Type I on Insulin Pump

[ErinC]

Hi everybody! My name is Erin and I'm quite low tech, so if I post on the wrong thread or something weird, I apologize now!

I began Atkins on 1/11/09, 4 weeks ago. I have been very strict Induction phase, my ketones have been moderate each time I check. I have only lost 3 lbs. My blood sugars are typically within range, but still do vary and go high. I can't explain why, since I am eating little-no carb! I have an appt with my endocrinologist next week, maybe my basals need to be adjusted?? I am scared to take more insulin, though. I do have to have about 1 1/2 glucose tablets if I run low...I don't want any more carb than that! I am nervous about exercising...but I will start walking tomorrow and maybe put my pump on suspend.

Has anyone else had such a slow start??
Anyone else on an insulin pump, induction, and exercising??

My start weight was 180 lbs, currently 177, goal 130.

Thanks for any help!

[Tstormchaser]

Re: Type I on Insulin Pump

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)

[ErinC]

Re: Type I on Insulin Pump

Hi Theresa! Thanks for all the info...you and Brian sound very committed to this diet...ooops, "lifestyle change"!! I really appreciate all of the info you gave me.

I am 43 years old and 5' 3 1/2". I find it interesting that Brian is still losing weight even though his BS are not always in the normal range. I thought that having highs might be affecting my (lack of) weight loss, guess not!!

I have a Minimed Paradigm and take between 1.3 to 1.5 u/h basal equalling 35.8 u/day. I take about 45-50 u/day total, including my meal and correction boluses. When I did a history, I see that my BS are running from 70-190. I was overeating on the nuts and, lately, on sour cream dip with veggies. I keep forgetting to bolus for this healthy stuff! Today: Breakfast: 2 eggs, 1 sausage patty, Lunch: 1 frozen meal (11 g carb--chicken and spinach), 2 slices ham with cheese stick, Snack at 5:00 pm: 1 hard boiled egg and another sausage patty, veggies (celery and cucumbers) with way too much dip, Dinner at 7:00: steak and salad with o&v dressing. Breakfast (8:30): 126 BS, Lunch (12:00): 95 BS, Snack (3:15) 190 BS, Dinner (7:15) 197 BS, and now (10:00pm) 159. Sooooo....I really don't know what made me high after lunch...the ham? Dinner I can understand b/c of the dip. You're right, I'm not drinking much water. 16 oz coffee and 2 bottles of H2o.

Brian has been exercising, right? That's what I HAVEN'T started yet! Maybe, that will be the key...soon....

My husband has lost 10 lbs...you have lost 13--way to go!! I'm sure my endocrinologist will be tweaking my basals and corrections next week...I'll let you know! I can't tweak myself b/c I don't see a pattern yet.

Best of luck to you and Brian!

[Tstormchaser]

Re: Type I on Insulin Pump

Erin, do you keep a log of your daily readings? Brian goes through his meter history every night and writes all his numbers on a log sheet. Obviously this can be done on the computer if you have a meter that is downloadable, but I like being able to look at a hard paper copy. (I'm still old school when it comes to stuff like that!) If he is having too many lows or highs we'll look at his log and try to find a pattern, and using at least 3 consecutive days of readings is best.

Do you use the same insulin to food ratio all day long? How about basal rates? Could you post your BS readings for a couple days prior to yesterday? Just looking at your readings, it seems like you need more insulin in the afternoon and evening. Did you correct the 190 at 3:15PM or the 197 at dinner? What rung are you on? And just how much is way too much dip? You may very well have answered your own question about why you haven't lost any more weight. I would cut back (or eliminate) the nuts, limit the dip (hopefully you've checked ingredients and all are legal) to 1-2 TBS per day, and watch the intake of cured meats such as sausage, bacon, ham, hot dogs, cold cuts, etc. These are all quite high in sodium which can make us women retain water.

This is probably the 8th time (or more!) that I've done Atkins. Have always had some success (best year was 60 lbs lost) but never managed to make it to my goal weight. After 3-6 months, I'd resort back to my old habits (chocolate, ice cream and just overall unhealthy eating) and gain back all the weight (sometimes more ). And during each attempt, I found that I simply could not go over 25-30 carbs per day and continue to lose weight. Mostly I found myself doing extended induction with an occasional serving of almonds or sunflower seeds. Very rarely I had a few berries. Since we are both on the "shorter" side, it may very well be that we are not able to go past that 25-30 carb point. I'd give it a couple more weeks, especially since you mentioned that you are starting an exercise program, and if still no weight loss, try cutting back to 20 carbs. Is your coffee decaf? Caffeine has been known to stall some people. I don't drink coffee but do have diet pop and try to have the caffeine free variety as often as possible. And yes, drink more water! I know the rule of thumb on the ADBB is to drink half your body weight in water (oz), so if you weigh 177 they would say have 88.5 oz of water. I don't necessarily follow that rule, but instead simply drink water whenever I'm thirsty, which is quite often.

Brian swims laps 3-5 days a week at his community college pool, but other than that has no exercise plan. I've been encouraging him to get into the weight room for some cardio, but he's been resistant (too many "buff" guys in there I guess). I don't think you'll need to suspend your pump while walking or exercising, but from Brian's experience and what I've read, you may need a lower basal rate approx 6-12 hours after heavy exercise. Just check BS often until your body adjusts.

Again, I don't think you need to wait until you see your endo before making any insulin dosage changes. Brian upped his basal rate (1.1) and insulin/food ratio (1/9) again yesterday, and finally started getting better numbers. Small increments is the key. Have you read any of Dr Bernstein's books? If you haven't, be sure to check out his website. Dr. Bernstein's Diabetes Solution. A Complete Guide to Achieving Normal Blood Sugars. Official Web Site Lots of good stuff and a forum there too.

I know it's not easy living with Type 1. But with this WOE you will be using so much less insulin and that is THE key to good BS control. Insulin is so unstable and variable in how it reacts in your body. And until we have a cure, the low carb lifestyle is the best treatment plan out there. Stay strong and keep me up to date with your progress!

Theresa

[Tstormchaser]

Re: Type I on Insulin Pump

Hi again Erin!

You asked about the Atkins breakfast bars on another thread, and at this point I would say NO! Stay away! Put down those bars! Especially since you are stalled, those (or any other type of bar/shake/frankenfood) would definitely not be something you'd want to eat just yet. Perhaps as you close in on your goal weight they could be used as an occasional snack. I'm pretty sure those have sugar alchohol, and the "net" carbs listed are questionable at best. Read what Dr Bernstein says about sugar alchohol, and I'm sure a quick search of "Frankenfood" here at ADBB will lead you to plenty of info on why we need to stay away from those sorts of foods. It's always best to eat whole natural foods, and for losing weight, nothing beats them. Look at Linda's Low Carb site Linda's Low Carb Menus & Recipes - Home and you'll find some good breakfast options. Do you have any Atkins or other low carb cookbooks? I've found some excellent recipes over the years and have discovered more new ones each time I've done Atkins. Having a good variety of menus and recipes to choose from definitely helps to keep me on this WOE.

Take care!
Theresa

[ErinC]

Re: Type I on Insulin Pump

Hi Theresa, I am such a goof when I comes to this forum stuff. I typed you a looooong response, filled with info and details and cudos to you...but proceeded to lose it all when I went over to try to get my ticker. Now it's too late to do it all again. In short, you are AMAZING! I took your advice and my BS were just about perfect all day! Thank you! You are so appreciated! I did get on the scale this a.m. and had lost 2 lbs more! So my total is 5 now. Woohoo! Slow and steady wins the race, right? I'll catch up more next time...gotta go catch some zzzzzz's......

[michelle23464]

Re: Type I on Insulin Pump

I was overeating on the nuts and, lately, on sour cream dip with veggies. I keep forgetting to bolus for this healthy stuff! Today: Breakfast: 2 eggs, 1 sausage patty, Lunch: 1 frozen meal (11 g carb--chicken and spinach), 2 slices ham with cheese stick, Snack at 5:00 pm: 1 hard boiled egg and another sausage patty, veggies (celery and cucumbers) with way too much dip, Dinner at 7:00: steak and salad with o&v dressing. Breakfast (8:30): 126 BS, Lunch (12:00): 95 BS, Snack (3:15) 190 BS, Dinner (7:15) 197 BS, and now (10:00pm) 159. Sooooo....I really don't know what made me high after lunch...the ham? Dinner I can understand b/c of the dip. You're right, I'm not drinking much water. 16 oz coffee and 2 bottles of H2o.

Your carb count looks like this..
BK - 2 eggs 1.8 carbs
BK- 1 sausage patty 1 carb ( guessing)

Lunch- frozen meal 11 carbs
Lunch- 2 slices of ham 2 carbs ( guessing could be more)
Lunch- cheese stick 1 carb

Snack- 1 egg .8 carbs
Snack- sausage patty 1 carb
Snack- veggies 2 carb (guessing could be more)
Snack- dip 6 carbs 2 servings (guessing since you said way to much)

Dinner- steak 0 carbs
Dinner- salad 3 carbs
Total for the day.. 29.6 carbs..

Ok.. you say you are doing a very strick induction.
1. Nuts are not on induction.
2. Is the sour cream dip pre packaged? If so it has carbs and sugar.
3. Did you count the carbs in the sausage?
4. Frozen meal? on induction? chicken and spinach shouldnt be 11 g of carbs unless it has sugar in it.
4. slices of ham? did you count the carbs in the ham and cheese?

I am on a insluin pump and have not raised my basal rates only dropped them. I would say you need to look at your diet and look for hidden carbs and sugar.

[jjemmert]

Re: Type I on Insulin Pump

I have been following the discussion on the Atkins Diet for insulin pump users. I started with the induction phase of the diet on June 12 and am getting along nicely. I want to thank you pioneers for the words of wisdom. One day into the diet I had to change all the parameters to keep my sugar in the normal range.

For example, my bolus went from the 60% range to the 30% range while the basal did the reverse. I am finding that with low carbs, basal carries the ball. I also changed my carb ratio and insulin sensitivity.

I use a Medtronics Paradigm pump (522). I want to share my log for the past few days so you can see what changes I made to my diabetic regimen. It may be helpful for other pump users trying to get started with the diet. You can view the log online at my website using the trackback url:

http://hands-on-mission.com/PumpLog.html

Emmert

[michelle23464]

Re: Type I on Insulin Pump

Hello Emmert,

Since I have been doing Atkins.. I hardly ever bolus for meals. I have a cozmore deltec pump. My basals keep me in the normal range. My insulin to carb ratio is 1-10 and my correction is 1-20. I have 3 basal rates.

My basal rates are
1.8 midnight to 6am
1.5 6am to 9 pm
1.7 9pm to midnight

Great job on your sugar numbers.

Michelle

[deboo1]

Re: Type I on Insulin Pump

hi everyone.. my name is debbie and i live in australia.. my 17 year old son has type one diabetes an he is a big boy.. his endo doesnt like the idea of him being on the atkins diet because she says its way to much meat, cheese and fats.. now my hubby and i went on atkins and we both lost over 4o lbs in like 3 months ... we were so happy and we think it would work for our son to..he needs to loose weight and we have tryed all the low fat eating and he just can not loose the weight.. i dont know weather to just give him a go on the atkins or not as i do not want to cause him any other problems.. what do you think.. deb

[michelle23464]

Re: Type I on Insulin Pump

Hi debbie,

As a diabetic.. who was pregnant the diet I had from my doctor was based around carbs. How many I could have per meal. It was the easiest diet to follow since I was already counting carbs for my own atkins diet. Each meal had a protiens and carbs and fats. Just more carbs than I would have had if I was on induction. It was more like a mantaince diet on atkins. Most diabetic diets are not low fat but lower carb intake and smart carb intake.

Your doctor does not fully understand the concept of atkins. Its not all meat and cheese and fat. Its alot of veggies and whole foods. The only part that is hard is the induction as your sugar will not be as high and on a pump you may get some lows. As of now .. I still do not have to bolus for meals unless I eat something that is loaded with carbs like speg or pizza. I have not changed my basal rates since I dropped them in half and my A1c is 6.3 . Eating low carb does not mean you cant have the occasional peice of cake or dinner out. It just means you dont eat that way all the time.

What I did was drop my basal rates in half and didnt bolus for meals. This kept my sugar from dropping too low. I wouldnt tell the doc you are doing atkins.. just eating low Glycimic index foods and watching your carb intake.

Atkins is not all about meat. Its chicken, fish, eggs, other protiens and lots of veggies. Yes fat is in there too but we all need some for our bodies to work. Do induction for 2 weeks only.. then go up the rungs so he has more choices and more carbs to react with his insulin pump. As long as I stay around 10-20 carbs per meal I do not bolus. If I go over I bolus for the total carbs.

I hope this helps.

Michelle