# Low Carb and Type One



## Aoife (Jul 24, 2013)

Sorry if this has been asked before...

I have started a low carb diet (only started sunday so please bear with me!).

I was always lead to believe that I don't need to bolus for protein but whilst "experimenting" this does definitely not seem to be the case!  I am a good carbohydrate counter but how exactly do things translate for protein???

I have had between 30-40g of carbs/day for the last 5 days, this would be 4-5 units of rapid (depending on time of day) total, so why is it that I have had spikes after meals? I have been taking more insulin than calculated for meals but not much coz I'm a bit scared, but eating dinner with one unit of insulin seems (and obviously is!) wrong.

Has anyone got any tips for insulin with protein or is it all guess work and corrections (been correcting little and often so far!). I know my basal is fine.

The only good thing so far is that the spikes have meant I haven't hypo'd and had to resort to carbs for that coz I think an open packet of fruit pastilles may just be my nemesis!

I miss carbs!


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## Redkite (Jul 24, 2013)

Carbs are the body's preferred energy source (readily converted into glucose), so when plenty of carbs are eaten, the protein in the meal isn't metabolised into glucose.  But when there aren't enough carbs in the diet to produce enough glucose for the body's needs, it will use dietary protein.  So as you've found, when you eat lots of carbs you don't need to bolus for protein, but when carbs are in short supply you do!  As to how much insulin to give, this will be a matter of trial and error.  The other unknown is how long it takes between eating and the protein metabolising into blood glucose.  If you were on a pump I would be advising an increased temporary basal for a couple of hours after eating.


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## DeusXM (Jul 25, 2013)

I have a policy of mostly guesswork and testing. My insulin ratio is about 1:5, so if I'm having a very low carb meal (say, steak and salad), then I'll usually just chuck in 3 or 4u of Novorapid and test afterwards. Eventually you just sorta get a feel for it and you start finding you get really good postprandial readings. On the days when I'm really going for it low-carb and putting the work in,  I don't get any BGs over 6.5 so it does work.

It is worth noting that low-carbing definitely isn't the panacea for T1 in the same that it is for T2. Anyone who tells you that low-carbing fixes everything for T1s is wrong. It can certainly lead to better outcomes but it's not quite as fire-and-forget as many successfully low-carbing T2s think it is.


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## everydayupsanddowns (Jul 25, 2013)

This graph might be a helpful starting point for experimentation...

http://www.diabetes-support.org.uk/info/?page_id=438


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## trophywench (Jul 25, 2013)

Yup Mike - when you DO need to bolus, my understanding is that the rough guideline for starters is 50% for protein and 10% for fat - but I think you'd have to be on mega low carb (a la Bernstein LOL) for fat to need insulin in the normal course of events - unless of course it was a VERY high fat meal.

Seal blubber for dinner, anyone?


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## Redkite (Jul 25, 2013)

We always need to account for fat in high-fat meals like Sunday roasts or takeaway meals.  We use an increased basal rate for several hours, in addition to bolusing upfront for all carbs.  Otherwise the 2-3 hour post-prandial can be fine, but a few hours later the BG just goes up.


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## Aoife (Jul 25, 2013)

Redkite said:


> The other unknown is how long it takes between eating and the protein metabolising into blood glucose.



Thanks Redkite, i'm certainly not getting post meal spikes but after 2-3 hours I do see a rise which I guess is the protein



DeusXM said:


> I have a policy of mostly guesswork and testing. My insulin ratio is about 1:5, so if I'm having a very low carb meal (say, steak and salad), then I'll usually just chuck in 3 or 4u of Novorapid and test afterwards.
> 
> It is worth noting that low-carbing definitely isn't the panacea for T1 in the same that it is for T2.



Do you give all your Novorapid upfront?  And if you do do you ever have a problem going low after a meal?  I'm not expecting low carbing to fix my woes lol, I hope to lose a bit of weight and try and get a bit more control over my glucose.  My A1c normally sits low 7's, last was was a shocking 8.2 and has kicked my into action to try something different.



everydayupsanddowns said:


> This graph might be a helpful starting point for experimentation...
> 
> http://www.diabetes-support.org.uk/info/?page_id=438



Thanks, thats interesting, I may try bolusing after my meal to match the rise a little



trophywench said:


> Seal blubber for dinner, anyone?


Only if I can have a side of bacon 



Redkite said:


> We always need to account for fat in high-fat meals like Sunday roasts or takeaway meals.  We use an increased basal rate for several hours, in addition to bolusing upfront for all carbs.  Otherwise the 2-3 hour post-prandial can be fine, but a few hours later the BG just goes up.


Takeaways have always caused my to spike after, I assumed it was all the sauces and hidden carbs etc but it was probably the fat after all!

Takeaways are off the menu for now at least!


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## trophywench (Jul 25, 2013)

Really?  

I wouldn't touch it with a kayak paddle, even with a side of bacon AND black pudding!


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## HOBIE (Aug 2, 2013)

Good luck with sorting !


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## HOBIE (Aug 8, 2013)

How is it going !


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## Aoife (Aug 9, 2013)

it's going!
I was pretty strict with myself until tuesday when I had a little blip which involved indian takeaway with rice and naan and a smirnoff ice with friends but straight back on it again.

Sugars are more settled, not quite worked out the science behind it yet but 3 or 4 units per meal seems to work, not having hypos and only had one or 2 days or crappy numbers which told me that I needed to re-up my basal after the very hot weather finished

Oooh and I have lost 2.5kg


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## Northerner (Aug 9, 2013)

Aoife said:


> it's going!
> I was pretty strict with myself until tuesday when I had a little blip which involved indian takeaway with rice and naan and a smirnoff ice with friends but straight back on it again.
> 
> Sugars are more settled, not quite worked out the science behind it yet but 3 or 4 units per meal seems to work, not having hypos and only had one or 2 days or crappy numbers which told me that I needed to re-up my basal after the very hot weather finished
> ...



Great news all round Aoife!  Well done on the weight loss!


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