T1D for 34 years. I just got a Dexcom G6 about a month ago. #lovingit. I was using Medtronic Guardian 3 with my Medtronic 670. Lately, I have been trying really hard with low carb. I just realized I won’t bottom out with less carbs. The past 2-3 weeks have been awful in that I will have just a steak & onions with a bolus for 15 carbs and my sugar shoots up to the mid 300’s! I try bolusing to bring it down and it stays up so that I never reach my daily goal of 70% in range. O have NO clue what is happening and neither does my endo. She just raised the insulin to carb ratio for my boluses. I’m tired of using a lot of insulin. Its making me fat!
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how long after eating does it spike? it usually takes mine 2 or more hours to reach the top of the spike but i have found that extending the bolus ( i do it 50% to start and the rest over 1.5 hours ) keeps it from going that high and without using additional bolus
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Welcome to FUD! @RavynsMom Glad you got switched over the G6, most of our members that make that switch from the Guardian 3, never look back and are very happy with the results.
As for the keto not working great for you. There are some people that it works really really well for, and others that it doesn’t work the same way in. Keto causing insulin resistance in Type 1 diabetics is a known thing, although somewhat rare. You might use the extedned bolus function that @3cTim mentions or you might need to change up your eating habits somewhat to find what works best for you. My son eats about 100 carbs a day and that suits him best.
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It usually spikes and stays high for about 6-8 hours. Crazy thing is when I eat carbs, it goes up and comes down in about 3- 3.5 hours. I’m not understanding how no carbs is making my sugar so wonky. So incredibly frustrating. How does the extended bolusing work?
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wow 8 hours is really crazy long! I use an omnipod and extended bolus is one of the settings. not sure how to do that with any other
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Well in the absence of carbs your body makes them through a few processes since carbs are fuel for important parts of your body. Some people go through a period of time where their body adjusts, others don’t adjust. Also, when being really low carb it is important to eat enough fat.
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A grilled steak with all the fat. Roasted chicken with the skin on. I am a lover of fatty meat! Thats why I figured this was the perfect way for me to keep my numbers closer to normal while enjoying food without the guilt. It isn’t working. I am already overweight and having to take more insulin is NOT helping.
Sound like a great time to try something else. We have people here being very successful eating everything from One Meal A Day (Paleo) to Keto to high carb vegan and everything in between. If you need any ideas just ask. My family has tried to eat moderate carb (100-120 carbs a day) since my son was diagnosed and that is working well for my wife and I even though my son is away at college. It just seems to be a not too restrictive way of eating that eliminates most of the really carby stuff (bread, etc) but lets us eat a varied diet of meat and vegetables. Might be worth a try, or pick one of the others and titrate what works best for you. In either case, we are here for you.
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Might be too much protien. Glucagon stimulates the conversion of stored glycogen (stored in the liver) to glucose, which is released into the bloodstream . This process is called glycogenolysis. The release of glucagon is stimulated by low blood glucose,but also by - protien rich meals and adrenaline. once the blood glucose starts to rise and you start to worry about it adrenaline goes up and makes it worse
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That absolutely sounds like what is happening. I am at a point that I am scared to eat at all. I would love to sit with a nutritionist but my health insurance doesn’t seem to cover it. I’m going to do a little research to see if they make exceptions for diabetics. I just retired and changed health insurance, plus I moved out of state so the coverage is VERY different to navigate.
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I hope they can make an exception, its so hard to navigate insurance (even without retiring and moving, so your job is a lot harder), but it is worth a try 
fingers crossed for you
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Thank you so much❤. Fingers crossed!
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My (US) insurance company sends me stuff twice a year inviting me to see a nutritionist.
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I’m in the US as well. I actually was in a meeting this evening via Zoom, of course, and in the meeting it was said that I could see someone out of network and submit forms for reimbursement as a retiree. I am getting all of the details about that tomorrow.
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As Chris said, digestion of carbs releases glucose into the bloodstream, but so does digestion of protein and fat. There’s one style of bolusing called TAG bolusing (for “total available glucose”) that tries to account for this. One formula I heard of is bolus for 100% of the carbs + 40% of the protein + 10% of the fat, and maybe you will also need to change your insulin:carb ratio.
Feel free to keep trying different styles of bolusing and different kinds of diets until you find what works best for you. I’ve heard of great results from people with high-carb, moderate carb, and low carb; it’s all a matter of what works easiest in your individual body, and that’s a matter of trying it out to see what you like.
Folks here will be happy to offer advice. My own suggestion for an experiment with your current diet would be to bolus up-front for 100% of the carbs, and at the same time put on an 8-hour extended bolus for 40% of the grams of protein. If that turns out to be an improvement, continue to make adjustments from there: to the insulin:carb ratio if you’re low or high after 2 hours, for instance, and to the duration of the extended bolus if you’re ok for several hours but then start to rise or fall, and to the 40% weighting if you’re steadily climbing or falling after 2 or 3 hours.
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Hi @RavynsMom
I’ve been low carb for nearly 4 years, much of that has been strict carnivore (only meat).
Proteins are complex molecules (amino acids), and the body takes much longer to break them down than it does most carbs.
You do need to bolus for protein. Some of the protein you eat replaces the body’s broken down proteins, while the rest of it is converted into glucose (carbs) or triglycerides. Depending on the amount of fat you eat with your protein, this generally starts around 2.5-3.0 hours after the meal.
This has been well documented, and the rule of thumb for bolus’ing for these protein-converted-carbs is count 50% of the total gram weight of protein as carbs that require insulin about 3 hours post prandial.
You may well need far more than 50%. I often bolus up to 100% or more for 60 grams of protein. In other words, I’d need as much insulin for the 60 grams of protein as I would 60 grams of carbs. The only qualification is I’d inject (pump) it for a BG spike 3 hours after the meal.
The more fatty the meal, the slower (and longer) the metabolism takes. Practice makes perfect!
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You might also consider the following:
The Warsaw Approach
A Method for Dealing with Fat and Protein
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@RavynsMom As others here have indicated, there are several of us here that have similar issues. I too have significant, if delayed reaction to a high protein/fat meal, between 2-3 hours after I’ll go above 200 and stay there unless I take additional insulin, and that’s after the calculated carbs for the meal. There have been several studies showing the impact of hp/hf meals to the point of creating varying formulas to project the needs for an extended bolus or partial delayed injection for 3-6 hours post meal. Check out the Waltzing the Dragon website for a good intro; similarly there’s a couple of episodes of The Juicebox (episode #263) that cover it. Alternately, do a web search for “diabetes” and “fat protein units” to find references like: How to Calculate Bolus Insulin Dosing for Protein – Diabetes Daily and https://care.diabetesjournals.org/content/43/1/13.
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I am so thankful for everyone who is giving me this information I knew absolutely NOTHING about!I will absolutely check out the suggested resources/tips/techniques/hacks. Something will work! Diligence & balance!
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That is one of the better Diabetes taglines I have heard. Now reaching back into the ridiculous old memories I have, this is the battle cry of my favorite cartoon super hero “SPOOOOON!”
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