[Tstormchaser]

Hi Erin!

My son (age 20) started the Atkins WOE on 1-12-09, and he is also type 1 using an Animas 1200 pump. His starting weight was 177 (he's 5'5) and he wants to get down to 150. He lost 1 lb the first week, 2 lbs the 2nd week, 4 lbs the 3rd week, and none the 4th week. He experienced a couple mild lows during the first 2 weeks (treated with glucose tabs or raisins) but over the last 2 weeks he's had some readings between 180-250. He's been slowly adjusting his basals (from .95 per hour to 1.05 per hour) and insulin to carb ratios (from 1/11 to 1/10) and also changed correction factor from 1/50 to 1/40. His numbers have mostly been in the 85-180 range, although more often between 110-160, which is still a little on the high side but WAY better than before Atkins. He's generally eating 25-40 carbs a day, which means boluses have been quite small, so I think that's why he's had to adjust his basals upwards.

Perhaps you could start with very small increases in basals and food boluses, in .05 to .10 increments? That's what he usually does, and if necessary will keep increasing in very small amounts until he sees better numbers. I don't think you need to be afraid to increase your basals as long as you do it slowly and in very small increments. Just make sure you are checking your BS often! My son checks anywhere from 6-12 times a day, before and after meals, before and after exercise (he never suspends his pump except when swimming), before driving, before bed, etc. IMHO, I don't think there is such a thing as checking too often! He's also been checking for ketones occasionally, and has been in the moderate to large range.

Before Atkins he experienced severe night-time hypos (26 was his lowest), but since starting this WOE he's had NO night-time lows. This has been the best treatment plan possible, as it has cut his insulin useage in half and there is virtually no insulin on board (other than basal) when he is sleeping. I used to have to check his BS every night around 2-4AM (he would never wake up to his alarm, or would just hit it and go back to sleep), but now he generally has almost the same reading in the AM as he does at bedtime.

How old are you and how tall? Even though you are in ketosis, perhaps you aren't eating enough? Could you post a typical day's menu? You should be having at least 20 carbs a day and don't skimp on water. I have to keep reminding my son to drink water when he reaches for a diet soda.

We're on this WOE together, and even though I have MUCH more weight to lose than he does, I bet him $100 that I would get down to 150 before he would. (I'm sure I'll lose that bet but hopefully it gives him a little more incentive to stay on this WOE!)

Hang in there and don't be afraid to experiment with your basals, boluses and correction factors. It's a trial and error process and with my son, something we're always changing and tweaking.

Theresa (mom to Brian)