@bkh, good advice…thanks!
In my case, though, and I suspect many others, it is none of the above, it’s simply that eating lots of carbs doesn’t work for us, maybe because of physioloigcal differences. Even when I’m “sugar surfing” (and I’ve read Ponder’s book, and was using many of his methods even before I’d heard of “sugar surfing”) and checking my CGM constantly throughout the day, I can’t keep my blood sugar in range while eating carbs. Keeping it in range even without eating carbs is a challenge, so adding in that additional (very unpredictable) factor makes tight control unattainable.
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Yes it’s the eating carbs for me that is the problem - I’ve been eating an omelette and half an avocado for breakfast here at the hotel that’s been working and is delicious - today I had a tablespoon of refried beans they added for a treat - my bg was 140 within 2 hrs with that extra dose of carbs - I had to take another 5 of insulin to reverse it - and even then it still got to 175 before finally I got it to turn the other way - no more beans for me I guess
@Jen: In my case, though, and I suspect many others, it is none of the above, it’s simply that eating lots of carbs doesn’t work for us, maybe because of physiological differences.
I fully accept the principle that “YDMV” (your diabetes may vary). I regret that I didn’t include it as “Third” in my post above, and I certainly didn’t mean that if everyone just surfed on their CGM we’d all be flatliners.
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1 tablespoon of refried beans is 3g carb. If eating 3g carb raises you to 175 and requires 5 units of insulin, then you are clearly ultra sensitive to carb - and from what I’ve read this may be due to the ultra-low-carb diet that you are eating? I have to believe that if you were eating enough carb that you were not ketogenic, then your BG would not react so radically to such a small amount of carb. Which begs the question whether it is worth being ketogenic, if it causes your body to have such a radical reaction to such a small amount of carb?
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Or something else was going on at the same time?
In our situation, I tend to not make any major changes or assumptions based on unusual behavior until I am able to repeat the scenario or see a pattern over a number of times.
There is just too much that happens that falls into the “weird” category so we often times have to discount quite a bit.
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Yep I’m on vacation in Mexico there is no guarantee what is in anything I’m eating
I’m happy with the sensitivity - I’ve always been sensitive to carbs anyway - my goal is trying to keep below 150 after meals I just can’t do that on carbs other than vegetables
The intensity of the gluconegenesis after eating protein I am starting to get used to - my 90 day average is still 105 despit all these problems I am posting about - I never came close to that when eating carbs
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Wow, being in Mexico, I can’t stay under 150 carbs JUST on the chips and salsa! 
We have tested this hypothesis a number of times. For reference, my son eats about 80 -100g of carbs a day, and we are able to manage this quite well. But when we go up to 150 - 200g of carbs we completely lose control.
I tend to believe that most people have a setpoint and that if they go over this their diabetes will be more difficult to deal with. We re-test our hypothesis every 6 months or so, just so if he changes physiologically we can adjust when that happens. We have determined that my son is carb sensitive and that isn’t changing anytime soon.
Additional info,we adjusted his carb intake up to the higher carb level for two weeks, so unless it takes longer than that to acclimate, I don’t believe in the eating less carbs means you make yourself more carb sensitive, unless you are talking about truly ketogenic levels. Also, once we reverted back to his lower level of carbs it took a couple of additional weeks to get back to normal.
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That is what I was talking about, since the member I was responding to reports eating an ultra-low level (ketogenic level) of carb. That said, it is only something I’ve read and have no personal experience with, as I haven’t tried eating ketogenic myself. But I agree with Thomas that there was probably some other food or insulin or exercise or hormonal effect going on, since I have trouble believing that 3g of carb could raise any adult T1 by 75 points or require 5 units of insulin.
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Can’t speak about the volume of insulin, since that is such a personal issues with many confounding things, but my son can easily go from 50-200 on 10g of carbs, so I have no problem believing 75 on 3 carbs. Also, his buddies from diabetes camp couldn’t believe it either. They have a low, take 15g of carbs, and go from 50-110 and are happy. We take 6g of carbs, and if he starts responding on his cgm within 15 minutes give insulin to blunt the glucose climb.
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I saw a quote on a Facebook group yesterday where a lady in the T1 group says the has to take a manual bolus of 20u every time she does an infusion set change just to hold her over until the new site is working well (I didn’t even know that was a thing!). I’ve seen other t1s say they need 5u for a cup of black coffee or a glass of wine… seems crazy to me too, definitely not in line with my experience.
I do notice (as I travel for a living and frequently end up eating more or less carbs for several weeks at a time due to circumstance) that when I eat more carbohydrates over several weeks I generally become less sensitive to them and when I eat less I generally become more sensitive to them. It’s as if my body has a set point of how much insulin it desires and adapts those needs somewhat to my dietary trends
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EH has up to a 50 point rise from black tea, no sugar. I think with so many of these things, it’s a YDMV thing.
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Tea has caffeine which can raise your heart rate. Tea also has theophyllin and theobromine which are stimulants. So those may cause a BG rise.
But for many people, coffee and tea coincides with time-of-day. Many people have it in the morning, and the rise may be just normal get-out-of-bed BG rise. So it is possible that the tea isn’t the cause.
Some people have tea after they eat, so other possibilities are that the rise is just from the meal.
Not saying these apply to EH. Certainly tea by itself may be causing a spike. Just want to mention that whenever you see something like that, you want to make sure to isolate it with different experiments, different time of day, different circumstances, etc. That helps you know without a doubt whether it is causing the BG rise.
I know you and EH are the sharpest cats in the world who know all this stuff. So this is just general commentary on isolating variables for anyone trying to figure out a particular food or situation they suspect is causing an issue.
I almost put in a disclaimer (typical YDMV that seems to be needed for all posts), but left it out. I hope that this may be an artifact of teenage hormones that will settle out in a few years, since it must be extra hard to keep balanced with that degree of carb sensitivity.
No worries, I enjoy the discussion. Yes it is a pain. Yes, we are hoping that it gets easier to deal with as he ages.
Found this as well which seems to agree with a lot I am seeing and people are discussing here
Thinking back to when I was uncontrolled and eating maybe 70-100g of carbs a day - my tdd was (30 tresiba and about 36 humalog)
After a brief foray down to 33 on the low carb I am back to about 60 thereabouts and I’ve lost 30lb
So essentially based on that - it really appears to not matter how much or what you eat practically - for me at least my TDD remains the same - it’s a little high to the recommended based on weight (should be 49)
That pesky liver just needs to regulate your glucose and whether you eat lots of carbs, protein or just lettuce it finds a way to get that glucose in your blood stream !
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I agree, I haven’t seen any change in insulin or carbohydrate sensitivity since changing the number of carbohydrates I eat (from 30 grams to 100 grams a day). My basal and ratios stay about the same (aside from usual fluctuations), but the amount of insulin I take does decrease simply because I’m bolusing less for food.
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But I think there are also people who respond to carbs with much more sensitivity or variability than others, and for whom high carbs are a much more difficult diet.
Right now we are able to eat medium carbs without trouble. But I know that could change.
That must be true based on the different responses to glucose tabs that I’ve read about here and elsewhere. For me each glucose tab raises my BG 10 mg/dL. Others get a much larger response.
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