[HelenM]

I really think I need a minium level of carbs. At the moment I'm staying with my parents and because they eat less (they're elderly and inactive) I find it difficult to eat my normal meals since they eat so much less.( I feel greedy as my plate has so much compared to them.) Yesterday I ate about 110 carbs compared with my normal 160 or more. I thought I'd bolused correctly and BS was OK. I ran a couple of miles and did some gardening but not really any more exercise than usual.
Today my BS has not been above 80 all day. My exercise was shopping ( admitedly I go over the top since I get withdrawal symptoms in rural France). I got completely disoriented at one point (luckily in Boots, a chemists) and was going round in circles looking for the glucose tablets in spite of having smarties in my handbag. Eventually I asked the pharmacist, who thankfully understood and got some for me. When I tested outside the shop, after eating threee tablets ( I normally only take 1), the meter said said 'lo'.
I had a good lunch but was back in the 50s before dinner, since dinner I've reduced the basal by 50% but was still only 68 at the two hour point.
I often have what I think are minor hypos but not like today. I'm convinced that I simply didn't store enough carbs yesterday and had nothing in the tank... no stored glucose.

[lottadata]

Helen,

It is a matter of adjusting all the doses. If you do, you can eat less carbs and do very well. 110 g is my upward limit for carbs and I have my dosing set up so that level or less works very well. But it took me a lot of tweaking to figure it out.

[BlueSky]

Originally Posted by HelenM

I'm convinced that I simply didn't store enough carbs yesterday and had nothing in the tank... no stored glucose.

The tank is always full. Even if you don't eat any carbs. Liver glycogen is topped up through gluconeogenesis. It sounds like you have too much insulin action. Also bear in mind that suddenly eating less carbo increases insulin sensitivity.

[HelenM]

The tank is always full. Even if you don't eat any carbs.

Conventional 'wisdom' is that depleted glycogen reserves have to be replaced. The normal advice to athletes (I'm not an atlete but I am active) is that depleted reserves can normally replaced within 24 hours if a diet high in complex carbs is followed, if a diet high in fat/protein is followed it takes much longer (according to one source up to a week).
I was advised to carb load/replenish when I was marathon training, (sports medicine doctor who gave conventional advice and said it applied to me just as much as to non diabetic runners .) I also found I had to eat more carbs when backpacking and thinking back had one day on holiday last year when I went low all day(though not 'lo') and for the rest of the week ate more carbs every day. I was more shocked this time as the only real difference to normal was the reduced carbs.

It sounds like you have too much insulin action.

I think you're right I should have reduced my basal earlier. I do this for formal exercise but don't really think of shopping as exercise.

With the flexibility of pumping I thought I would be able to be more flexible and on occasions eat less/use less insulin, certainly to avoid eating for the sake of feeding the insulin.
So far I am using less (on MD1 TDD was about 32, normal days now about 27. On the 'low' carb day I only used 20 and was quite sucessful in maintaining a good BS level that day but not the next. I think thats what surprised me as the only real difference to normal was the reduced carbs.

One of the reasons for going on the pump was to avoid the frequent but low grade hypos not to get more I must be one of the few people that doctors tell off for having too low an HbA1c! Back to the drawing board.

[Mich]

Hi Helen,

I think it's just France. For the three weeks I was there, I walked walked walked. Had to reduce my basal. HAD to eat croissants with chocolate. It was a tough life.

It was a much more active lifestyle that I am used to, even in Southern California with sailing and hiking and biking.

Just getting the day's fresh food for dinner was a two mile trip. Also, we walked to meals at restaurants and walked home. I loved it.

Mich

[fgummett]

On the Liver and tank being low discussion, I understood that the muscles are also involved... they keep a store of "ready use" sugar. Once that is depleted we need to eat in order to replenish that

[lottadata]

As long as you eat a reasonable amount of protein, the glucose you need for all bodily functions is supplied perfectly without any need to eat carbohydrate.

Fifty-eight percent of your dietary protein can be converted into glucose.

I have written a calculator that tells you how much protein you need to eat when you are on a ketogenic diet (one of approximately 100 g of carb a day or less.)

Calculate Your Protein Need on a Ketogenic Low Carb Diet

Note that the amount of protein you need to eat to supply glucose drops dramatically after 3 weeks because your brain adapts to burn ketones and needs far less glucose.

I have heard a lot of very stupid things from nutritionists about how without 130 g a day your brain stops running, etc. I published a bunch of books during the 6 years I ate about 60 grams of carb a day and my brain worked just fine the whole time!

I've been eating about 40 g a day thae past three weeks and taking hour long walks, mowing my acre of lawn etc. I take a bit of glucose with me on the walks, just to be sure, but so far, so good. When I eat this low a carb intake, I do not need any insulin except basal.

[rzrbks]

my first question would be "Are you exercising more than normal?"

You know your body better than anyone.

If you ARE exercising more than normal, combined with lower carb intake, you're bound to have hypos.

It sounds like you just might need to check B/G more often while you're with your folks.

Or just, perhaps, be nibbling on Chocolate Croissants while you wander the town.

[HelenM]

Thankyou everyone, today has been a bit better though I've still been running my pump at .25units hour for much of the day. I did at least reach 90 after dinner and the lowest was 58

I' m not exercising more than I did last year (perhaps a bit more than recently during winter).I was running up to 40 miles a week at one time, the difference was I was eating a regular amount of carbs at meal times supplemented if necessary for running.
I actually don't want to low carb as I don't seem to have any reason to. I couldn't easily eat more protein at my parents (that would seem just as greedy!) and to be honest long term I would be worried about the possibility of kidney problems. I was simply trying to be less rigid, and was surprised to find I seemed to have run out of fuel. At home I tend to eat a fairly pattern of meals with 40 carbs for breakfast,50-60 for lunch and 60-70 in the evenings. (really just an adaptation of the plan given to me when I left hospital which was about 50, 70, 70,).When I've varied my carb intake its been upwards for eating out and my bolus additions have always worked. I hadn't really realised that the opposite might be problematic.





Sadly, I remember my last croissant very well. I ate it in a cafe, just after a fasting blood test. When I got home my doctor called me 'go straight to the hospital, now!. I haven't had a croissant since then. They don't make very good ones in Bournemouth where my parents live anyway

[thomaca77]

Originally Posted by HelenM

Sadly, I remember my last croissant very well. I ate it in a cafe, just after a fasting blood test. When I got home my doctor called me 'go straight to the hospital, now!. I haven't had a croissant since then. They don't make very good ones in Bournemouth where my parents live anyway

I remember my last dinner before I was diagnosed... a Denny's Lumberjack Breakfast (eggs, bacon, sausage, ham, pancakes, full sugar syrup) and an order of Chili Cheese Fries and about 5 sodas.........I was hungry about an hour later....guess that should have been a clue?

I have the same problem with carbs as you do...you would think that just taking enough insulin to match the food would take care of it, but if I eat considerably less, it's like I have to throw my whole basal program out the window.

And as for shopping...I had to go back to the same store 3 Saturdays in a row last month....everytime I would gather all the clothes I wanted to try and get to the Changing Room, my blood sugar would be around 50, and I would have to stop and get food! They should have shopping in the olympics, it is so strenuous!

-Carisa

[rzrbks]

The reason I asked about "exerciseing" is that I seem to use more "fuel" when I go shopping with my wife than I do when playing golf(walking), basketball, or even using the healthrider.

I have come to believe that's its because when I go shopping with her, there is constant movement for several hours at a time. NOt high intensity movement of short bursts but constant low intensity movement and I find that I have to be more vigilant with B/G numbers than I do with above-mentioned activities.

[fgummett]

Originally Posted by rzrbks

The reason I asked about "exercising" is that I seem to use more "fuel" when I go shopping with my wife than I do when playing golf(walking), basketball, or even using the healthrider.

I have come to believe that's its because when I go shopping with her, there is constant movement for several hours at a time. NOT high intensity movement of short bursts but constant low intensity movement and I find that I have to be more vigilant with B/G numbers than I do with above-mentioned activities.

I wonder how much fuel our male-brains use when she asks, "how do I look in this..?"

[thomaca77]

Does your wife make you carry stuff for her?

I find my BG drops the more arm excercise I get. When I am shopping, I am reaching, grabbing, stretching (I'm short), and sometimes carrying 40 pounds of clothes around in my arms till I can get to the changing room to try them.

I have read somewhere before that I am not alone in the "arm exercise low" thing, it is pretty common....which is why I can walk two miles into town and be fine, but I vacuum the carpet for ten minutes, and I start acting ditzy.

-risa

[HelenM]

I wonder how much fuel our male-brains use when she asks, "how do I look in this..?"

since there's no right answer, you must use a huge amount due to increased stress and adrenalin levels. OH says, it depends whether its the first or the 300th