Confused About Insulin Needs and LC

[djorg]

Hi,

I am a Type 1 diabetic and have been doing low carb for 7 days. Finally motivated myself to start. :)

While I have seen some improvement in my sugars (never over 200), it is not what I anticipated. I am still getting very high fasting readings - 180's. Other times of day, sugars are between 120-165.

What truly concerns me is the amount of insulin I am still taking: 35 lanuts/day (same as pre-LC) and 10-15 units of humalog 3x/day (used to be more like 20-25/meal). This is still not getting my sugar below 100 and it's A LOT of insulin (70 units) for a low carb program.

Regarding what I am eating, I am allowing myself more veggies (grean beans, spinach, and broccoli) than, say, induction would allow for. But intake has been consistently under 40g/day and I have been good! I write everything I eat down anyway, regardless of change in diet. I am finding it incredibly hard to understand why I need 70 units a day.

I think it has to do with the weight I've reached - 200 lbs - and increasing resistance. BUT, as I understand it the presence of high amounts of insulin prevents weight loss. I wonder if, as a type 1, where others on LC stop producing insulin without carb intake, I am still giving so much to myself, and am hindering my progress in some way? But I absolutely need to get sugars under control.

I am mostly concerned about the quantity of insulin I require for LC. I guess I'm just frustrated - sorry for the long post. I will keep going no matter what. My number one priority is to get sugars down, so if weight loss is slow or comes later, I will survive.

Any comments would be appreciated, especially regarding amounts of insulin needed for a LC diet.

Thanks,
deb

[Debi Warne]

I think too, some people respond quicker than others. It seems you've notice some change in that your numbers are now below 200 -- that's a good start. As you continue this your body will begin to respond better -- I begin to see differences the first week, but the longer you stay with it the better my numbers become. I am type 2, had surgery in December and am now fighting all those old carb habits, but within 2 weeks my sugars are coming down more and more.

Are you taking less insullin than before? I only had 1 insullin injection during my hospital stay, the evening after surgery, so I'm not that familiar, but I think too that you will be able to take less as your body assimilates itself.

Lisa N and Ruth can probably help you on this better than me, but I want to encourage you to keep it up and keep an eye on your sugar levels, because I feel they will start moving down soon.

I hope this helps.

Debi

[wsgts]

I know very little about Type I management, other than what my cousin (who is Type I for 42 years now) has told me.

He has gained a good bit of weight since starting the insulin pump, but he has perfect control (hba1c 6.1) as well. Recently, like last week, his endocrinologist just started him on Glucaphage XR 500mg because of the very reason you mention. So basically, he's Type I and II at the same time, meaning that because he has used the synthetic insulin so long, he is becoming resistant to it.

He told me that he routinely using 150 units (whatever that means) a day or more. I will give him a call and see how the Glucaphage is working for him, but maybe that could be the same problem you have? I am throwing this out, might be something to talk with your endocrinologist about.

Good luck to you,
wsgts

[Lisa N]

Hi Deb!

You've only been doing this for about a week and you're seeing improvements already. It can take up to a month or more for your blood sugars to settle down into a predictable pattern or at least as predictable as they can be with type 1 diabetes.
One of my standard recommendations for diabetics is to get and read Dr. Bernsteins Diabetes Solution Diet by Richard K. Bernstein. He's an MD, but he's also a type 1 diabetic himself who has used low carb successfully for over 40 years to not only keep his blood sugars consistenly in the normal range, but also to reverse diabetic complications that he had developed. Even if you don't follow his plan, I think it's a must-read for any diabetic whether you are newly diagnosed or have been a diabetic for years.
The amount of insulin that you need will slowly begin to decrease as you continue on low carb. How much they decrease and how fast is very individual. If you've been taking insulin for quite some time along with a higher carb diet, you could have insulin resistance and that takes some time to heal; a lot more than a week or two, but it will happen if you stick with this.
If you're interested in learning more about Dr. Bernstein's program or even reading a few chapters of the book online, his website is www.diabetes-normalsugars.com
HTH!

[willsmom7]

My son is Type I, and one of the things we learned is that there are dozens of things that affect blood sugars, and carbs, excercise and stress are the only things you have any control over. Your body responds to all kinds of things that can make your blood sugar do crazy things, so although your carb intake may be lower, other things may be making your blood sugar go higher.

My son is only 8, so we don't do restricted carbs for him and we are also getting an insulin pump to help control all the highs and lows. I know that I can feed him exactly the same thing from one day to the next, and get completely different results from his meter.

How long have you been Type 1?

Good luck!!

[djorg]

Thanks, everybody, for the responses. Things are looking better on the bg front. My last three morning sugars have been 99, 87, and 95. I am totally psyched at this improvement.

I am still finding that my sugars are going up for no reason at all... eat nothing and sugars go up 40 pts. Probably stress.

I was diagnosed with type 1 almost two years ago at age 25. I didn't want to believe it, I thought I must be type 2, but they did the antibody testing and everything. I went on to gain 40 lbs since diagnosis, and now I think I am facing the same insulin resistance as type 2s.

No weight loss as yet, but I will hang in there. I am feeling a lot more positive.

Thanks again!

p.s. I have been trying to find Bernstein's book: went to 3 bookstores and none of them had it. I was totally disappointed. There is one nearby bookstore (Borders) left to check, but I may have to order it online. I will get it soon.

[c6h6o3]

I bought mine there and they always seem to have it in stock no matter how many people buy it. You need to have that book in your hands as soon as possible. Literally a life saver. Don't listen to anything that disagrees with him.

[Sherrielee]

They have it at Barnes & Noble. I have bought two there, (one for me and one for my doctor).

Br Bernstein is such an amazing and inspirational person...I wonder if he has ever been on Larry King...or any other of the magazine show? Anyone ever see him in person?? I am considering it...going to check into the Insurance Issues....I still have not been diagnosed!!

[crush180]

I'm a type 1, diagnosed at age 16, 9 years ago. I take 30 units of lantus and 2-6 units novolog per meal. I've been on atkins for 1 week at first my blood sugars were ridiculously high, fastings in the 250-350's and I couldn't figure out why. My energy however tripled. I started working out during day 3 and saw that my numbers were slowly but surely coming down. My personal opinion is that since fat gets metabolized very slowly your numbers are slowly creeping up throughout the night. If you've ever monitored your numbers after you eat a few slices of pizza you know that you get a bs spike about 30 minutes after eating (carbs) and then it's very hard to bring it down (fat). After a meal that's high in carbs and fat bringing your blood sugar down could take up to 12 hours depending on how much you eat and at what time of day (evening is the worst for most people). Anyway, the same thing is happening with protein/fat combo on this diet. If you exercise aerobically you WILL see a huge change in your numbers, and you'll be able to decrease your insulin doses. The best part of low carbing is that you don't get spikes because you're eating protein as opposed to carbs so the SLOW metabolism of fat actually keeps your BS steady throughout the day. I was skeptical at first, but I LOVE this WOE, will never go back to carbs!

One word of advice keep glucose tabs on hand for lows. In regard to your weightloss, type 1's need to lower their insulin doses to lose weight so stay away from carbs, have as few lows as possible, and exersice.

[kjturner]

You may also want to ask your doc about adding Glucophage XR to your routine to improve your insulin resistance. You're right, you are still taking a lot of insulin so now you've got to battle with the insulin resistance problem that type two's have. Exercise will help, definitely. And may I also recommend you give up caffeine? You'd be amazed at how caffeine affects your bg's.

I love the Bernstein method, but my only complaint about his book is it isn't up to date on the latest insulin technology. However, you can call his office if you need some clarification. I've not ever needed to call him personally, but I've seen several posts on other forums where folks did call and were quite pleased with the response.