Taking insulin on keto

(Melissa Hendon) #1

My Dr has me taking insulin. How does that impact keto? My morning fasting glucose levels are still very high, 250 and above. I’ve been very strict with my diet. Advice? Suggestions?

(TJ Borden) #2

Watch it VERY CAREFULLY. Once you stop eating carbs, you won’t need near as much insulin. Many are completely off insulin within a matter of weeks.

(You've tried everything else; why not try bacon?) #3

Listen to T.J. The last thing you need is a hypoglycemic episode.

(TJ Borden) #4

Thanks @PaulL. That’s nice to hear. I usually recommend the opposite.

(bulkbiker) #5

Have you been eating keto already or are you new to it?
And why does your doc have you on insulin… could be some very useful info…

(Melissa Hendon) #6

I’m nowhere near that. If I woke up and my glucose was below 200, I’d be shocked. I just don’t know where it’s coming from.

(Melissa Hendon) #7

Been doing keto for two weeks. I’ve lost 6 pounds (all water I’m sure.) but since insulin makes your body store fat and use up the glucose, I wonder what will it do while I’m on keto? And where is this glucose that’s in my body coming from? I’m just really confused.

(Melissa Hendon) #8

I am diabetic type 2. We started insulin months ago. I’ve been increasing my doses (per doctor) regularly. It does not work.

(bulkbiker) #9

Hmm if you are eating a strict ketogenic diet and taking insulin and your blood sugars keep going up then I’m guessing you maybe want to look at your diagnosis of Type 2. Maybe go back to your doctor. Which country are you in?

(Melissa Hendon) #10

I’m in the us. I’ve had type 2 for three years and was treating it metformin and glxambi for 2 and a half years. (Roughly) my a1c was high so I was taken off of glxambi and put on Tresiba (a once a day insulin.) my fasting glucose remained in the 200’s so we increased steadily and waiting a few months. Then my morning fasting was reaching 300 regularly. So my tresiba was raised and a started NovoLog (insulin with meals) and was also given trujenta (spelling not sure) to take with my metformin. I also went in keto because I really want my sugar down. Weight loss is great and all but I want to move that sugar first! Now with all those pills and all that insulin and almost no carbs, I’m getting morning glucose numbers in the 250’s and up. It should be below 100. I do not snack at night or during the day. I eat breakfast, a late lunch, and a very very small dinner (I’m trying to eliminate it.)

#11

Hmmm - this sounds unusual to me (but that’s just from watching many stories of T2 folks on the forum - I’m not an expert!).

Are you testing during the day as well? Often we get a glucose dump into the blood stream first thing in the morning so number are quite high. I’m sure you know that already…
Do you test pre and post meal? If I were you that would be my next step - test many times over the day just to get a more complete picture - but I’m also really curious what other folks recommend. If you don’t get more responses over the next few hours, you can always bump this up.

Is there any chance you’ve actually moved into T1? If your pancreas is no longer making insulin, keto will still help (enormously), but it definitely changes the insulin side of the story.

#12

Hi,

Is your doc a specialist in diabetes? Or is he just throwing insulin and medications at you in the hope your blood glucose will come down?

Not wishing to criticise his treatment (don’t know the full story), but he should NOT be leaving you with such raised blood glucose for so long. It makes diabetic complications much more likely in future.

Type 1 diabetes is an autoimmune condition. It may come on fast or slow, at any age. But type 2 (and endocrine condition) will never turn into type 1. Most people with type 2 have something called Insulin Resistance. This makes natural insulin less effective, and leads to weight gain as the body pumps out more and more insulin to overcome the resistance. Adding injected insulin, in the presence of severe insulin resistance isn’t very effective. Eventually the body’s capacity to produce huge amounts of insulin wears out, and injected insulin becomes necessary - unless carbs are reduced so much that insulin resistance can drop.

In contrast, type 1 is where the body’s capacity to produce insulin fails, and insulin is needed to transfer glucose from the blood into the body’s cells.

When blood glucose is too high, (200+) the body tries to rid itself of the damaging glucose by peeing it out through the kidneys and bladder. Not ideal! This can lead to rapid weight loss for type 1s and 2s but it is a clear sign that glucose levels are too high.

Can I ask how much carb you are eating?
And how long have you been keto?
Do you know what dawn phenomenon is?
How often are you testing?
And what happens to your blood glucose later in the day? Before and after food?

#13

I thought that at some point in T2 it’s possible to have enough strain on the beta cells (from high glucose) that they can’t produce insulin (or enough insulin). Is that not true?
In any case, it’s probably possible for someone with T2 to also develop T1 independently, right?

#14

Was going to ask this too.

I agree that you may want to get a second opinion. There are other variants such as T1.5 and Mode (sp) that I do not know much about other than they exist.

Yes but that is far down the road. It will happen faster with a TOFI than someone who can still store excess glucose in their fat cells, eg get fatter. The newer theory that Fung talks about is that the beta cells get stuffed with excess fat that the excess glucose was converted into, Some research seems to imply that in many cases these can get unstuffed from an extended medically supervised fast. Note emphasis on medically supervised but I am not a doctor or a scientist

#15

They are still classed as two different conditions. Type two can become insulin dependent, if the body’s capacity to produce insulin fails, but unless the beta cells are killed by the body’s own immune system, it isn’t type 1.

A shocking number of medical professionals don’t understand this, and tell patients that needing exogenous insulin automatically makes someone T1. But that really isn’t the case. Eventually, I am sure, what is now called T2 will be subdivided into many different sub categories. I have seen someone trying to do this already. One of them is Severe Insulin Resistant T2. But there are several others. Often the beta cells are ‘smothered by fat (non alcoholic fatty liver disease) which stops them working, but it isn’t an auto immune thing. :slight_smile:

#16

@Brunneria and @Saphire
Thank you both.

@Melissa_Hendon, sorry to have sidetracked your thread. Please keep us posted!

(bulkbiker) #17

I would definitely suggest getting back to your doctor asap.
Try and see if he will be able to test for other forms of diabetes or even better refer you to a specialist endocrinologist for follow up. Something doesn’t seem right with what you are describing but we’re not really in a position to diagnose. Try and get to an expert.

#18

Very interesting article although it does not help explain my good friend. She developed severe diabetes around age 48, within a couple of years had kidney failure. Was a smoker but not an eater but is a TOFI, interesting may even be more classifications and subgroups. This may explain why someone might not respond to a keto diet although it is speculative at this point.

I was going to suggest to look at the low fat high carb diets and run those by her doctor. Such as the Duke Rice Diet and the Ornish Diet. While I would not want to eat that way for some people that has reversed diabetes. If money is not a major concern maybe try working with the IntensiveDietaryManagement.com team or Sarah Hallberg’s Virta Health https://www.virtahealth.com/about/drsarahhallberg

(You've tried everything else; why not try bacon?) #19

At the end stage of Type II diabetes, it is possible for the β-cells in the pancreas to burn out, yes. And since in Type I, the β-cells are killed by the body’s immune system, it is technically possible to have both Type I and Type II. I don’t know whether such a case has ever been recorded, however.

Type III diabetes, also known as Alzheimer’s disease, can exist concurrently with Type II, since they are both caused by insulin resistance.