I’ve been eating a low carb, high fat diet for about 6 months now. Mostly, my glucose levels have stabilised quite well. I still have the occasional low but they’re very few and far between. And I still have the occasional high but they don’t reach the astronomical heights that they did in the past when I was still eating a moderate to high carb diet. That is, until this weekend!
As well as being a full time diabetic, i’m a part-time Viking re-enactor. From May to October, most weekends you’ll find me sleeping under canvas, cooking over an open fire and generally living the life of a Viking or Saxon woman throughout the Dark Ages. We have about 30 people in our group, including many warriors, a priest, women, children and dogs. We, as a war band and a family group are part of the wider group, the Viking Society. In preparation for the season soon to start, this weekend was our Society organised training weekend.
It’s a chance for new combatants to learn how to fight and to pass their basic combat tests, so they are safe to go on the field when we recreate historical battles. It’s an opportunity for seasoned veterans to hone their skills and to undertake any advance combat tests, such as the mighty Dane Axe or the very skilled Florentine where they fight with a weapon in each hand. It’s a time for anyone to learn a new craft from the period, such as basket weaving, naalbinding (a form of Viking knitting), embroidery, felting or many of the other crafts that were part of everyday life for the people living throughout that timeline.
I knew the weekend would be a challenge for me foodwise. I hadn’t thought it through as much as I should’ve and in hindsight, I was unprepared. I had no easy access to my kitchen at home and all the items I now take for granted, such as my kitchen scales and my food calculation book. And, although i’d taken food for breakfast and to snack on throughout the day, i’d not given any thought to dinner, thinking that I could grab something suitable locally. Unfortunately, in a carb-fuelled world, that’s easier said than done!
We found a fish and chip/kebab shop and Mr B had a portion of fish and chips and I choose kebab meat and salad with garlic mayonnaise. As well as my dinner, I had a little bit of Mr B’s fish, too and did my carb/protein estimations and took a 7 unit dose of bolus (quick acting to cover the rise in blood glucose due to food consumption) insulin. Sitting around the fire, an hour later I felt like the earth was sucking out my energy through my legs. I could feel it draining out of me as my glucose levels started plummeting. Despite the brain fog and confusion that was now settling in, I managed to stumble into my tent and find my glucose testing kit, and through years of practiced experience carried out the test. I wasn’t surprised to see the meter was reading 2.9mmol/l (52.2mg/dl) as by this point I was shaking, sweating, dizzy, disoriented, slurring my speech, feeling anxious, feeling ravenous and the veil between normalcy and the surreal world of hypoglycaemia had well and truly come down.
It was at this point, in my swirling thoughts, that I remembered I hadn’t picked up glucose tablets before we left. Now, glucose tablets to a type 1 diabetic are a lot like American Express – don’t leave home without them! We had a bag of goodies that we’d picked up to nibble on as we were travelling, so I promptly stuck my head in the bag and inventoried the contents: Olives, nope, no good. Cream cheese, nada. Carrot sticks, oh dear. It was looking grim until, suddenly, I spotted Mr B’s chocolate biscuits and caramel chocolates. I’d hit on manna from heaven. With incredible restraint, I daintily scoffed down half a biscuit and a couple of chocolates.
Now, you often hear people say that you can treat a hypo with chocolate. I’ve lost count over the years of the number of people I’ve heard say that the best treatment for hypo is a Mars bar. This is so incorrect as to be downright dangerous. The form of sugar in chocolate has to first be converted to glucose through the digestion process and this process is slowed down by the absorption of fat in the chocolate. This is a slow and clumsy way to manage a hypo and will take a while to raise the glucose levels to a reasonable level.
20 minutes later I checked my glucose levels again and I was still falling – I had now gone down to 2.7mmol/l (48.6mg/dl). I munched another biscuit and a couple more chocolates and waited. At this point Mr B woke up (he’d been snoozing in front of the fire) and realised what was happening. He promptly diluted a teaspoon of sugar in some hot water and gave it to me and insisted I drink it. At first I refused. Belligerence is only one aspect of hypo and not a pretty one. In my addled state I knew i’d already consumed enough carbohydrate that I was going to rebound from it later. But as it was taking so long for my levels to come up, I knew I had to drink it, so i did. 15 minutes later I was back to reality and feeling a little bit sheepish. They say good luck is the design of good management but in this case, my lack of forward planning had hoisted me on my own petard. 2 hours later and a glucose check before bed found my levels at 25.6, nearly five times higher than it should’ve been.
Before LCHF, if I had a hypo I’d turn into a carb monster and eat everything in sight and then spend the rest of the day chasing highs. And, despite 6 months of eating in an alternative manner, I fell for the same old trick and paid the price by getting back on the glucose roller coaster. The best idea is to manage the low without having a blood glucose overshoot or as Dr Bernstein says, to raise your blood sugar predictably.
Glucose tablets (made from the same sugar as blood sugar) do not have to be digested or converted by the liver into anything else. Unlike other sweets, they are directly absorbed into the blood through the mucous membranes of the stomach. They contain 3g of glucose each and 1 tablet should raise the blood sugar of a 140lb person by approximately 0.83mmol/l (15mg/dl ). For a person who weighs 175lbs that goes down to 0.66mmol/l (4mg/dl ) respectively.
Take your target glucose level, figure out how much below it you are (not easy when you’re in hypo, I know!) and then chew enough glucose tablets to get you back to your target. Say your target is 5.5, at 2.8 you’re 2.7 under target. If you’re 140lbs, 3 tablets will raise your levels by 2.49, 3.5 will raise it by 2.9. If you’re 175lbs, 4 will raise it by 2.6. You will need to check the impact this has on your levels and if you are still low after 45 minutes, take some more. As you have safely corrected the hypo, if you feel you need to eat, have a small, low carb snack with your usual medication.
As you eat less carbs, you might find your insulin requirements are falling as your insulin resistance lowers and so may need to adjust your background insulin, as this is what controls your fasting glucose levels.
Dr Bernstein’s ‘The Diabetes Solution’ is an excellent resource to have in your diabetes toolkit and I can’t recommend it highly enough. He has been a long term diabetic, who, feeling let down by the medical community became a doctor himself and has since helped many, many thousands of people achieve near normal glucose levels with dietary carbohydrate restriction. http://www.diabetes-book.com/
According to Einstein, the definition of insanity is doing the same thing over and over again and expecting different results. Now, if I don’t learn my lesson this time and prepare myself better for my weekends away, i’ll be officially declaring myself insane – i’ll even wear the hat to prove it!
Bye for now,