Intermittent Fasting

[UnexpectedDiagnosis]

Hey all,

Before getting T1 (diagnosed in Jan) I used to do a lot of intermittent fasting, roughly 20 hours a day for 5 days a week. How does that look with T1, is it a complete none starter due to the Hypo risk? Maybe a stupid question but I do miss it. I am very busy through the day and tend not to eat lunch, however fasting for only 8 hours seems pointless as I won't enter Ketosis.

Also, if I don't eat lunch and just snack a little in the day, does it matter if I don't take my bolus dose? I take it currently for meals, but if at lunch I don't have a meal, then do I just leave it? I haven't been on my DAPHNE course yet and I am trying to figure out how to get closer to my previous eating patterns. I was told to take NovaRapid x3 times daily (with each meal), but I am assuming I could have 2 larger meals and just adjust my dose without too many issues? Or am I missing something

Any input is appreciated

 

[helli]

@UnexpectedDiagnosis if you are on a basal/bolus insulin regime an not on a fixed dose, you should be able to eat when you want.
The important things are

1. Have the correct basal dose that will keep your BG stable in the absence of any food and other insulin
2. Have the right amount of bolus insulin for all carbs that you eat whether at meal time or snacks. I was advised that I could eat 10 to 15g carbs as a snack between meals without taking insulin. This could be something like a small apple, a biscuit or a small packet of crisps such as Skips. It is not about having NovoRapid 3 times a day. If you eat once a day, you need one dose; if you have 6 meals a day, you need 6 doses
3. Track your blood sugars at all times and treat a hypo whenever it occurs. This may mean breaking a fast. Treating a hypo is more important than a fast.

Could add a fourth to push to be registered for a DaFNE (Dosing For Normal Eating) course as soon as possible. If you get resistance or have a long waiting list Bertie online is the online version of DAFNE which you could do in your own time.

Edit as I have just re-read your email and noticed you mentioned Ketosis. There are some people with Type 1 who aim for ketosis but you may get push back from your diabetes team/DSN because

• Ketones could be an indication of DKA and ketosis may hide this symptom. Typically it is the combination of ketones and high blood sugars but I did read about DKA at lower BG related to covid.
• When eating very low carb, our body will break down fats and protein to produce glucose. Therefore, you may need to bolus for these. I found that much more complex than dosing for carbs as the timing and dose varies for different protein. I had different ratios for nuts, cheese, salmon, prawns, ... and I don't eat meat. It is doable but you will not be making your diabetes management easy.
• This one I am not sure about but I have read that eating very low carb can increase insulin resistance.

 

[bulkbiker]

If you want some info on fasting, ketosis and T1 you could do a lot worse than follow Dr Ian Lake on twitter (if you use it) or check out his website at https://type1keto.com

He's a T1, doctor and all round good egg. A nicer man you'd have to search hard to find and he participated in the 100mile fasted run over 5 days.

Nutritional ketosis is well-tolerated, even in type 1... : Current Opinion in Endocrinology, Diabetes and Obesity

ays while only consuming water. All eight individuals completed the project with no physical injuries or problems with diabetes control. The blood glucose levels ranged from less than 3 mmol/l to 7 mmol/l in those without T1D, and less than 3 mmol/l to 9 mmol/l in those with T1D. The continuous...

journals.lww.com

UK Team Completes a 100-mile, five-day Run with no Food - Diet Doctor

Eight runners ran 100 miles in five days without food. They aimed to dispel myths surrounding daily carbs and energy needs.

www.dietdoctor.com

 

[UnexpectedDiagnosis]

@UnexpectedDiagnosis

Thanks for your reply, I have started reading up on it but I think I need a better understanding of diabetes and get used to it all a little more first.

I've always believed that nutritional ketosis to be healthy if not abused but I was surprised to read how little carbs you were told you could snack on, and that I may need to bolus for proteins and fats I'll get back using the libre sensors religiously but I'll try to log food too, I just don't want all this to become too much work tbh.

Thanks @bulkbiker I will check that out.. so much to learn