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Type 2 Diabetes and KETO
Replies
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I am not opposed to Chiropractic care but I need someone to help manage my mess at this point. Even reducing my meds I am getting lows. Two today had to eat carbs to correct. Anyone have a recommendation for a meter with cheap strips. I am going to be out of strips before I can renew my script.
I use the Relion Prime. It seems to give reasonably good predictions of A1C when I enter the numbers in mySugr. The strips are $17.88 for 100 at Walmart.2 -
I am not opposed to Chiropractic care but I need someone to help manage my mess at this point. Even reducing my meds I am getting lows. Two today had to eat carbs to correct. Anyone have a recommendation for a meter with cheap strips. I am going to be out of strips before I can renew my script.
@2t9nty
@ralflott
@kim_m_kk -
1. Here are a couple recent round-ups of glucose meters:- https://www.diabetestechnology.org/surveillance.shtml
- https://www.consumerreports.org/products/blood-glucose-meter/ratings-overview (subscription req.)
Of the inexpensive meters that were top-rated in both studies, I have tried only the FreeStyle Freedom Lite and Bayer Contour NEXT. I really like the Contour NEXT and bought 3 of them recently on Amazon for $25. You can get large quantities of soon-expiring strips for the Contour NEXT from Amazon or eBay at very good prices, if your insurance doesn't cover them. (Don't get the plain Contour - it's not the same animal.)
2. Your idea of getting an adequate supply of test strips is spot on!
If it were me......
I would test rigorously - upon waking, before each meal; 30, 60, 90, 120 minutes post meal; and before bed for maybe a week so that you can get a handle on how your meds, diet, and exercise affect your BG levels. This will also be great info for your (new) doctor. You would need 10-12 strips per day for the initial period until you've got these relationships established to your satisfaction.
Article on using glucose meters:
How to prevent diabetes and heart disease for $16
https://chriskresser.com/how-to-prevent-diabetes-and-heart-disease-for-16/
(Note - the meters recommendations in the above article are pretty dated.)
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Off topic.....
3. If you haven't had full bloodwork and your insurance permits, it might be a good idea to fill in some blanks. Hopefully you can find a competent doctor (preferably a younger endo, IMHO), but if that will take time, perhaps you can get your current one to order whichever additional tests you might need. At a minimum, I would think you might want to get a complete blood count, HbA1c (or, better, fructosamine, which gives you a more recent average and more quickly shows changes in your BG from changes in diet and meds), a comprehensive metabolic panel, a hepatic panel, Vit. B12, Vit. D, CoQ10 (and possibly thyroid tests, depending on your history).
4. Lipids - my $.02
Keto experts and researchers Stephen Phinney and Jeff Volek emphasize that your LDLs and other lipid tests may initially appear to show worsening numbers - but this may be a transient thing that has nothing to do with your long-term health or lipid management! It's common to experience rising lipids as you begin your keto journey as a result of your body processing and disposing of the material stored in the fat cells you're burning as you lose weight. For that reason, it's best not to overemphasize lipid tests until your weight has stabilized and you've been at goal weight for a while.
The bigger lipid picture would be revealed in an advanced lipoprotein test. The advanced lipid test my endo orders is the "NMR Lipoprofile", which shows the breakdown of LDL and HDL subgroups. He also orders "Apolipoprotein A1" and "Apolipoprotein B." He also ordered Lp(a) one time in order to check for a genetic issue affecting my whacky lipids.
Triglycerides and ApoB tend to correlate pretty well with a real culprit - small, dense LDL particles. These nasty sdLDLs in turn tend to correlate with heart disease. The relationship between triglycerides, ApoB, and sdLDL varies between individuals, and the standard lipid panel just doesn't yield this sort of info. Before leaping to conclusions from triglycerides alone, if it were me, I'd want to get the more complete test. It can probably wait, but I really wish I'd gotten a snapshot of my full lipid picture when I started keto!
5. Another possible test....
If you've got a lot of cardiac risk factors, you can always consider asking for a coronary artery calcium (CAC) scan, which actually shows in a CT image whether you have any calcified plaque in your arteries. Judging from your youthful appearance, I would guess you'd have a comforting score of 0, which would reinforce the idea of not being too hasty with lipid management as your body goes through the healing process you're treating it to!
Good luck!!
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PS Here are a couple short vids explaining how your lipid profile might get temporarily whacky when you're in the weight-loss phase of keto.
https://youtu.be/MNfjkTyBUdQ
https://youtu.be/mZ-deF9I31s
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Wow thanks for all the advice. I had blood work done on dec 13. So pretty recently. My a1c was 7. I took myself off one of my diabetic meds altogether because. I have an appointment with a new dr in a couple weeks. We will see how keto friendly they are but ultimately my choice. My youthful appearance might be deceiving as I am 43. Still young but maybe not youthful anymore. Lol1
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Well my journey had an interesting twist. Very scary too. If you are on Jardiance be careful. Good news my a1c is 6.1. Bad news I just got out of the hospital from dka. I am now off all meds but of course my sugars are higher. Ugh.2
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Whew! Glad you're out of sick bay!
I'm totally perplexed by the DKA scenario, as all the diabetes docs seem to say that it only happens with very high BG (in "real" life, that is, not thinking about all the meds). But your A1c would suggest an average BG of maybe around 140. ?? So, I'm wondering.... was your recent BG extremely high?0 -
No I haven’t had a blood sugar reading over 200 in months. My blood sugar when I arrived at the ER was 99. I have been really working on keeping my blood sugar in range and being healthy since I saw 7.4 as my a1c in early December. The only explanation I was given was the Jardiance. I spent two days in icu and two days in a regular room. Was scary.1
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No I haven’t had a blood sugar reading over 200 in months. My blood sugar when I arrived at the ER was 99. I have been really working on keeping my blood sugar in range and being healthy since I saw 7.4 as my a1c in early December. The only explanation I was given was the Jardiance. I spent two days in icu and two days in a regular room. Was scary.
Jardiance has a side effect warning for DKA. Sorry you had to go through that.
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It is apparently a rare side effect of Jardiance that generally happens within 2 weeks of starting the medication. I had been taking it since June.1
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That takes the, um, cake.
So the gurus at the ADA are worried about the relatively-remote possibility of hypos if they stop recommending carb-laden meals and snacks, yet their website and magazine are loaded with ads for profitable diabetes meds that carry the relatively-remote possibility of DKA.....2 -
Maybe I am the fool as I had no idea about this possible side effect until I was in the hospital. Also many medical providers and prescribing doctors don’t know as I had been to a minor emergency place and my pcp who both dismissed me. It was a scary experience for sure and I thought I was doing all the right things for my diabetes.1
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Maybe I am the fool as I had no idea about this possible side effect until I was in the hospital. Also many medical providers and prescribing doctors don’t know as I had been to a minor emergency place and my pcp who both dismissed me. It was a scary experience for sure and I thought I was doing all the right things for my diabetes.
OMG! If your docs didn't even know, you're hardly the fool! Ideally, it's the business of physicians to help you select a course of treatment that combines lifestyle choices and meds, balancing costs and benefits in the light of reliable and complete information (well, ok, as close as possible)....
Hopefully, your LC diet will be of clear benefit as you move forward without scary meds! In the meantime.... Dr. Bernstein's advice is to keep your carbs down, get adequate protein, avoid extra fat - and avoid meds except for metformin and insulin, and then only if you need them.
Metformin has the advantage of being around for a long time with a good safety profile, and not causing hypos. (Of course, the fact that it's an older med means selling it does not bring the whopping $$ returns that new drugs on patent, like Jardiance, can fetch....).
Good luck!!
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Well went to the endo who wants me to be eating 15grams of carbs at each meal. Not sure how I feel about that because I know it won't be good for my blood sugar. I said I would try to eat more at least until all of my numbers are completely back.
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Hmm. What's the point? Perhaps if you only eat 1 meal per day.........
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Well she is not a fan of the keto diet. I said I would consider it but I was making no promises. So far I haven’t done it.1
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I don't suppose she gave a lucid explanation (other than making a face like she'd just bitten into a lemon)?0
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Avocados have around 12 carbs per fruit. 3 avocados a day and no other carbs? Would she be satisfied with that? LOL!1
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She said I don’t want my body making ketones and I need glucose for fuel. She also told me low fat. I actually haven’t done it. I am still eating keto. Shhhh. I had a ton of sugar in the hospital though by iv and these d50 tubes.2
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Hmm. Some folks do better on low fat diets.... but you'd think she'd give diabetics some mighty good reasons to think they're among them!
Any tips for being prepared for unexpected hospital visits?1 -
Well went to the endo who wants me to be eating 15grams of carbs at each meal. Not sure how I feel about that because I know it won't be good for my blood sugar. I said I would try to eat more at least until all of my numbers are completely back.
At 15 g of carbs a meal, and three meals a day, she is prescribing you a ketogenic diet if 45 g of carbs a day.... She seems confused, especially if she is saying you need glucose for energy.
That all being said, moderately high protein us often helpful during weight loss, for preserving lean tissue. You could always go moderate fat with higher protein if it agrees with you.
Hugs.2 -
She said I don’t want my body making ketones and I need glucose for fuel. She also told me low fat. I actually haven’t done it. I am still eating keto. Shhhh. I had a ton of sugar in the hospital though by iv and these d50 tubes.
This statement above in general, without the context of your ill health when you arrived, is the generic blanket statement of those who don't understand a ketogenic diet, those who think that glucose is the only viable fuel. When done properly, as you have probably read here from others and researched yourself, a ketogenic diet INTENTIONALLY CREATING AND RUNNING OFF OF KETONES is completely healthy.
The statement that "you don't want your body making ketones" should have BY ACCIDENT added to it...
Because when you are running a ketogenic/ketone metabolism, you're no longer a glucose system, removing the conflict that results in DKA...
@kim_m_kk - I have absolutely no idea what (specifically, medically) happened to land you in the hospital, but (in my opinion) any doctor who doesn't understand that a dietary plan of Nutritional Ketosis that FUELS YOUR BODY THROUGH KETONES wouldn't be my doctor much further. She actually could have created a worse situation by not understanding that you were ketone-fueled when she attempted to dump glucose into the system. I'm quite shocked, actually, that you didn't end up in a diabetic coma with all of that...unless she flooded you with insulin, too. This sounds like an incredibly scary situation in which miscommunication and/or misunderstanding was prevalent.
I hope you can find a safer way forward. (hugs)
I do understand that if you weren't following a ketogenic diet, and had ketones present in your urine and blood, that would have been justification for her response, because for your body to do all that without dietary causes is a deadly condition (DKA). The fact that this was intentionally caused by your diet should have been a flag for her to stop the panicking reaction and look for other causes... Because since this likely wasn't a true DKA (since you were intentionally fueling your body with ketones, not as a deadly byproduct, and your blood sugar wasn't out of control high because of lack of insulin production in your body), I'd be scared NOT to know what really happened - because without understanding it, you could REPEAT it... Does that make sense???3 -
I really was in dka my ph was 7.203 and my anime gap was 24. They were giving me both insulin and sugar as treatment. This dr was not the one that treated me at the hospital. I went to the nearest ER for a racing heart rate. That is when they discovered the dka. This DKA was likely caused by taking Jardiance - apparently this is a rare side effect of this medication. The strange part is that I had been on it for 6 months when this happened. Even if I could I would not take this medication knowing what I know now. I would not take Invokana either as they work in much the same way.3
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Diabetic ketoacidosis cannot occur in people that make insulin in adequate amounts.
Metabolic acidosis CAN.
The presence of ketones in the blood due to the low carb diet is creating the confusion.2 -
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