[tony0611]

Using a low carb diet and carb counting her BG levels have dropped significantly to the following:-
Fasting 115-135
Pre meals 120-150
Post meals 90 - 120

This is far better than the 250 - 300 we were seeing a month back. Her meal time insulin has dropped to 10-12 units (from 16). We have not modified night time levemir which I want her to. I think thats the next step. Mom wants to ask the doctor first. Anyways her total insulin has dropped from 64 units per day to 48 units a day


My question is regarding effect of carbs on BG level.

I read in Dr Berstein's book that for a T1 like him with no insulin generating capacity level one gram of carb increases his sugar by 5 mg/dl.

Does that mean for all diabetics 1 gram carb increases BG by anywhere between 1-5 mg/dl depending on remaining pancreatic capability

Based on my mom's experiments it appears that 1 gm of carb raises her 5 points and 1 unit of novarapid drops her 10 points. This way we have all her post meal numbers between 90 and 120. I am hoping that as she drops weight these two metrics (rise per gram of carb, drop per unit of insulin) should improve....... Will they ?

 

[ColaJim]

As far as I know the rise in blood sugar is determined by the amount of blood in the body and the the grams of digested carbohydrate. The dysfunctional pancreas has little if anything to do with it.

ColaJim

 

[John.in.France]

@ColaJim's statement agrees substantially with my understanding.
Body weight (or blood volume) is the primary driver for the impact of carbohydrate intake. I'd quibble a bit on the remark about the dysfunctional pancreas having no impact. I'd expect it to confuse the issue due to its "random" contribution. However, since you've qualified your statement to imply that your mum has no insulin response, Jim is right.
I also think the other confusing factor will be the nature of the carbohydrate intake. Simple carbs like glucose will show up quickly, slower digested, like pasta - later.
I believe Bernstein's figures basically assume a glucose intake.
So, as the body weight falls, the impact of the carbohydrate will rise - roughly in line with Bernstein's table figures. Offsetting this, the impact of the insulin will also rise just as you say. Coordinating the two will be the challenge!
John

 

[jwags]

I don't think it has much to do with body weight. It is we are just all different. If I remember Dr Bernstein is quite thin. In the morning if I eat carbs I will spike 4-5 points for every carb I eat. In the afternoon my ratio seems to be more like 1-2 points for every carb I eat. So you really need to test and see how your mom's reaction is. Also I have found on a LC diet, I do seem to be more sensitive to carbs.

 

[John.in.France]

I don't think it has much to do with body weight. It is we are just all different. If I remember Dr Bernstein is quite thin. In the morning if I eat carbs I will spike 4-5 points for every carb I eat. In the afternoon my ratio seems to be more like 1-2 points for every carb I eat. So you really need to test and see how your mom's reaction is. Also I have found on a LC diet, I do seem to be more sensitive to carbs.

In his book, Dr Bernstein provides several little tables including one which relates the impact of glucose to body weight. In that table he suggests that someone who weighs 140lbs will see a blood glucose rise of 5 mg/dL for each gram of glucose.

As a starting point, it seems as good as any but I do agree that we are all different and not all carbohydrates behave as predictably as glucose, so I'm pretty sure Tony will find some serious trial and error is called for before he pins down how his mother will cope.

Dr. Bernstein also offers various tables showing the impact of a variety of insulins. Same issue - As a first cut? probably helpful but given his book was written over 10 years ago, (still useful - don't get me wrong, but even with his revisions, its age shows in places), and we are all individuals, .....

John