Question about insulin levels

[E_Lou]

I am still very new to Type One and I have a couple questions. Before meals I am taking Rapid but I know how many units you take depends on your carb intake. But what if I have a meal thats really low carb? Do i just take a minimal amount or any at all? I am trying really hard to change my diet but I also want to avoid low BS. Are carbs a necessity at every meal? Thanks for anyone who can help.

Also, I am finding that now (this is about my 5th week taking insulin) that I seem to not need half as much as i did in the beginning and I am getting a lot of lows. Is it normal to have to cut back after the beginning? (this is regardless of having a lot of carbs with my meal or not)

Thanks Again:)

[HiImDan]

Nerve cells need carbs, your diet should consist of about 50% carbs or more, and they should be natural (apple or banana over a twinkie, for example). Insulin should be one unit per 10-20 groms of carbs, depending on metabolism (higher metabolism, higher carbs each unit will effect)..

[RLK]

Yes, you can adjust your insulin intake to match the number of carbs you're eating. Also, it's normal to need lots of insulin adjustments after diagnosis. Injecting insulin takes some of the strain off of a pancreas that may still produce tiny bits of insulin. This is called the "honeymoon" and is only temporary- eventually the pancreas stops producing insulin altogether in people with Type 1 diabetes.
I suggest that you talk to your doctor or nurse about making these insulin dose adjustments. Like you said, you're pretty new to this and they can help you make these changes safely. As you get more experienced with insulin and learn how your body reacts to various types and doses, you will be able to make adjustments on your own.
Good luck and welcome to DF!

[xMenace]

Here's a couple of links that may give you a comprehensive overview of what we're all trying to do, the pumping one especially, even though you don't pump.

Intensive insulinotherapy - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Intensive_insulin_therapy)

Insulin pump - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Insulin_pump)

You will have to find your own insulin/carbohydrate rates. working with a DE or Dr. is definately recommended for noobs. I teach my people how to do it :) You may also have different rates for different times of the day. I range from 1:10 to 3:10. Then the buggers can change for no apparant reason or due to physical or mental stresses. The saying that 'we're all different' is so true.

Your basal rates also need to be discovered. That is much trickier to find than i/c rates, but just as important, if not more so. In fact, you can't really trust your i/c rates if you don't have flat-lined basal numbers.

Good luck and don't be discouraged.

[MJM]

I am still very new to Type One and I have a couple questions. Before meals I am taking Rapid but I know how many units you take depends on your carb intake. But what if I have a meal thats really low carb? Do i just take a minimal amount or any at all? I am trying really hard to change my diet but I also want to avoid low BS. Are carbs a necessity at every meal? Thanks for anyone who can help.

Also, I am finding that now (this is about my 5th week taking insulin) that I seem to not need half as much as i did in the beginning and I am getting a lot of lows. Is it normal to have to cut back after the beginning? (this is regardless of having a lot of carbs with my meal or not)

Thanks Again:)

Hi E_Lou,
In my opinion you should be counting carbs and taking insulin to accommodate the carbs you are eating by using the correct carb ratio for that meal. You have to establish your correct carb ratio for each meal.
You should also establish a proper basal rate.
I cannot understand how your doctor or hospital set you on your way without fully understanding how to properly treat yourself. In my opinion it's almost criminal.
Google Carbohydrate Ratio and Insulin Sensitivity Factor and you will find the formulas for these.
If you're getting lows then you are taking too much insulin for the prior meal to the low or conversely you are not eating enough carbs. If you establish the correct carb ratio then you can establish the correct insulin for the meal.
I'm repeating myself a bit but if you need any help you can PM me.

[Cyborg]

Back to the original question... Some people find that other foods also affect bg. Low carbing or non-carbing is not a solution to diabetes. Low carbing can help, but protein also affects bg. Check this (http://www.insulin-pumpers.org/howto/pfandbs.html) link out for more info on food metabolism.

[Emm]

Nerve cells need carbs, your diet should consist of about 50% carbs or more, and they should be natural (apple or banana over a twinkie, for example). Insulin should be one unit per 10-20 groms of carbs, depending on metabolism (higher metabolism, higher carbs each unit will effect)..

Have to disagree with Dan here (lovely chap that he is). I don't think anyone needs a diet consisting of 50% carb, especially a diabetic. I'm not telling you to go low-carb (tho that does work for a lot of people) but I do think anything that high is asking for trouble. I can't deny that our bodies need carbs (tho I've still never seen proof that explains it to my satisfaction) but get to know your carbohydrates and stick with the stuff that doesn't spike your BG.

Carbs are best found in natural slow acting sources - things like carrots and other vegetables. Fast acting things like pasta, potatoes, cakes etc are best saved for treats, or had in very small amounts alongside extra low carb foods for balance.

The amount of insulin you need is entirely personal. Some of us still produce a little, so don't need much. Some of us have insulin resistance to the max and need a truck load every day. You need to spend a little time experimenting and testing often til you're comfortable with the amount you're taking.

As MJM said, I think the best method is to learn to count carbs, know your insulin to carb ratio, and work from there. In time when you're used to some foods you'll end up working from educated guesses, it's really not hard work at all and makes for a better balance in your numbers.

But what if I have a meal thats really low carb? Do i just take a minimal amount or any at all?
I still need a small dose of insulin for any low carb meal - some proteins need insulin (albeit less, and over a longer time) and just the fact that your tum is full means you need insulin, as a full tum brings on a little glucagon secretion. Go easy on the insulin for a low carb meal, and maybe jab after eating to catch the slower acting stuff.

Do be aware that carbs are everywhere - even eggs and lettuce have a tiny amount, though you'd probably never notice any spike from them unless you ate piles in one sitting!

There's a lot to learn with T1 D but you'll get there - and this is a brilliant place to start. It wasn't that long ago I was a learner and the people here gave me the confidence and curiosity to learn more about D than I ever thought possible! Ask anything, any time, and let your DF addiction grow ;)

[BlueSky]

.... what if I have a meal thats really low carb? Do i just take a minimal amount or any at all? .....

Also, I am finding that now (this is about my 5th week taking insulin) that I seem to not need half as much as i did in the beginning and I am getting a lot of lows. Is it normal to have to cut back after the beginning? (this is regardless of having a lot of carbs with my meal or not)

Thanks Again:)
Yes, the less carbohydrate you eat, the higher your insulin:carb ratio needs to be (the more insulin you require per gram of carb). You will also find that, the closer your blood sugar is to normal, the less insulin you need. And, while you are in the honeymoon period, it is not unusual for injected insulin requirements to decline sharply after treatment starts. It is temporary, though, and you will need to moinitor the situation closely.

[HiImDan]

emm, I've studied this stuff my whole life. Not sure where your info comes from but I've got a list of college professors. you think 50% is HIGH carbs? Please.

[BlueSky]

Your body is able to make all the glucose you need through gluconeogenisis, and it isn't a lot. Not if fat is your primary source of energy. So you don't actually need to eat any carbohydrate. Glucose is more easily turned into energy. But, for most requirements, your body will run happily on ketones too. On the other hand, if you have trained your body to rely on carbs for energy, it needs a lot of the stuff.

The high-carb diet is a new fangled innovation. And while it makes good political and economic sense, the public health consequences are unfortunate to say the least. But for a diabetic, a 50%+ cabohydrate diet only makes sense if you are able to achieve good BG control in spite of it.

[soso]

Yes, the less carbohydrate you eat, the higher your insulin:carb ratio needs to be (the more insulin you require per gram of carb).

Hi Bluesky
this comment intrigues me.......could you explain further please?
Thanks
ss

[BlueSky]

The less carb you have in a meal, the higher the proportion of protein in it becomes. And protein uses insulin. This increases the I:C ratio as carbs are reduced. Lets take an extreme example. I will inject 4 units of Regular insulin to cover a meal consisting of a nice big steak and a salad (maybe 8 grams of carb). That is an I:C Ratio of 1:2, which is very high. If I were to eat a potatoe containing 40 grams of carb with the same meal, I would need another 4 units of insulin, reducing the I:C ratio to about 1:6. The big difference between these food types, of course, is that protein uses insulin over a much longer period than carbohydrate does.

[DeusXM]

The less carb you have in a meal, the higher the proportion of protein in it becomes.

Only if you're adding extra protein.

Incidentally, I notice mention using 'regular' insulin. Is this what you're using? I ask because a low-carb diet on R certainly makes sense because R can't deal with the intial BG spike as quickly as Novorapid or Humalog.

[Stuboy]

Nerve cells need carbs, your diet should consist of about 50% carbs or more, and they should be natural (apple or banana over a twinkie, for example). Insulin should be one unit per 10-20 groms of carbs, depending on metabolism (higher metabolism, higher carbs each unit will effect)..

My insulin to carb ratio is much lower, and I know people with much higher. So this is not neccessarily true.

You can work out your rough ratio with a rule of thumb and adjust from there...

Total Daily Dose / 50 = u p/10g Carb (says my diabetes Doctor anway)
This has worked very well for me.

My ratio is 0.5u/10g.

[soso]

Thanks Blue Sky,
I have not noticed protein increasing my need for insulin, though of course, with some of my own, it's not something I can really check out... and also, I have never tried a carb only meal since being on insulin..might be an interesting experiment.
ss

[Cyborg]

Personally, I tend to eat too much protein. I've learned that I do need to bolus for protein, but differently than for carbs. Since I use fast-acting insulin, it's not simply a matter of increasing the I:C ratio. As a pumper, I do a 30/70 combo bolus over 3 hours for the "equivalent carbs" that I calculate (75% of the protein content). Check this (http://www.insulin-pumpers.org/howto/pfandbs.html) link out for more info on how foods affect bg...

[Tyler]

Personally, I tend to eat too much protein.

According to who?

I am still very new to Type One and I have a couple questions. Before meals I am taking Rapid but I know how many units you take depends on your carb intake. But what if I have a meal thats really low carb? Do i just take a minimal amount or any at all? I am trying really hard to change my diet but I also want to avoid low BS. Are carbs a necessity at every meal? Thanks for anyone who can help.

Also, I am finding that now (this is about my 5th week taking insulin) that I seem to not need half as much as i did in the beginning and I am getting a lot of lows. Is it normal to have to cut back after the beginning? (this is regardless of having a lot of carbs with my meal or not)

Thanks Again:)

You'll find that for any meal containing protein or carbs, that you'll need some insulin. This is dependent on you the individual and and amounts that you are eating. More carbs and protein equals more insulin. And no, you don't have to eat carbs at every meal, or at all for that matter. Although getting in at least 100g is a good compromise and may make you feel better if you don't do well in ketosis.

Yes, the insulin therapy you have started is saving/prolonging the life of your islet (insulin secreting) cells. This is a good thing. The beginning is rough but work on it hard, keeping some function helps tremendously with control later on. Eventually you'll find that it will fade.

In the beginning I followed the traditional high carb diet and it was disaster. Low carb diets are pretty limiting. There is a happy medium though. I've found a diet high in protein and moderate in carbs and fat to be the best.

Nerve cells need carbs, your diet should consist of about 50% carbs or more, and they should be natural (apple or banana over a twinkie, for example). Insulin should be one unit per 10-20 groms of carbs, depending on metabolism (higher metabolism, higher carbs each unit will effect)..

Percentages are stupid. Basic requirements don't change.

As well, nerve cells don't need carbs.

[BlueSky]

.... I notice mention using 'regular' insulin. Is this what you're using? I ask because a low-carb diet on R certainly makes sense because R can't deal with the intial BG spike as quickly as Novorapid or Humalog.
I am on a somewhat mixed insulin regimen. I bolus with regular for breakfast and supper, which are low-carb and high-fat/protein meals. I use Novorapid for more carby lunch boluses and for corrections.

Yes, you are right in that longer action profile makes Regular insulin more appropriate for low carb, high-fat/protein meals. Which, for me, stabilises BG levels at two important times of the day - after getting up in the morning, and before going to bed at night.