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1967rs

My keto rant

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1967rs

I really avoid the diabetic forums because they depress me and I don't really need help there when winter rolls around.

I’m 56yo and I’m hitting 20 years as a diabetic and 6 yrs on the needle.  Two months ago, I was injecting Humalog 15u and Humulin N 15u twice a day and I was up to an A1C 8.0

I decided I needed to try something.  Over in the UK some other Yanks were talking about keto so I decided to look into it.  Yes I’m a yank. I got the youtube education.  I think DR Boz really likes being on Youtube. I’d buy her book if I know she would just get to the point quicker.

So drop the carbs to 7%, proteins to 16%, and elevate fats to 77%.  I find it makes you have to plan your meals if you want good meals.  I did this for awhile but ran out of time so I now just grab stuff that isn’t carbs.  Tough time hitting my fats so I use brain MCT’s.

I also use mynetdiary app for diabetics.  Nifty app if you remember to fill it out regularly.  I started at 220lb and I’m on my feet all day as a pharmacist but wouldn’t call it exercise.  I’m down to 198 after 2 months. I have keto strips and they are always purple med to dark.  Eating isn’t really fun or exciting anymore, I have to make myself eat.  I don’t come close to hitting my calorie goal on most days and certainly not balanced meals so I started taking a good multivit. 

My first month my sugars were amazing low.  I told my doc I would switch over to a Humalog pen because I really didn’t use much insulin anymore.  Around month 2 that changed. My sugars went up again to the point where I had to do something. The Youtube docs were saying maybe I needed to fast from time to time so I did that.  Dr Boz is saying “fast until you wake up in the am and your sugars are less than 100. That’s when you know your carb stores are empty” Makes sense I guess but does that mean I need to go days without eating?  I could easily do it but I don’t want to end up in the ER.  Yesterday my bs was 124 at 5:30 am and it was over 200 by 9am with no food.

As a diabetic we need to keep our sugars down. I really don’t eat many carbs but my insulin usage is almost back to my pre-keto days.  So if our sugars start to rise, we need to exercise to lower them?  Do we want to use insulin since it’s the enemy and just stores the sugars and we’re trying not to do that? We need a diabetic guru on youtube to explain how keto works best for the diabetic

 

vic

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TX_Clint

Don't over think it. Keep your carbs low. At your point I'd say shoot for 30 carb per day fairly evenly split. Watch out for the protein as the liver will convert it to glucose and create those dawn phenomenon wakeups. I shoot for 30g carbs but usually hit closer to 50. I take 2000mg metformin a day and 30 units of basal insulin at night. If I've been a good boy my morning bg is under 100. If I cheat on my diet it can jump to 120's and higher. My A1c has been running at 5.8 for the last year.

Oh,, and please feel free to rant. We likes a good rant.

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meyery2k

I have found exercise and low carb together provide the best results for me.  I am clearly insulin resistant and the exercise reduces that resistance.  I found a good brisk program of walking helps.  The goal of 10,000 steps a day helped me lose 75 pounds and kick the Metformin.

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1967rs

Tx_Clint, 5.8 sounds good.  You don't have a fast acting ins but you use a basal.  Which one? When I started on the insulin journey I was on Lantus but that never really seemed to do anything so I switched. 

 

You use your basal with dinner or at bedtime and this will cover your whole day, meals included. When I used the Humalog and N I would get lows now and then (presumably from the N) but more often than I liked. Supposedly a basal won't do that or be so slow in happening that it doesn't take much to cover it.

 

Doing keto should keep my carbs relatively low and consistent. I suppose if I started again on a basal I would use less Humalog.  Maybe its time to try it again.

vic

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TX_Clint

I take 30 units of Basaglar at bedtime. That plus the metformin and low carb plus exercise as Mike (Meyery2k) mentions keeps my bg down. I had an 86 this morning. My worst bg levels were always first thing in the morning and the basal insulin peaks about 8 or 9 hrs after injection so it stops that high morning bg.

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Hammer

1967rs, it sounds like you've been getting bad information in the past.  First, as the others have said here, you need to lower your carb intake.  Also, exercise will help.  As far as insulin goes, Lantus is a basal insulin.  A basal insulin will only lower your fasting glucose levels, it has no effect on your after meal spikes, that's what a bolus insulin, like Humalog and Novolog, are for.  It sounds like you need both types of insulin.

 

When you use a basal insulin, like Lantus or Levemir, you take it once a day, although some people find that splitting the dose to twice a day works better for them.  I take Lantus every night at 11 pm.  The amount of Lantus I take varies all of the time, but I adjust my dose so that I get a morning wake up reading in the 70's.  If you take Lantus and wake up with BG levels that are too high, then you need to increase your dose.  I started out taking 8 units of Lantus, which had no effect, so I upped my dose every night until I was able to get down into the 70's.  At that point, I was taking 156 units of Lantus every night.  As I changed my diet to a low carb diet, I lost weight, and by losing weight, I had to lower my nightly Lantus dose.  At one point, my dose was 42 units a night, now it's back up to 79 units a night, so it's constantly changing.

 

As for my bolus insulin, Novolog, I needed to find what my insulin to carb ratio (I:C) was.  To do that, I'd count the carbs in the food I was about to eat, then take 1 unit of Novolog for every 18 carbs that were in the food.  I'd take a BG reading just before I ate, and exactly two hours after I had eaten, I'd take another BG reading.  If my after meal reading was a lot higher than my before meal reading, that meant that I didn't take enough Novolog.  At my next meal, I'd count the carbs in the meal, take a BG reading, take 1 unit of Novolog for every 16 carbs in the meal, eat, then take a BG reading exactly two hours after I ate.  If it was still a lot higher than my before meal reading, then at the next meal, I'd take 1 unit of Novolog for every 14 carbs in the meal.  I'd keep doing that....taking 1 unit of Novolog for fewer and fewer carbs until my after meal reading was close to my before meal reading.  Once that happens, that's your insulin to carb ratio.  MY I:C is 1 unit of insulin for every 3.5 carbs, so if I eat something with 21 carbs, I'd take 6 units of insulin.  If I ate something with 28 carbs, I'd take 8 units of insulin. 

 

You said that you were taking 16 units of Humalog every day.  You don't use Humalog or Novolog like that, because the amount of Humalog is dependent of what you are about to eat, so it's not going to be a constant 16 units every day.  It would be X amount of units before breakfast, Y amount of units before lunch, and Z amount of units before dinner, with X, Y and Z dependent on the amount of carbs in each meal.

 

As far as fasting until you wake up with a BG level under 100, that's really bad information.  Fasting doesn't lower your BG levels, because if you fast for days at a time, your body will use up it's fat stores, converting that into glucose, then when the fat stores are gone, your body will begin cannibalizing your muscles, converting that into glucose, so not eating for days will not lower your fasting glucose levels.

Edited by Hammer

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meyery2k

I had a little more to add but wanted to think upon how best to word these next items.

 

Forums - I am not a particularly social person  Not anti-social but not into it either.  For this reason I never really got into forums, chat rooms, Twitter, and other social media.  Facebook is about it for me.  Just a handful of friends.  That being said, having a group of people that actually live with diabetes and deal with it everyday, helped me figure out how to live with it and live well.  I have looked a several sites and I found this one to be the best for me because, for the most part, it focuses on the problem and there is little of the depressing topics.  I have made friends here too.  If you can find a group that you like, it can really help with managing the challenges of diabetes.  Sadly, there is a lot of misinformation out there.  Much of it provided by medical professionals.  My doctor was skeptical of my plan at first but had to concede that it must work based upon his observations of my progress.  I went from being morbidly obese to athletic and test as a non-diabetic using the fasting BG and A1C tests.  My BP, cholesterol, and other stuff is good.  I am NOT saying I am cured or have reversed diabetes but I am able to keep it controlled with diet and exercise.

 

Keto -I think the awareness and promotion of Keto has been a wonderful thing.  I was diagnosed a little over 3 years ago, found this forum, tried low carb, and it was like hitting a reset button for me.  I look, behave, and feel younger than I did in my 40's (I will be 53 in December).  At first, it was impossible to find low carb things in restaurants and at the store.  That has changed greatly.  Not as much as WE would like perhaps, but there is change.  I would best describe my diet as low carb high fat.  Close to keto but I don't follow keto too vigorously.  I just eat the things I like that match my criteria of low carb/high fat.  I don't test my ketones.  Just one more thing to follow that I don't want to deal with, or see a need for.  If I feel good and perform well on my bicycle, I am happy with that.

 

From day one when I decided to change, my diet had to change dramatically.  I loved the fast food and convenience food.  I decided that of all the gorillas on my back, I would need to work on diabetes so I focused on things I could do to control my BG.  I learned to eat to my meter and to do things to improve my fasting BG.  At first diagnosis my fasting BG was 313.  I got it down to the 80-90's and kept it there as best I could (sometimes I get thrown a curve due to illness or stress and have the occasional blip over 100).  Everything else just seemed to fall into line as far as weight, cholesterol, and BP which was a good thing for me.

 

As far as what to eat, yeah, it was tough at first.  There are many great recipes on this forum and all kinds of wonderful ideas for eating.  Today, I didn't feel like making breakfast.  I had coffee, macadmaia nuts, hummus, a hunk of Havarti cheese, and almond milk with a Tbsp of cream and some sweetener.  The old me would have scoffed at this breakfast but now I enjoy it.  Once it became a habit, it became easy.  I eat mostly non-root vegetables with good proteins.  I lean towards more fatty cuts of beef and pork (love pork belly roasted Chinese style) because it is flavorful and the fat satiates me.  I also enjoy fish.  Lots of nuts.  Butter and cream are staples.  I have tried many different kinds of cheeses and also played around with wine and cheese pairings.  Any diet that promotes cream and butter is one I can get on board with!

 

A common comment is how expensive this diet can be.  While the items might indeed be a little more expensive, I eat less which offsets it a bit.  I also stock up on mayonnaise, dressings, butter (freezer), roasts (freezer again), canned fish, and on, and on when they are on sale.  I find it costs about the same if I shop carefully.  I am "the 50% guy" at Safeway because they will have meat or fish they must sell the same day and will knock 50% off the price.  I buy it up and freeze it.  My daughter (now 23) does this as well and I don't enjoy the competition lol...  The meat doesn't look as good as it did when it was first cut but they add carbon monoxide and dye to do that.  It is fine to eat either the same or next day, or freeze it.

 

I have a tendency to write novellas here if something ignites my passion and this has become the case so I am going to stop here.  Welcome, I hope you will stick around.  We are more than a forum.  I have come to view this place as family.  I have some very good friends here whom I have never met face to face but would trust them nonetheless. ~ Mike

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Kit
13 hours ago, 1967rs said:

I really avoid the diabetic forums because they depress me and I don't really need help there when winter rolls around.

I’m 56yo and I’m hitting 20 years as a diabetic and 6 yrs on the needle.  Two months ago, I was injecting Humalog 15u and Humulin N 15u twice a day and I was up to an A1C 8.0

I decided I needed to try something.  Over in the UK some other Yanks were talking about keto so I decided to look into it.  Yes I’m a yank. I got the youtube education.  I think DR Boz really likes being on Youtube. I’d buy her book if I know she would just get to the point quicker.

So drop the carbs to 7%, proteins to 16%, and elevate fats to 77%.  I find it makes you have to plan your meals if you want good meals.  I did this for awhile but ran out of time so I now just grab stuff that isn’t carbs.  Tough time hitting my fats so I use brain MCT’s.

I also use mynetdiary app for diabetics.  Nifty app if you remember to fill it out regularly.  I started at 220lb and I’m on my feet all day as a pharmacist but wouldn’t call it exercise.  I’m down to 198 after 2 months. I have keto strips and they are always purple med to dark.  Eating isn’t really fun or exciting anymore, I have to make myself eat.  I don’t come close to hitting my calorie goal on most days and certainly not balanced meals so I started taking a good multivit. 

My first month my sugars were amazing low.  I told my doc I would switch over to a Humalog pen because I really didn’t use much insulin anymore.  Around month 2 that changed. My sugars went up again to the point where I had to do something. The Youtube docs were saying maybe I needed to fast from time to time so I did that.  Dr Boz is saying “fast until you wake up in the am and your sugars are less than 100. That’s when you know your carb stores are empty” Makes sense I guess but does that mean I need to go days without eating?  I could easily do it but I don’t want to end up in the ER.  Yesterday my bs was 124 at 5:30 am and it was over 200 by 9am with no food.

As a diabetic we need to keep our sugars down. I really don’t eat many carbs but my insulin usage is almost back to my pre-keto days.  So if our sugars start to rise, we need to exercise to lower them?  Do we want to use insulin since it’s the enemy and just stores the sugars and we’re trying not to do that? We need a diabetic guru on youtube to explain how keto works best for the diabetic

 

vic

 

 

Hi @1967rs, welcome to the group.

 

First off, congrats on the weight loss.  :)

 

A few things have stuck out from your post that I wanted to comment on.

 

Yes, keto does require meal planning.  However, as time goes on, it gets a lot simpler.  After 5 years of this, its second nature for me as I know what I can and cannot eat and beeline to the sections of the grocery store which contain those options.  I avoid the rest unless I'm cutting from one far section to another.  :)

 

With the introduction of cold weather, I'm considering making a thai style soup this weekend

https://explorermomma.com/low-carb-keto-thai-coconut-soup/

So there can be lots of variety if you are willing to cook for yourself.  And I personally recommend everyone know how to cook, even if its not something you do on a regular basis.  It gives you a lot more variety and a lot more options.

 

Eating out can be back and forth.  Some places are pretty easy, some not so much.  Even after 5 years, I will check out a restaurant's online menu to see if there's stuff I can work with before hand.

 

Fasting:  I'm actually near the end of my third week doing intermittent fasting.  Specifically a mix of OMAD (one meal a day) and 18/6 (eating two meals within 6 hours of each other and nothing else).  Its been working pretty good for me this time around, though it absolutely did not the last time I tried.  No idea why there.

 

So, here are some things to keep in mind about that fasting.

Its very normal for a diabetics BG levels to go up after getting up, even without having eaten anything.  Our liver's store glucose as glycogen and release it into our systems when we get up.  This gives us the energy we need in order to start the day.  I mean think of it.  My great grandparents (around the turn of the 20th century) had a farm in a rural area.  My G Grandmother was up before anyone else, build up the fire (fireplace early on, had a wood burning stove later), gather eggs, etc and then had to cook a meal for her family (16 kids) from scratch before they could even eat.  While this was being done, my G grandfather would milk the cows, feed the animals, draw water from the well and stack the full buckets that G grandmother would need to get started for the day.  It was easily a couple of hours between them getting up and working until they were actually able to eat.  If you had to eat immediately after getting up, you would never have survived.

 

However, as diabetics were a little broken and we have trouble dealing with that glucose jump.  I feel fasting until you get to a certain BG level before eating is completely ignoring a number of factors.  First off, where are your starting numbers.  If you wake up at 200, I'll just about guarantee you that you are not going to hit 100 that day without intervention of medications.  Our livers are going to do a pretty effective job at keeping our numbers up.  From my experience, it takes time for those to come down and won't happen drastically just because you're not eating.  It will happen, don't get me wrong, but it takes time as well.  However, trust me, you would not end up in the ER because you didn't eat for a day or two.  heck I've done that when I was sick and didn't end up in the ER.  1 pound of body fat contains over 4000 calories.  If you have weight to loose, you are not going to starve because you didn't eat for a day or two.

 

If this was a case, it would be suicide from an evolutionary standpoint.  If someone could no longer function because they hadn't eaten for a day or two, the species would have never survived lean times and humans would not exist now.

 

And now onto the point that bothers me the most.

 

1)  You are on keto

2)  You are using insulin

3)  Your numbers continue to rise

 

I would recommend you get your doctor (this might take some doing) to test your c-peptide levels (shows how much insulin you are making yourself) as well as antibodies for an autoimmune attack.  It may be you are LADA (Latent Autoimmune Diabetes of Adults) or often referred to as type 1.5.  While keto can be really helpful in helping treat this type of diabetes, its not the only answer and an appropriate insulin regime needs to be followed, usually a mixture of fast and slow acting insulin.  The slow acting is used to counteract the glucose our livers release all the time, the fast for countering meals.

 

As for your numbers initially improving after going keto?  Look up Honeymoon period.

 

I wish you well and let us know how things go.

 

I can't say this is your case, but from what you have said, I think it could be a possibility that should be looked into.

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1967rs

Good Stuff!  I'll make an appt with my doc and we'll see if I can't get on a basal again and try harder to get this under control.

 

vic

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