down stairs 20 times will drop my levels by about 2mmols) or a good brisk 20 min walk or if appropriate, inject some more insulin. Much as I like cinnamon, eating a spoon of it or bitter gourd is not going to be pleasant or reduce your levels by any significant amount, if at all! Have you not been taught about doing correction doses with insulin? I am quite surprised that you have been diagnosed so long and not been taught carb counting and corrections. It is something you would need to learn to use a pump. And yes, they usually start you off with 10g carbs requires 1 unit of insulin but it varies from person to person as some are more sensitive to insulin and others less so. It can also vary with the time of day, plus if you are following a low carb way of eating, you have to factor in protein as I mentioned in a previous post. If you don't know how to do corrections when your levels are high and you are following a low carb way of eating, you are at risk of DKA, especially if you were to get ill.

It sounds like you have been left behind with current thinking and support in diabetes management and I think you should be pushing for a referral to a specialist diabetes clinic because your GP surgery is not knowledgeable enough to support you with Type 1 diabetes management and particularly now you have gastroparesis and unless you have some particular reason not to want it, you should have been getting Libre sensors on prescription for at least the last year. You should also have access to the specialist diabetes dietician for your gastroparesis.

Yes, cheese is a mixture of protein and fat (and so are eggs) and contains no fibre, so it is fine on a low carb diet with gastroparesis I would think. You have to get your energy from somewhere and just eating protein with very little carbs and very little fat and not much fibre is likely going to bung you up, so not only will your stomach be slow to empty but your gut will probably be really slow too.
No coleslaw doesn't contain sugar, at least the full fat ones don't or shouldn't, but they do contain cabbage which sounds like it is not good for you.

I really strongly feel that you have not been supported with your diabetes management as you should be and that you need specialized support from a diabetes clinic, especially now you have gastroparesis and an intensive education course like DAFNE would be beneficial.

A dafne course is something I’m definitely going to recommend doing, also I don’t have any problems with eating and am absolutely fine, I had a sugar spike last night of 11 because of having half a potatoe, with my meal,I did insert the right amount of insulin, ok I added an extra unit, I usually do give myself about 1 or 2 if needed, , especially if the post meal is abit high, because it helps bring my blood sugars down. I also had two fillets, thawed and mashed, seasoned, and some boiled carrots and abit of mushroooms sautéed. Maybe I need to reduce my protein intake abit, but I did give myself enough insulin, not the exact amount but an extra unit. It may be that 12- 15 grams is one unit, or 10 grams, i might have made a mistake with the fillets, cos each fillet was 22 g and I only gave one for each, & one unit for the carrot, cos carrots have 10 grams of each I think. I should have given two for each of the fillets, mistake could have been made there, or maybe I should eliminate carbs completely if that works for me, but we’re all different, probably insulin sensitivity could be the case. Being worried constantly dosent help either, my main concern is just maintaining my hbc1 levels. Hopefully a visit to my Diabetes review should make the difference. Otherwise I’m always on my feet, full of energy, hoping for the best. Didn’t you mention that it’s normal for it to go slightly high after a meal. Thanks

 

[Leadinglights]

L

Well I had included some carbs in my meal yesterday, about half a potatoe, so that equivalent to one unit of insulin, I’m sure it’s every 10 grams isn’t it for every 1 unit, so yeah I had half of a potatoe and when I checked my glucose levels after one hour, it fluctuated to 11, my post meal reading before was 4.3 followed by a small little hypo, so I slowly brought that up. Maybe carbs don’t work for me, hence why I think it’s best I eliminate them completely to avoid spikes. Majority of the times after meals I have a pretty good reading, cos of no carbs, also does missing a meal & I dot mean intentionally, it’s just abit difficult at times when having to run errands, can that spike your blood sugar post meal, I’ve been getting that a few times, and it’s always after I have had a few boiled eggs for breakfast with avocado, can you pls explain? Thank you

Somethings are difficult to explain as every body will react differently, you will react in a different way to somebody who is Type 1 but without the complication of the gastroparesis and certainly very different to somebody who is Type 2. Hence I personally can't explain.

 

[Isma1123]

Somethings are difficult to explain as every body will react differently, you will react in a different way to somebody who is Type 1 but without the complication of the gastroparesis and certainly very different to somebody who is Type 2. Hence I personally can't explain.

I am type 1, so yeah, everyone is different, how are you dealing with your gastroparesis & how long have you had it for

 

[Isma1123]

You can eat some fibre and fat, it depends upon how your gastroparesis tolerates it. One of the recommendations if gastroparesis worsens (which it doesn't necessarily do) is to eat pureed food and liquid food - this is in the later stages only if it progresses BUT does mean that you should easily be able to eat well cooked vegetables blended into a soup or a smoothie (or what the vegetable version of a smoothie is 🙂 I can eat a small amount of vegetables in small salads etc but I'm not sure how much of that I've been able to tolerate because of the medications that I'm on. But yes you right to avoid high fibre food in it's "natural" state due to the risk of it getting stuck in the stomach - obviously I can only speak for my experiences but I haven't had that happen.
Two questions
a) you say that the food takes two days to digest - how do you know that?
b) has your weight change since the gastroparesis "diagnosis"
I really hope that you're able to get the gastric emptying test so that it can properly be confirmed that it is gastroparesis and not something more simple causing your problems.

Hey there, in terms of the food emptying, it does take the most, two days for me, why do you say? My gastroparesis doesn’t tolerate fibre at all, hence why I’ve cut it out completely. The clinician said to me yesterday that when I go for my diabetes review, they may be able to further refer me to any other specialists. I hope so too. My weight hasn’t changed since the last month, even though I’ve lost 10 pounds, over the year, presuming I had changed my diet and was eating more healthily, like a lot of vegetables and salads, cutting out anything bad etc. I wouldn’t say I’m gone gaunt or anything, more than anything, I look pretty much the same.

 

[Leadinglights]

I am type 1, so yeah, everyone is different, how are you dealing with your gastroparesis & how long have you had it for

Sorry I think you have got the wrong end of the stick or are thinking of someone else, I don't have gastroparesis.

 

[Isma1123]

Sorry I think you have got the wrong end of the stick or are thinking of someone else, I don't have gastroparesis.

Oh I apologise, I misinterpreted what you had said

 

[PattiEvans]

Sorry to poke my oar in, but if your tongue was white could you possibly have thrush? Any infection will probably push BGs up. Perhaps ask a pharmacist to look at it.

 

[Isma1123]

Sorry to poke my oar in, but if your tongue was white could you possibly have thrush? Any infection will probably push BGs up. Perhaps ask a pharmacist to look at it.

My tongue goes white quite a lot, so I’m always sipping on water to avoid further dehydration, gastro does make your tongue go white because the food is sitting in the stomach and spikes blood sugars

 

[PattiEvans]

My tongue goes white quite a lot, so I’m always sipping on water to avoid further dehydration, gastro does make your tongue go white because the food is sitting in the stomach and spikes blood sugars

Which might point to thrush. Very common in diabetes.