Got into a row on FB about lchf.

I was in a discussion about lchf and I was accused of giving unsafe advice.

T
3 hrs · London
Right guys, long one for you.
Yesterday evening, I undertook a training session that was extremely difficult and really pushed me to the edge of what I could do. It was a resistance session on my legs. Halfway through it I found that I was feeling dehydrated and swallowed a litre of water straight down (this was after consuming 4l during the day), and it properly pushed me to the point where I was retching. It was tough. By the end I had a classic tension headache and was exhausted.
Fast forward to today and I've been drinking water like it went out of fashion (and not excreting it). i was clearly dehydrated after all the exertion. What's been far more odd has been my insulin reaction. My diet today has been no different from normal, and yet I've needed to bolus at least twice as much insulin to deal with protein (I typically eat low carb when in the midst of a trained ng programme). It's been a real challenge to get my BG levels to fall to where I want them. My insulin response has just been terrible. My diet between the two days has been the same, with limited carbs, mostly made up of fats and proteins. So it shouldn't be a dietary thing.
After a physically demanding session (of whatever it might be) has anyone else experienced what appears as decreased insulin sensitivity like this? Does anyone have an explanation as to what has been going on?
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A.  Are you on a pump? If so check for air bubbles. If not, I've heard of people running a marathon and then struggling to get sugars under control for a day or so. Could just be you've stressed yourself and you're getting mad liver dumps. I've had this happen before (not running marathons).
3 hrs · Like · 1

T Hi Ann, no I'm not pumping, I'm MDI. My thoughts were along similar lines, in that I massively pushed my body, and also depleted my leg muscles of glycogen, and my liver has been trying to help them out a bit.
3 hrs · Unlike · 1

Ann maybe a glass of red may help? I've heard the liver can only cope with eitherprocessing alcohol or being very 'helpful' dumping sugar.
3 hrs · Like · 1

Ana What are your ketone levels
3 hrs · Like

Tim When I say "high" I mean outside of what I consider to be normal, so I've spent the day running at 9mmol/l rather than the 6.0 or so I normally inhabit. No ketones.
3 hrs · Like

Ann Yep, same here. Had that happen in the 8-9 range And rage-bolusing passed myself because you expect to get a free dinner (no bolus) out of it.
3 hrs · Like

Ana Your body is probably recovering from pushing it above the norm. It sounds like you need to start eating more carbs too. This will help you enhance your performance. Type one is a bitch and this stuff happens when we do the things we love. Good luck
3 hrs · Like · 1

Tim Thanks Ana. The carbs are cyclic. Massive carb load one day a week and usually about 50-70g a day other days (about 10% of calories).
2 hrs · Like

Ana Sound like you need to eat more. The body may be getting confused with the variable intake. The Central nervous system alone needs about 130 a day not including your energy expenditure needs. You may want to visit with an experienced RD that sees active type ones like yourself . Take care
2 hrs · Like

Ciara most doctors would recommend 300-400 carbs a day if you are excercising at the level that you are and believe me your body needs it. even non diabetics need that much.
1 hr · Like · 1

Ann I'm on less than 50g of carbs a day. You don't need 300-400g a day if you do LCHF and are in ketosis. You burn fat for fuel, I runsugars between 4-8 when training and have ketones (for fuel) between 0.5-2.0. There is a lot of research on lchf now and sports. See Dr Tim Noakes, Phinney and Volek. But some people still buy into carbs for diabetics - personal choice I suppose.
1 hr · Like

Ana I have to disagree with the above . Ketones for type ones could lead to dka. My friend decided to surf on moderate ketones and a very high bg without taking insulin to correct the problem. He ended up in DKA and was stabilized in the ICU.
46 mins · Like

Ann And I disagree with you. My blood sugars are in the range of 4-8 so I am nowhere near DKA. I have nutritional ketones caused by a lack of carbs. Not ketones caused by a lack of insulin. I'm sorry your friend ended up in hospital and hope he's now well. ketosis and diabetic keto acidosis are 2 different physiological (?) processes.
36 mins · Like

AnaAre you a type 1?
35 mins · Like

Ann sorry Tim for high jacking this.
34 mins · Like

Ana It is not medically recommended for type ones to exercise with moderate to high ketones. If left untreated this could lead to DKA which is life threatening .
34 mins · Like

Adam From what I understand ana, ketones when under ketosis from low carb diet arnt harmful like ketones from high sugars. Please correct if im wrong. Im researching the low carb diet now so see what it offers.
33 mins · Like

Ciara I agree with Ana. Ketones are everything doctors tell us to avoid. They literally turning out blood to acid. Non diabetics are ok cause their body's are capable of getting rid of them. And I'm studying sports science. There is nothing of that type of i...See More
29 mins · Like · 1

Ana A type one makes no insulin. It is an auto immune disease. Insulin is necessary to sustain life. Lack of insulin for a type one or a medical emergency such as an infection may force the body to produce acidic waste products called ketones. This pus...See More
28 mins · Like · 1

Ann Yes I am type 1. I've been in ketosis for approx 18 months. My highest bs was 11 a while ago due to bl@@dy bubbles in my tube. normal sugars for me run in the range of 4-8. My lows are in the high 3s because I'm not always perfect. Ketosis may not be ...See More
27 mins · Like

Adam I think the whole low carb diet/ketones is a whole other argurment. Does anyone know how to help Tim? (although a bg of 9 after and intense session would be brilliant for me!)
26 mins · Like

Ann Adam you are right mate!
26 mins · Like

Ana Low carb is one thing. Moderate to high ketones leading to medical emergencies is another.
25 mins · Like · 1

Ana Take a wild guess why there is such a high incidence of insulin pumpers going into dka?
23 mins · Like

Ann See Dr Tim Noakes, Phinney and Volek. i teach science and believe in doing my own research As well. Again I use ketones for fuel. In 18 months my blood has not turned to acid. ketones caused by fat burning due to a lack of carbs are safe. Ketones cause...See More
19 mins · Like

Adam Ann just out of interest do your weights sessions increase your bg less now you are on lchf?
18 mins · Like

Ann Give us a clue Ana, why is there such a high incidence of insulin pampers going into DKA?
17 mins · Like

Ana I'm RN CDE at UCLA in the states and have seen plenty of cases. Your bad advice on this blog is downright irresponsible . Forget fuel for performance. This kind of advice is life threatening and misinformation.
15 mins · Like

Ann Adam, weights always increase my bs so what I do us I get on the treadmill first and get down to bs of roughly 5 before Istart. I also increase my basal on the pump by 100% for 30 minutes before I leave for the gym. I also run it roughly 30-60 minutes after. I have liver dump of a morning. If I get the dump from hell (can go up 2-3 points) then I skip weights and run it down on the treadmill.
12 mins · Like

Adam Thanks ann
6 mins · Like

Ann I'm going to bow out now. Sorry Tim for high jacking your thread again. Ana good luck in your career as RN CDE AT UCLA. I'm sure you'veseen plenty of DKA cases but sounds like you've never come across ketosis or Ketogenic diets. recommending high carb diets is like recommending alcoholics drink a certain amount of alcohol. But again like I said I've never had DKA. Best wishes Ann
5 mins · Like

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Bet you can't guess which one is me.

Sometimes you just want to grab some people by the shoulders and shake them lol ! It's so frustrating sometimes !

I bowed out because it was going in circles. She continued for longer about how I was irresponsible and giving bad advice. Then the thread starter jumped in and said he was low carb 6 days a week but high carb 1 day a week.
Fair enough, have your cake and literally eat it. He's doing it for training purposes and he's staying safe overall.
A couple of people then tried to tell her that ketosis is different to DKA. she wouldn't have it and it ended up with her calling someone a dork. Skilful debate!

Some people are ridiculous, though I guess it's entertaining watching them dig a deeper and deeper hole for themselves.

I find the following video is a great one - a Type 1, an MD and a heavy-duty exerciser:

It never ceases to amaze me, hearing from long term diabetics, who clearly have no idea about even the basics of metabolism and controlling diabetes. So many do not realize ketones are perfectly healthy and a normal situation, especially on a low carb diet or fasting. Only when BG is high are high ketones dangerous. What's also dangerous is long time diabetics, some are forum mods, spouting complete nonsense re. ketones.

Above is a great video from an expert well worth watching. At around 17.55 he gives numbers for ketones at ketoacidosis levels 15 to 25 mmol, trying getting to that sort of ketone number with adequate insulin levels, impossible I reckon. Even on a 30 carb per day diet I never got above 3 mmol.

From our website. http://www.lowcarbdiabetic.co.uk/index.htm

Diabetics, and even some health professionals, often confuse two quite distinct metabolic processes - ketosis and ketoacidosis. Ketosis is a perfectly natural and healthy state during which the body uses stored or dietary fat for fuel. In order to enter this state, carbohydrate intake needs to fall below a certain level. Ideally, a healthy metabolism should regularly use ketosis, while fasting overnight for example, to fuel the body's processes and utilise stored fat reserves. Most of the body's organs, the heart for example, in fact run very efficiently on ketones.

Ketoacidosis is quite different and is typically the result of a chronic lack of insulin, not a lack of carbohydrate. With insufficient insulin, the body attempts to fuel itself by breaking down fat and protein stores in an uncontrolled way, a process which results in the blood becoming dangerously acidic. In short, ketosis usually occurs when blood sugars are at the lower end of the normal range, and ketoacidosis occurs when blood sugars are dangerously elevated. Ketosis is a result of low carbohydrate intake, ketoacidosis is a result of inadequate insulin levels.

Thanks that Troy Stapelton is a brilliant example. And he's medically trained. Shock horror.
I was accused of being irresponsible. If we had been having this discussion in a pub I'd would have..... Probably done the same and walked off - she was thick as s@@t and self righteous so no sensible discussion there.
I'm getting soft in my old age or am I actually growing up?

Mrs Vimes wrote:she was thick as s@@t and self righteous

Has she considered a role as a Diabetes Educator? She sounds eminently qualified!

She told me she was a registered nutritionist (RN) or registered nurse I think. Or at least a health care professional. Or a complete kn@b.

"Or a complete kn@b." Can we get back on topic please.

Heading out now for an italian. They do a gorgeous lchf salad with I think Parma ham but it tastes like barbecue with about a pound of that posh Italian cheese on a bucket full of salady stuff with chicken.
My fella is having his favourite pasta dish as I make him lchf mercilessly the rest of the time.
Then shopping for ingredients for Jan's kiwi and black current sponge. Dessert for tomorrow.
I feel so deprived eating this way - nightmare!
I should still be in ketosis, get me back on topic, without a single swear word. Xxxxxxxxxxxx

Mrs Vimes wrote:Heading out now for an italian. They do a gorgeous lchf salad with I think Parma ham but it tastes like barbecue with about a pound of that posh Italian cheese on a bucket full of salady stuff with chicken.
My fella is having his favourite pasta dish as I make him lchf mercilessly the rest of the time.
Then shopping for ingredients for Jan's kiwi and black current sponge. Dessert for tomorrow.
I feel so deprived eating this way - nightmare!
I should still be in ketosis, get me back on topic, without a single swear word. Xxxxxxxxxxxx

Hope you had a nice 'Italian' meal yesterday ...... and you enjoyed the low carb sponge  dessert.

Did you miss the rain that was about today ?

I wrote on the 'Bank Holiday' thread that it was dry ........ unfortunately it turned a bit wet    Typical  

All the best Jan

Hi Jan, thanks for asking - the Italian was lovely. The other half enjoyed his carb fest and I enjoyed the posh meat and cheese.
Back on the wagon today with a lchf roast followed by the sponge. Kiwi and blackcurrent was a lovely combo. We've just finished the last of it off between 3 of us.
We are thinking of making our own lchf ice cream next. I fancy coffee but he wants some thing fruity flavoured.
We are a stuffed now. Bs are 5.4 at the mo.
The weather here has been miserable but we've had a lovely lazy day. (I went the gym this morning though so don't feel guilty about eating loads of cake!)

Hope you've had a goodun.

Mrs Vimes wrote:Hi Jan, thanks for asking - the Italian was lovely. The other half enjoyed his carb fest and I enjoyed the posh meat and cheese.
Back on the wagon today with a lchf roast followed by the sponge. Kiwi and blackcurrent was a lovely combo. We've just finished the last of it off between 3 of us.
We are thinking of making our own lchf ice cream next. I fancy coffee but he wants some thing fruity flavoured.
We are a stuffed now. Bs are 5.4 at the mo.
The weather here has been miserable but we've had a lovely lazy day. (I went the gym this morning though so don't feel guilty about eating loads of cake!)

Hope you've had a goodun.

All sounds good to me and your BS numbers GREAT  

Easter with us so far so good ...... just wish the weather would brighten a little, maybe tomorrow

Have a good weekend - and do let us know about your LCHF ice-cream ......

All the best Jan