Low Carb = HIGH sugar??

[GeishaGirl]

Yesterday was my first real full day of trying low-carb. I probably had about 40 carbs, most of them in the afternoon. For dinner, I had tacos -- I'll be honest, I forgot to bolus for the taco shells, but I corrected that before bed.

This morning, my fasting sugar is 225. WTF?? I went to bed at 160 WITH a correction. My usual fastings are 90-120, and, yes, I remembered my Metformin before bed. I'm only doing low-carb for my sugars and some weight loss -- if this is what happens, I'm gonna quit really **** fast.

[fgummett]

As ever with D... you shouldn't really read too much into a single episode... watch for repeatable patterns :)

[Moonglo]

Could it have been a fluke?

[GeishaGirl]

Both my pump and insulin are fine -- my body accepted the correction bolus and got me down to 130 within an hour and a half. The only thing I can think is I went low in the night and had a MASSIVE liver dump... except that I don't go low at night. And, on the rare occasion I do, I wake up when I hit the 40s because I'm too warm. Plus I'm on Metformin, which would block the liver dump, at least partially, anyway.

Tonight won't be a fair test, since today is my 15-hour day and I treat myself with lunch at Panera between teaching school and attending school. I'm going to be good the rest of the day (salad, string cheese, etc) but I'm blowing my carbs around 3:30pm. So I'm going to discount ANY reading I get tomorrow morning as being part of any pattern. I guess I'll wait and see what Thursday and Friday morning bring.

I still want to low-carb, so if I have a problem, maybe I'll just add a small carby snack (15g or so) an hour before bed.

[poodlebone]

I know that everything with diabetes is YMMV, but my experience with low carb was similar to what you described. I could do okay during the day and go to bed with a good number. In the morning my readings would be insanely high - 400s to 500s! I don't know if my body is really efficient at turning protein & fats into carbs or if my liver just sees the lack of the carbs as a lack of energy and wants to help me out. I gave up on the idea of low carb because it doesn't work for me. I was not on the pump then so there wasn't a good way to bolus for protein & fat and no way to adjust my basal. Still, even with a pump, I would not want to try it again. I didn't enjoy that way of eating and it would be worse now as I eat even less meat than I used to.

[CarrieJett]

I just did a CGM study, and on days where I woke up with high blood sugar, it turns out that I actually went low in the night and the stress made me spike way up for my morning reading. Maybe that pre-bed bolus took you down in the night?

I also find that unlike a carby dinner, a high protein one digests more slowly, so maybe it just hadn't caught up with you yet.

[sarahspins]

To be perfectly honest, and blunt, I'm pretty sure a majority of my dawn phenomenon is from gluconeogenesis.. which is the production of glucose in the liver from protein (from food). I think I am active enough during the day that it doesn't pose much of a problem, but at night, everything just goes haywire.

Since I tend to eat more protein with dinner this makes sense. It's the prime reason I am not honestly a fan of an extreme low-carb or high protein diet for T1's. It may work for some, and it most likely works well for many T2's, but in my experience, it results in insidious highs for me that do not respond easily to corrections as well as absolutely crappy overnight and fasting #'s.

So, it just doesn't work for me. In fact if I eat more protein in the evenings than "normal" for me, I am almost assured that I will need a +20% basal rate (or higher) all night to compensate for it... even still that doesn't always work.

[sarahspins]

I just did a CGM study, and on days where I woke up with high blood sugar, it turns out that I actually went low in the night and the stress made me spike way up for my morning reading.

This is the somogyi effect.. since wearing a CGM for nearly a month now, I've seen it happen to *me* exactly once, and it took a SEVERE hypo to trigger it, and the rise to high from low was very slow (entire process takes 4+ hours), and very linear. What tends to happen for me though, on nights where I've had more protein, is that my #'s hover in the mid-upper 100 range (like 160-190, even with repeated corrections, it never drops) then shoot up *rapidly* between 4-5am in the span of maybe 20-30 minutes to 300+, and come down slightly by morning... but without a correction I am almost always still at least 200 when I wake up (8am most mornings). The graphs for the two look very different.

[CarrieJett]

This is the somogyi effect.. since wearing a CGM for nearly a month now, I've seen it happen to *me* exactly once, and it took a SEVERE hypo to trigger it, and the rise to high from low was very slow (entire process takes 4+ hours), and very linear. What tends to happen for me though, on nights where I've had more protein, is that my #'s hover in the mid-upper 100 range (like 160-190, even with repeated corrections, it never drops) then shoot up *rapidly* between 4-5am in the span of maybe 20-30 minutes to 300+, and come down slightly by morning... but without a correction I am almost always still at least 200 when I wake up (8am most mornings). The graphs for the two look very different.
Hmmmm now I am very curious. The doc's explanation was that I went low then high, but it wasn't low enought to wake me up so I wonder if the protein has anything to do with it. I may need to do some experiments.