Re-Booting

T1DCarnivoreRunner
T1DCarnivoreRunner Posts: 11,502 Member
I completely stopped a few weeks ago, I think for good reason. I have both type 1 and type 2 (i.e. I don't make insulin and I'm resistant to insulin), so I take A LOT of insulin. I started trying to lose weight by managing calorie intake / expenditure starting Jan. 1. At first, I was losing weight just as easily as a non-diabetic who did the same thing. Then, I started having to feed lows constantly. I lowered my insulin rates and lost a little bit more. But then I started feeding lows and by the time I got insulin rates low enough, I seemed to be stuck not losing any weight (maybe lower metabolism?). I persisted for several weeks hoping that I would see some progress.

Then, I had a day of low blood sugar that really scared me. I was going hiking and felt a bit low, so before heading out, I tested and was 20. I had over 100 grams of carbs to fix that, and brought it up to 46 before heading out on the trail (figuring it was still rising) with a temp basal on my pump of only 1% of my normal basal rate (so almost none). This was a really easy hike compared to what I normally do. After completing the hike, a couple hours later, it was 43 (I assumed that it went up and back down again). I had a root beer float (with regular sugary root beer) - around 125 grams of carbs. I did not take a bolus for that. I then went go-karting, and about an hour later was back down in the 60's again. I ate another 150 grams of carbs without a bolus and went shopping. An hour later, I was up to 110. After more shopping, I was back in the 60's again. I ate about 80 grams of carbs, and did more shopping. After another hour, I was low yet again. Anyway, this went on for some time - no bolus, lots of carbs, and still low.

Anyway, that day just discouraged me so much that I quit. Now I am going to come back and try to lose more slowly. First, I'm going to spend some time doing basal tests and re-adjusting my rates. Whenever I notice issues, I'm going to do that again (which means 24 hr. basal testing probably every 4-6 weeks). I really doubt I will lose more than 1-2 lbs. each month, which will be discouraging.

Has anyone else had the issue of feeding lows? How did you deal with it?

Replies

  • carolinatx
    carolinatx Posts: 58 Member
    I have, but like what it sounds like you're trying to do, it works for me to have a little something or turn off my pump before I start to exercise, depending on what i'm doing and my blood sugar at that time I start.

    I'm certainly no doctor, but I would say that you are having successes at lowering you weight and likely your need for your medication for diabetes. I would talk to your doctor about adjusting your meds. I have type 1 so I can't comment about drugs for type II, but it sounds like you're making really good progress and maybe getting less resistant to insulin so maybe the pills you are taking for resistance are really multiplying the effect of the small amount of insulin you have in your body? And it's not just the insulin that you're putting in while working out, but the tail of insulin in your body from earlier that day. My doctor always told me, if you're going to use the temp basal for exercise, to start it 60 mins before your work out because that's the dosing that would be having an effect on your when you're working out, if that makes sense.

    Congrats on your progress so far! Good luck figuring out the lows... as if it isn't hard enough to lose weight - I know!
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    Yes, I asked my endocrinologist and his response was to use temp basals. I'm already doing that, but someone on another group said she was cutting basals a couple hours prior to workouts also. So I'm going to start doing that. For short term, highs are better than lows, so I think I'm just going to over-do it and correct later if needed. But before I do anything else, I'm going to figure out my rates.

    As far as medications and such, I have type 1 and type 2... I've always taken insulin for type 1 (since I was 9), and that has changed over the years (I am old enough to have taken pork insulin at one time). I use Apidra through an insulin pump today. Because I also have type 2, I take a very high dose of insulin and also take Metformin.
  • AlliSteff
    AlliSteff Posts: 211 Member
    A lot of people have success using a temp basal (starting 30-60 min prior to exercise), but my basal rates are already fairly low (.6-.8 units per hour), so I completely disconnect about 30 minutes prior to working out AND add gatorade to my water bottle DURING workouts (and even then, I sometimes drop!). Then, post workout I bolus in the insulin that I missed to I do not spike post workout. I also drink some Powerade Zero and have protein, which seems to help
  • 2hobbit1
    2hobbit1 Posts: 820 Member
    Basal testing is a start, and one you will need to redo when ever you see a return to the unexplained lows. Once you get the basal back in line you need to redo your I:C ratios, your C.F. and duration on insulin as well. And as you lose more weight and get stronger/fitter you will need to keep redoing it. Weight loss and better fitness will reduce your insulin resistance, which in turn will alow you to reduce insulin further.

    Working in the exercise piece with out needing to feed the insulin too much can be hard. It changes with time of day as well as type of activity. Have you read the Diabetic Athlete Handbook? It has a lot of good info.

    Whoever even with guidance it will still be trial and error to find what works for you at any given moment.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    Yes, so I think I'm on the right track. It's just going to be very slow and continue to be frustrating for that reason.
  • okulyd
    okulyd Posts: 147 Member
    Like you I am on insulin and metformin. I also spend a lot of time treating lows. I think the key is to reduce your overall rate of insulin, check your basals (should be 50% of your total insulin consumption) and adjust downward if you notice that the lows are at the same or similar times each day. For me, mine are never consistent so I can't adjust pump settings.

    To treat I always have skittles on hand and find that only a few get me back to where I need to be. I'll have say 5 not the whole package. I also like hot chocolate and will have half a cup to get me back to where I need to be.

    Also take the pressure off yourself and think about exercise as a way to get in shape, live longer, etc... Most weight gains and losses come from food intake not exercise. As you lose weight your insulin intake will go down. Good luck!
  • kimosabe1
    kimosabe1 Posts: 2,467 Member
    1 unit per 50 glucose sugars is the way I do it.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    In case anyone is still following this, I went ahead and took the trip I was planning 5/23 - 6/1 - this was a road trip with a lot of hiking at various destinations. I ended up hiking 63 miles for the trip, which was short of my goal of 70. Though I didn't track what I was eating, I don't feel as though I was eating so much more than normal (in terms of the additional amount of exercise). Still, my weight just before leaving and just after returning was a gain of 2.7 lbs. (ugh). It is a few days later and I'm back down to 0.3 lbs. below my starting weight.

    The plan had been to start lower carb on Monday (I got back from my trip on Sun.). But, I still have a lot of carbs in the house that I need to use up (cereal, oatmeal, ice cream - mostly left by the person pet-sitting and I can't bring myself to throw out food). The plan was never to eliminate carbs, but to decrease them in favor of more long-lasting and consistent glucose from protein and fat. But now that I'm trying to use up carbs, I'm wondering if this may be a good time to quit soda instead.

    I drink diet soda, so no carbs or calories. But, I am aware that it could increase appetite and I really hate to feel like I am so dependent upon it.

    What would you do? Would you throw out the heavy carb foods and plunge forward with lowering carbs? Would you eat them more slowly, and at strategic times like for late afternoon / early evening meals to give yourself a short term boost before bed? Would you try to cut soda simultaneous to these things?

    I'm really leaning towards using up the carbs towards the end of the day and cutting soda simultaneously (4-week soda-reduction plan).
  • jamie_lee80
    jamie_lee80 Posts: 176 Member
    I don't know about you- but i'm an all or nothing kind of person. I have to dive in head first or else I can't keep myself in line. I gave up grain on March 31st. No bread, no rice, no pasta. I was just tired of taking so much insulin everyday and having so much extra weight on myself. I threw away all of my little flatbread, pitas, tortillas....all of it. If I would have it around I would cave and eat it. I still keep bread and snacks around for my husbands lunch but I try to buy things that weren't my weakness. This has been working good for me. Over the weekend I was craving pizza so badly, so I gave in and had 2 slices. After not having anything like this in 2 months let me tell you, I savored every single bite. But I also had to take such a large bolus to cover that and got right back on track the next meal.

    I have reduced my overall daily insulin to around 70 units today, before this lifestyle change I was taking anywhere from 140-170. My blood sugar levels have never been so good in the 23 years that I have had this disease. I have to go for bloodwork tomorrow and for the first time and really excited to get my A1c Results!

    So my vote is for you to throw it all away and start fresh! I know if I had chips and ice cream around I would be lurking around that stuff come night time and not be able to resist it!
  • okulyd
    okulyd Posts: 147 Member
    I like you can't bring myself to throw away food that I like. I would save it as a treat or share when you have guests over. Put it somewhere far away so you don't see it all the time. I am definitely watching what I eat but I admit I had two bite sized snickers today and enjoyed every bite. Sometimes you need it. Limit your intake of the foods and you should be ok.
  • jbalistriere
    jbalistriere Posts: 300 Member
    I've had non-stop struggles in my journey. I feel like every time I found my "new normal", I hit another weight loss milestone and had to struggle to find another new normal. I've had near ER visits, ridiculous doctor bills, and an incredible amount of days where I just left like garbage because my sugars were off.... Every issue pushing me to quit. BUT, I didn't. I made it through with the help of my doctors and I can tell you, as much as it's frustrating, it's worth it. I've gone from bawling my eyes out because I've busted my butt in the gym burning x amount of calories just to have to eat 2xsX just to stay alive to being amazed by the person in the mirror (really not vain but you spend so much time avoiding the mirror that once you hit milestones, that mirror sometimes is nice... sometimes.). I just started the pump and am still learning all the features. I always run into issues while exercising but, again a test to sticking with it ,I've gone from a A1C of 7.6 to an A1C of 6.0 since starting the pump. If I can do it, I have 1000000000000000000000000000% faith that you can do it.
  • Varikk
    Varikk Posts: 1 Member
    I have the same issues as you do with weight loss and feeding lows. I think the key here is that you know that you are going to go low if you exercise so you don't need the insulin you normally do. I run 3 - 5 miles 4 times a week, bike, and do cross fit. I almost never wear a pump during those activities - check bs before workouts and after. Don't be afraid to eat clean foods like fruit in place of juice to help stave off a low. As you know it is better to turn that low around before you plummet or you end up binging to bring it up.

    The hardest part of this for me is the biology of a low screams - eat eat eat or die - when the reality is far from that.

    Cheers on starting up again and hang in there man. It's worth it.