I’ve been very calorie conscious this week, being very careful to not eat more than I burn, working to start losing some weight again (it’s been creeping up on me lately…).
I had a big lunch scheduled for this afternoon, where I just knew I’d be taking in a TON of calories. I also woke up with a high blood sugar (overtreated a reaction last night). Those two factors combined were enough to convince me to skip breakfast.
I know that your body needs to burn energy from one source or another. If you have carbs on board it will use those, otherwise it starts looking for alternative sources (fatty acids, etc). In this scenario I hadn’t had any carbohydrates since right before bedtime when I overtreated that low.
What else do we know about burning those fatty acids for energy? That’s right – ketones! So, theoretically it is possible to be spilling ketones with a normal blood sugar, just because you are burning fat for energy (a process of which ketones is a side effect). Now, spilling ketones TENDS to make you more insulin resistant, driving your blood sugar higher.
You could theoretically keep your BG’s normal by increasing your insulin, but you are still spilling ketones because you’re burning fat for energy! The insulin will not eliminate the ketones – to get rid of them you need to drink a bunch of water, but it will help manage your blood sugar level.
So, I wake up at 7’ish, not having eaten anything since like 11pm the night before. But, I was high from overtreating a reaction. Here’s the breakdown:
7:17 – 357 – 7.35 unit correction bolus
9:05 – 272 – 0.00 unit correction bolus (still had some on board from earlier dose)
12:51 – 252 – Asking myself, “Why the heck am I still so high – I corrected that high this AM, and haven’t eaten ANYTHING?!?! …”
It was precisely then that I had an “Aha!” moment! By skipping breakfast my body did not have any carbs on board for a fuel source, so it turned to alternative sources like burning fat – spilling ketones, therefore making me a bit resistant to my insulin!
I should have been prepared and had some ketostix around – it would have been very interesting to prove my theory! Maybe if I plan on fasting I have to run a slightly higher basal rate? I would like to test this theory when starting with a normal blood sugar rather than such a high one.
Does this theory sound possible? Crazy? Maybe I’ve got too much glucose in my brain, and I’m just making things up? What do you think?
hi scott….
i think that you theory could really be true….because what you are saying is that the times you get high is at the times you are skipping a meal….but you know scott i also thinlk that you should really take a pole with others that are willing to because there could be a chance that not everyone is the same way….but i do like you thinking and you have come to a great conclusion….i enjoyed reading your atricle, thanks for sharing it!!!
Hi Scott!
Wow! I am amazed at the similarities in problems we both have when dealing with insulin pumps and all the baggage that goes with it. I’m 36 and I’ve been a diabetic for 22 years (not on the pump that whole time, only since 2001) and so far have no vision changes, no kidney problems, and everything is in pretty good shape… except my last A1C was 9%. :-O My biggest problem is carb counting and serving sizes. I’m working on it though, hopefully my next one will be better.
I too experienced weight gain (hovering at about 240 right now) and am working hard to lose it.
If you ever want to correspond, feel free to drop me a line at [email protected]
Your ketone theory could be correct. But, it could also be that you need to adjust your basal rate. If you’re high again even when skipping a meal, raise your rate, but only after seeing a trend for a few days.
Even if you were high at breakfast, you could’ve eaten. You would of course do a correction in addition to covering your carbs.
As for increasing your basal rate if you’re skipping breakfast, be careful. Because you have so little glucose in your blood stream from the overnight fasting, you may set yourself up for a low later in the morning.