High BG on LCHF...

[DeusXM]

I take it from this you regret doing it? One of the first things I can remember being told at diagnosis was control the carbs. If you don't it's not long before you find out why. I've done that ever since and typically have between 120-200g a day although it is more when I'm exercising. I'm not sure if that's considered high or low. Ratios are 1:10, 1:12 and 1:10 with 20 units of Tresiba. Corrections are 1u to 3 mmol/l. (No need for IV 😱). These ratios haven't changed much in 30 years, in fact sensitivity has increased with the 1:12 at lunchtime. So I'm almost on fewer units of insulin than you but 4 to 7 times the carbs. Control is okay and my last HbA1c was 48. Hopefully when I go on the pump this will improve. Compared to your experience, most of all I find my quality of life is fine as I don't consider what I do too restrictive.

Interestingly, I don't actually regret it, for multiple reasons.

Firstly, it's removed the spikes that I get. As a result, I rarely get those periods after meals where I feel rank for a few hours. That has also led to my blood sugar average essentially being non-diabetic. That's a good thing.

Secondly, the last time I checked, my cholesterol readings were awesome. TC was elevated at 5.2, but the split and the trigs were actually better than what you'd find in someone without diabetes.

Thirdly, I think I was sort of built for low-carbing anyway. Put steak, chips and salad on the table, tell me I can't have the chips and I'll be struggling to see the problem. I've always been a very protein-and-fat guy anyway and it does make you realise how many empty calories you eat from what is essentially edible packaging for food. The only things I genuinely miss are gnocchi in pesto, pizza, and baguettes with fresh butter - all of which would have been problematic even if my insulin resistance hadn't gone up.

So, ok, yes, low-carbing for me isn't the fire-and-forget it appears to be for T2s, but I actually don't feel my quality of life is compromised. Fine, I need to put in a bit of forethought and planning into my life, but I have to do that anyway.

There is also a slight aspect that I'm partly to blame for this - I'm not a great exerciser and I imagine if I got off my arse and did a bit more, I'd probably have better insulin ratios.

I guess the point I'm making is that low-carbing can and does work for T1s for blood sugar control, cholesterol etc, but is very different from the idea of a T2 low-carbing. My understanding is if you're a T2 and you cut out the carbs, you pretty much solve all your problems. That is not the case for T1s.

 

[Bloden]

@DeusXM
I am at about 100-150g carbs per day which isn't super low by any means but my control appears to be OK and my diet seems sustainable.

Same here, zx10pilot. I tried sticking to about 90g a day, but only lasted 3 days cos I was soooooooo hungry it hurt! So I'm back to my usual approx 120g carb a day and using exercise to iron out the bumps in BG. 🙂 Vive la difference!

Good luck finding your perfect carb amount, Jessica.😛

 

[Martin Canty]

My understanding is if you're a T2 and you cut out the carbs, you pretty much solve all your problems.

It's hardly the case, I'm still diabetic, still need to watch what I eat.... Make sure I remain in control, test & check BG

 

[DeusXM]

It's hardly the case, I'm still diabetic, still need to watch what I eat.... Make sure I remain in control, test & check BG

Yes, but you can be pretty sure that if you're eating low-carb, your blood sugar will be generally pretty good as well. I can be in the 5s, eat a low carb meal, end up in the teens if I'm not careful and then have to solve the conundrum of bolusing for protein. Diabetes isn't easy for anyone, but arguably low-carbing is far easier for a T2 to get right than it is for a T1. I haven't even touched on the complexities of managing benign ketosis from low-carbing to prevent it becoming fatal DKA, which is something T2s don't even have to think about.

 

[Owen]

Yes, but you can be pretty sure that if you're eating low-carb, your blood sugar will be generally pretty good as well. I can be in the 5s, eat a low carb meal, end up in the teens if I'm not careful and then have to solve the conundrum of bolusing for protein. Diabetes isn't easy for anyone, but arguably low-carbing is far easier for a T2 to get right than it is for a T1. I haven't even touched on the complexities of managing benign ketosis from low-carbing to prevent it becoming fatal DKA, which is something T2s don't even have to think about.

DKA presents in all types of diabetes, it is more dangerous to T2's as it is often missed. There are so many variations in all types of diabetes. Some T2's have lower insulin resistance than some T1's. Some T1's produce more insulin than some T2's. Some T2's are actually T1's, some T1's are actually MODY. Diabetes is diabetes and that is common amongst most diabetics. Prognosis and management is the variable.
I don't know you personally, but I can see you have reasonable intellect, however, any management that would result in self medicating to a level that includes iv insulin, perhaps needs some tweaking. IV treatment of insulin is an advanced life support mechanism.

 

[Martin Canty]

DKA presents in all types of diabetes, it is more dangerous to T2's as it is often missed.

Interesting @Owen , did not know that...... I was assuming that DKA was extremely rare in T2's though as the following link mentioned there are normally other underlying causes. The study mentions that 21.7 admissions for DKA were T2 which was really surprising....

http://clinical.diabetesjournals.org/content/22/4/198

 

[Owen]

Interesting @Owen , did not know that...... I was assuming that DKA was extremely rare in T2's though as the following link mentioned there are normally other underlying causes. The study mentions that 21.7 admissions for DKA were T2 which was really surprising....

http://clinical.diabetesjournals.org/content/22/4/198

Yes and then to add to the conundrum T2's can suffer from Hyperosmolar Hyperglycaemia (HHS), and that has a higher risk of complications than DKA and a higher death rate.

 

[Matt Cycle]

There is also a slight aspect that I'm partly to blame for this - I'm not a great exerciser and I imagine if I got off my arse and did a bit more, I'd probably have better insulin ratios.

Would almost certainly help. I've always been active but have ramped it up another notch over the past couple of years and this has resulted in increased insulin sensitivity. My issue with LCHF and exercise is the only examples people quote are some anecdotal evidence of someone running 100 miles on a frittata and some walnuts. That's all well and good but what about adding T1 into the mix - it becomes a whole different ball game. I don't know of any professional athletes with T1 diabetes on LCHF (in fact I'm not sure if there are any professional athletes without T1 who are on LCHF). For inspiration myself I look to Team Novo Nordisk, who are all T1 and professional cyclists. I'm not suggesting people load up on gels for a jog to the shops but this gives an idea of what the team have before, during and after a race.

http://www.teamnovonordisk.com/balancing-energy-needs-blood-glucose-levels/