New eating routine, I need some input

[George83]

Hello all, apologise in advance for a sort of post, and thank you in advance for reading and posting.

I have a few queries, but let me first explain what I want to do!

I am on MDI's of Novorapid, minimum of 3 to cover meals averaging between 4-12units depending on food and for any corrections if need be and 1 basal injection of Lantus 26units at midnight each night.

Now heres what I plan doing, cutting down carbs to a bare minimum, the only substantial amount of carbs I will have is going to be in the morning, the rest of of the day will be little to no carbs, in doing this I i'm guessing I will have to split basal insulin also, so heres what I have come up with;

10:30pm - before I go to bed I will take a basal injection
6:30am - at breakfast I will have carbs and inject rapid
10:30am - have my second basal injection
11:30am - at lunch will have a salad or stir-fry with minimal carbs - no rapid
6:30pm - will have dinner with no carbs - no rapid

The whole idea of this is to cut down on the amount of carbs & insulin that my body is dependant on in order to maintain the weight im at now.

My questions are as follows;
Will the daytime basal cover any unexpected spikes in my blood sugar?

How will I be able to determine how much basal I will need to inject at the pm and am times?

How would I get my head around fasting to test this?

And also any thought or input you may have about it just post it?

[NoraWI]

George, what you plan to do is outlined in Dr. Bernstein's plan. Cutting down on carbs as well as insulin in order to lose weight is a very good thing. The fallacy of your plan is that pretty much everything you consume, except fat, has some carbs (including protein, although it is a much smaller amount and takes longer for the body to process). At a certain point most T1s have to dose for protein as well. The salad you propose eating for lunch will contain carbs... a minimal amount that may allow you to eat a larger volume, but carbs nevertheless. A supper with no carbohydrates is near impossible. If you are a long-time T1 whose beta cells no longer make any insulin at all, you will need to bolus for meals, although your boluses will probably be a fraction of what you have been taking.

In "Diabetes Solution -- The Complete Guide to Achieving Normal Blood Sugars," Dr. Bernstein suggests consuming one's daily carbs in the following scheme -- 6g for breakfast, 12g for lunch, and 12g for supper. He also recommends eliminating all "white" foods -- anything made with grains (breads, pasta, etc.), sweet stuff, root veggies such as potatoes, and, most difficult for me to do, fruit. Certain foods commonly considered veggies such as corn and peas are also banned as they are extremely carby. The Atkins diet lays out a comparable scheme for eating, although it permits adding back certain carbs after the "induction" period, which I don't think fits a diabetic's permanent eating need.

As to your basal insulin, I suggest you reduce your dose as you proceed with your eating changes. Once you have arrived at a workable dose (one that allows your BGs to keep steady if you skip a meal), then you can try splitting that dose, keeping in mind that your split may not be an even one. Frequently, one dose (depending upon your body and daily schedule) will be up to 2/3 the size of the other. Personally, I don't like a split dose and even though my Lantus peters out at about 20 hours, find it more practical to bridge with my supper bolus. A bolus may cover a gap in basal need; while a basal will NEVER cover meals.

Many diabetics have found that blood glucose control improves when they begin eating low carb and they can reduce their insulin requirement. I hope you achieve such an improvement. Keep us posted on your progress.

[xMenace]

TY Nora. I'm currently experiencing all of this.

A bolus may cover a gap in basal need; while a basal will NEVER cover meals.

Very important. Basal is for basal. Bolus is for meals. Try to seperate the two as much as possible.


Many diabetics have found that blood glucose control improves when they begin eating low carb and they can reduce their insulin requirement. I hope you achieve such an improvement. Keep us posted on your progress.

My basals were the same for about the first ten days then suddenly dipped to about 85% of normal. I've been doing this since July 9ish., bot long enough or low carb enough to base your decisions on.

Test, Let your meter tell you when to cut back.

[viranth]

I have no idea how you guys are doing this, but eating every 5 hours?

Try cutting it down to every 3 hours, it's better for your body too.

[NoraWI]

Eating more frequently would not clear the bolus from my body and I would be stacking insulin. Besides, I have no time nor desire to eat every 3 hours ;o).

[timmyp]

Hi George,

I like you have started a very low carb diet and have been excited and scared all at the same time.

Just a word of caution. I have recently been on Dr Bernsteins diet and I have seen amazing results in my readings and my average has came down in an impressive fashion.

My problems however have been:

• Loosing too much weight too quickly (not a problem if you need to loose). I am already under weight for my height.
• I have developed ketones (not due to high sugars) because of the lack of carbs. I increased my carbs to 8g (breakfast) 20 (lunch) 20 (dinner) and still had horrible symptoms of keytones and got a little freaked out. I think traces are probably normal but in my case had some serious traces as in 1 +++ (Fort).

I am back on higher ‘normal’ carbs for the moment until I can figure out how to balance everything but based on the results I have seen, am keen to find middle ground to get my Hba1c down.

My Diabetic Nurse was by no means supportive of this diet and it really irritated me as I have put in so much work and expense trying to sort out my readings.

Good luck!

Tim

[NoraWI]

Ketones are normal when you go on an extremely low carb diet. This will not harm you. Do not be alarmed. Ketones are the product of your body burning fat instead of carbohydrates. If your BGs are not high, then the presence of ketones is NOT a symptom of ketoacidoses (DKA) but, rather a sign that your body is changing to a different fuel.