I've read Dr. Bernstein's books one in 1983, and the latest in Dec of 2010. I've been following a low-carb diet since Dec of 2010. I have lost 60 pounds and my insulin levels have been dropping since I have lost weight and stopped eating carbs. My A1C has been <= 5.5 since I made the change. I feel great. I have a hypothesis that it would be easier to bolus Humulin R instead of Humalog and switch from an extended square wave bolus to a normal bolus as most of my insulin bolus is for protein and fat. I use an Insulin pump and am looking for advice from other type 1 diabetics on a very low-carb ketogenic diet as I have been. Please let me know if you use Humalog or Humulin, if you have changed from one to the other, and whether you use a square-wave bolus or not. Thanks!
I've been adhering to Dr. Bernstein's guidelines for over 3.5 years. Not a real answer to your question since I'm on MDI, but I use R &/or Apridra for bolus depending on the meal. I actually like R because of its longer duration for protein/fat. It's smooth & level. Also helpful for my situation because of gstroparesis. The downside is correcting highs. You could get around that by injecting Humalog, if needed. I imagine it would be tricky at first figuring out basal with R since it stays around for a while & takes about 45 minutes or so to kick in.
I actually use a Dual Wave. I think either method is fine. But, for the most part when I bolus I take about 80% of the insulin upfront and spread the remaining 20% over 30 or 60 mins. This all depends on what I eat of course. As for insulin, I am using Novolog (basically Humalog). I haven't taken R for 10-15 years. It just works too slow to bring my BS down to normal levels. I am impatient and want it down as quick as possible to the 85-95 range. As I mentioned before, I go for walks to get my BS down quicker. I am on a ~150 carb/day diet. As Gerri mentions, Regular is likely good for gastroparesis. But, I don't have that (at least not that I know of). I would think for that a dual wave or square wave with a longer duration would fix that problem. Ken
Congratulations on your A1c!
I have a couple of questions for you since you are quite successful. Are you very strict on the diet? Meaning, are you only consuming 3 oz of protein at meals and sticking to the strick carb guidelines when you eat your veggies?
I am currently using Humalog for boluses to cover protein and fat. Other people on the DR. Bernstein site say not to use Humalog for boluses but to use Regular or Humulin R for coverage because it works better for protein and fat coverage.
I haven't made the switch just yet. I am still working on my protein size. I have been eating upto 5 oz at one time and my sugars show it. It's awful. Instead of eating real carbs or real sugar, to much protein can shoot a person over 250 anyway.
Keep up the GREAT WORK!!
Long post follows. I should probably start a new thread as my new lifestyle has complete reversed all of my diabetic complications. Here I go **spiel on**:
I am not following the Bernstein diet exactly. I have switched to a paleo or primal lifestyle as it is a better fit for me. I biked 76 miles on the weekend and only had carbohydrates from non-starchy vegetables, mostly greens including 3 celery tops (not stalks, the whole top of the plant), 2 bunches of swiss chard, 2 bunches of romaine lettuce, and 1 large carrot. As far as protein goes, I hadn't eaten too much on Thursday or Friday and went a little overboard. I ate approximately 4.5 pounds of meat over the weekend. What can I say, I was hungry. That is the most amount of meat I have had in such a short period of time. I'm 5'8", 196 pounds. Again, that was not a normal weekend. I am starting to bike long distances and am trying to figure out how much protein I need to sustain my blood sugar without resorting to eating foods with high glycemic indices. 4.5 pounds was way too much :-)
I used to have all of the "opathies" including retinopathy, nephropathy, neuropathy, etc. After years of inactivity and poor diabetes control, I have renewed my will to survive and turn my life around. I have gone to the opposite extreme to achieve this. It has taken 7 years to restore my health with the most change occuring in the last year. For the last year, I have been experimenting with a "local" version of a paleo diet especially for weight loss and health. I have been eating mostly foods that are seasonal except for green vegetables which I have been eating year round. When the summer fruit is available, I will start eating fruit again. Since December of 2010, I have not had any dairy, grains, nor legumes, except for the occasional mistake (exceptions: occasional butter, and occasional beans if they are in prepared food at restaurants or from friends). By following this lifestyle, I have been able to stay in ketosis for most of the year. That metabolic state has conserved my lean mass while I have lost significant amounts of fat. I have been able to reduce and than eliminate all of my medications over the year except for insulin. I used to take 150 units / day. Now, I take between 12 and 48 units per day depending on exercise and food intake.
Now that it's bicycling season again, My activity levels have increased from a couple of hours at the gym per weak to bicycling a minimum of 10 miles 4-5 days per weak. I use bike riding or walking after meals to correct high blood sugars. I successfully biked 72 miles over the weekend without high or low blood sugars I only needed about 10 grams of "smarties" candy to prevent low blood sugars.
Don't let your doctors convince you that 6.9 is a good HgbA1c. It was at that level that I had all of the "opathies." At 5.3 and 5.5, my kidneys are starting to filter again at normal levels. I have no more nagging constant pain in my extremeties, and no more buzzing and tingling. My holes at the periphery of my maculas have closed and healed. (Ahem, my "private" life will remain "private" except to say that "that" has healed too). My resting blood pressure has reduced to 110/59 and my resting pulse is usually around 55. 3 years ago, my resting blood pressure was as high as 180/100 without meds, and typically 140/85 with meds. My pulse would rise to 135 just to put my clothes on or 120 just to get out of bed. As I type this, my pulse is now 56.
If you have not heard of the paleo diet or primal life style, please use google and look these terms up.
Read the health books by Loren Cordain, Robb Wolfe, Mark Sisson, and Gary Taubes.
I agree about the Paleo way of eating. It is very similar to Bernstein minus the fruits. My A1c in March was 6.9 and I couldn't agree more that I still have frozen shoulder and do get leg cramps. Not fun. I am working on taking the right amounts of insulin both long and short lasting, food amounts, and exercise. My goal is to have an A1c of 5.5 I have been on Bernstein for about a year and a half. And will try till I accomplish my goal!
Hi Yolanda, I hope you get over your frozen shoulder. I had that about 15 years ago. Then, it went away. A year later I got it in my other shoulder (not as bad). Then, that went away after 6 mos. Haven't had any incidences of that since. Are you doing the crawling the arm up the wall exercise? That hurt, but, it seemed to have shorten my duration. Are you testing and correcting your BS throughout the day if its high? Ken
Hi Ken, haven't heard of the crawling the arm up the wall, will have to Google that! Yes I check my BG every 2-3 hours and correct highs. I think that's how I have an A1c of 6.9. It used to be a whopping A1c of 13. I am still a work in progress. Thank you so much for your comments.
I am new to type 1 - my 9yo daughter was dx four months ago. I am type2 and have been reading Bernstein for a few years. I just switched my daughter from Humulog to HumulinR because I felt like the Humulog was too powerful for the low-carb diet. She was crashing and complaining of hunger soon after eating with barely any insulin. We've been on the Humulin for three days now, and what a difference! She loves it, and is bouncing around the house saying "I'm not always hungry!"
Sorry I can't help about the square-wave...we do MDI. Good luck!
I'm also thinking of trying Humalin-R instead of Humalog.
I do need insulin for bolus, but not much (usually only 1 - 2 units on low carb) and the humalog seems to be too powerful. I read that Humalog is double the strength of 1 unit of Humalin-R. Does anyone know if this is true.
I'm also MDI.
The problem with Humulin-R is that it takes forever to correct a high. If I recall correctly, Dr. B keeps a vial of Apidra for corrections in addition to using R for bolusing.
Foy my dd, HumulinR is about 2 times less potent. We followed Dr. B's instructions and injected, then tested every 10 minutes. It does take 45-50 minutes to start working for her. I thought this would stress me out, but it actually turned into a blessing for us....since we do the shot well in advance of a meal, it takes the "shot stress" away from getting the meal on the table. And for me with four kids including a toddler....wow...sooooo much better! We do always have the Humulog on hand for corrections and or road trips where we can't plan meals, etc.
I actually use intramuscular injections for corrections. That is what Dr. B recommends. He injections into his delts (shoulder), but I just use my quads.