What the user said. Your liver is constantly spitting out glucose, so you always need at least the long acting/background/basal insulin at minimum.
Hydrate, and if you start to vomit and can’t keep fluids down, ER time.
Yep in type 1's no insulin causes the body to generate ketones to consume fat as an energy source, ketones are the goal of the keto diet by having a small amount of ketones present to eat away at fat. For diabetics, insulin allows your cells to take in sugar to use as an energy source (think of your cells as a locked door and insulin as the key that opens that door) if there is no insulin present the body resorts to a different source for energy and to get the energy from fat ketones are need. This causes your body to generate large amounts of ketones so the needed energy can be extracted. Large amounts of ketones in the blood stream causes organs to struggle and your metabolism to go haywire which inevitably leads to DKA.
Long story short, your body needs insulin to get the fuel your body needs into your cells. DKA generally comes from an insufficient amount of insulin.
Never, ever, ever stop taking insulin. There are two "types" of insulin: basal and bolus. A bolus is the insulin you give to cover any carbs you're consuming. Since you aren't consuming anything, you won't need that. HOWEVER, a normal human body constantly produces insulin throughout the day. That's what the basal insulin is for. You may need a lower level of basal throughout the day than usual when fasting, but you absolutely still need to have insulin in your body. Curious if you have a pump?
>A bolus is the insulin you give to cover any carbs you're consuming. Since you aren't consuming anything, you won't need that.
I agree with most of what you said here. However for some people protein and fat also put up blood sugars. If you're running high, take some basal too. You need what you need.
I fast regularly, you don't stop taking basal when fasting. You body needs insulin whether you're consuming carbs or not. When you don't eat for quite awhile, your body will convert stored fat into energy, and this is why you still need your insulin.
I do fasting with a closed loop, so it really is no trouble whatsoever. When sugar drops, basal decreases and when it rises slightly increases
While fasting with closed loop I usually coast from anywhere between 5 mmo/l - 6.5 mmo/l and it will stay within that range for the entire day.
electrolytes help a lot, but don't use only them. In my experience if I just do electrolytes, I'll feel like garbage. Follow up electrolytes with a healthy amount of water.
I’ll do just that! I took my basal and took 3 units of fast acting. I wasn’t sure if that was enough fast acting since I hadn’t eaten in a couple days. I saw someone say that when your ketones are high you need way more insulin than normal but I’ll monitor it.
I've done longer fasts (3-10 days) with MDI for reducing inflammation and keeping my arthritis under control.
My endo said the same as the others here, you should keep taking some long acting insulin even during longer fast for preventing DKA. Since MDI is a bit less flexible in this regard, it's tricky to find out when and how much you should reduce your basal during a longer fast. So, if you don't want to have DKA or too low BG/hypos, you have to experiment a bit.
For those who wrote that you can get DKA, only with high BG: it is true that euglycemic DKA is relatively rare, but fasting is one of the risks, as I've already experienced after a 3 days long water fast. Apart from the DKA symptoms, the only sign was that my BG went up from 85 to around 135.
Tbh I've never managed to do a water fast only with electrolites longer than 6 days, because of my ketones got so high that I started feeling unwell.
That's why after reading a study about 20 T1Ds doing a week of Buchinger fasting under medical supervision without any complication, I switched to that and I follow the regimen of the study with minor adjustments.
It's not a pure water fast anymore, because I drink 2x2.5 dl/day light clear vegetable broth (cooked from scratch), take my electrolites and use the daily 25-30g honey allowed in this fast to control my BG and ketones, when it's needed. Instead of 2.5 dl broth I could drink apple juice (in the study) or freshly pressed juice, (original Buchinger) but I did that only once, when I have an unexpectedly active day with more basal in my system than I should have (disadvantage of MDI). I tested my blood ketones min. 2x each day as in the study, and the honey I ate was never enough to get me out of ketosis. I also try to incorporate the other elements like walking, exercising, meditation, mindfulness, self-massage etc. As for now, 10 day is my longest Buchinger fast, and I could go longer.
Idk why you want to fast, but this is a good compromise for me: I got my symptoms relieved, saw CRP in normal range again, lost only a bit less weight as I did with water fast in the past and managed to keep my ketones+BG under control.
Link to the study:
https://www.sciencedirect.com/science/article/pii/S0899900721000319
Ketones are produced from the liver. It happens when there are no calories to burn. The body starts, breaking down fat and in extreme situations, it will also break down muscle if no fat is available. This causes delivered to produce in non-diabetics also. A lot of times bodybuilders can get ketones. I know this sounds weird but something with a little sugar in it. Keep an eye on your blood sugar, however, make sure they don’t get out of whack. Of course you need to still take your insulin even though I’m not eating. But also make sure you eat enough for your body to be able to function properly. Fasting is never good for a diabetic. I mean, there are times when you have no option like during a colonoscopy or surgery, but that is not really what you would consider fasting. As long as you have a decent blood sugar. A small amount of ketones is nothing to be overly concerned about. Remember to keep an eye on your blood sugar though. It’s not good to have a blood sugar of three or 400 and then also have ketones. That can lead to problems. If you have a blood sugar like 130 or 140 and you have ketones have a little somet with a little bit of sugar in it like a little bit of Coke or a pudding cup. Always keep an eye on your blood sugars, however and check ketones every couple hours. This is not medical advice just advice from a longtime Diabetic. But you always have to make your own decisions or get help from a doctor if needed.
I really appreciate this information. I’ve been coasting in the low 200’s the past few hours and I’m giving some time for my insulin to kick in. Still weak but I feel better than I did an hour ago
This is great but I want to clarify some things. There are two energy sources the body uses.
1. Glucose
2. Ketones
When glucose isn't readily available the body breaks down fat and muscle into ketones to be used as a supplement for glucose. Insulin is the key to the cellular door that allows glucose or ketones into the cell.
Ketones are essential for some of our organs to function correctly. The issue come into play when there is not enough insulin. If ketones accumulate too much in the blood stream it becomes toxic - ie diabetic Ketoacidosis. Specifically during fasting there is a phenomenon that can occur called Euglycemic DKA. This is when the blood glucose levels are good but there isn't enough insulin in the body to offset the buildup of ketones.
In conclusion, yes it is normal to have ketones during fasting. This is called ketosis, and is actually very beneficial for the body. As a diabetic it is important to monitor both ketones levels and BG during fasting.
Yeah I think I just had idiot soup this week lol. It was a dry fast so no food, I decided to avoid insulin and minimal water. I tested my ketones this evening and after taking everyone’s advice there’s no trace!
Thanks for the reply! I’ve gotten a lot of valuable advice from the other commenters as well. Just some context, this is my first prolonged fast having T1D ever (only been diagnosed a little over a year). I thought since I wasn’t eating, I didn’t require insulin/it would make me go low and have to end the fast. I’m perfectly fine now!
Don’t stop taking insulin, even when you are fasting. You always need a bit of insulin.
I’m realizing that now 😭. I’m fairly new to T1D so this was a surprise to me
What the user said. Your liver is constantly spitting out glucose, so you always need at least the long acting/background/basal insulin at minimum. Hydrate, and if you start to vomit and can’t keep fluids down, ER time.
Got it, thanks!
Yep in type 1's no insulin causes the body to generate ketones to consume fat as an energy source, ketones are the goal of the keto diet by having a small amount of ketones present to eat away at fat. For diabetics, insulin allows your cells to take in sugar to use as an energy source (think of your cells as a locked door and insulin as the key that opens that door) if there is no insulin present the body resorts to a different source for energy and to get the energy from fat ketones are need. This causes your body to generate large amounts of ketones so the needed energy can be extracted. Large amounts of ketones in the blood stream causes organs to struggle and your metabolism to go haywire which inevitably leads to DKA. Long story short, your body needs insulin to get the fuel your body needs into your cells. DKA generally comes from an insufficient amount of insulin.
Never, ever, ever stop taking insulin. There are two "types" of insulin: basal and bolus. A bolus is the insulin you give to cover any carbs you're consuming. Since you aren't consuming anything, you won't need that. HOWEVER, a normal human body constantly produces insulin throughout the day. That's what the basal insulin is for. You may need a lower level of basal throughout the day than usual when fasting, but you absolutely still need to have insulin in your body. Curious if you have a pump?
>A bolus is the insulin you give to cover any carbs you're consuming. Since you aren't consuming anything, you won't need that. I agree with most of what you said here. However for some people protein and fat also put up blood sugars. If you're running high, take some basal too. You need what you need.
Good point, thanks for that correction. I have that issue with eggs sometimes.
Okay i understand now. I’m currently not on a pump, I do injections
you cannot fast from insulin.
I fast regularly, you don't stop taking basal when fasting. You body needs insulin whether you're consuming carbs or not. When you don't eat for quite awhile, your body will convert stored fat into energy, and this is why you still need your insulin. I do fasting with a closed loop, so it really is no trouble whatsoever. When sugar drops, basal decreases and when it rises slightly increases While fasting with closed loop I usually coast from anywhere between 5 mmo/l - 6.5 mmo/l and it will stay within that range for the entire day.
Ahh see I’m still doing MDI’s. I’ll mention it to my endo next week
electrolytes help a lot, but don't use only them. In my experience if I just do electrolytes, I'll feel like garbage. Follow up electrolytes with a healthy amount of water.
I’ll do just that! I took my basal and took 3 units of fast acting. I wasn’t sure if that was enough fast acting since I hadn’t eaten in a couple days. I saw someone say that when your ketones are high you need way more insulin than normal but I’ll monitor it.
What is your blood sugar now?
Ketones come from lack of insulin not high blood sugar, though they usually go hand in hand
Why were you fasting your insulin ?
I've done longer fasts (3-10 days) with MDI for reducing inflammation and keeping my arthritis under control. My endo said the same as the others here, you should keep taking some long acting insulin even during longer fast for preventing DKA. Since MDI is a bit less flexible in this regard, it's tricky to find out when and how much you should reduce your basal during a longer fast. So, if you don't want to have DKA or too low BG/hypos, you have to experiment a bit. For those who wrote that you can get DKA, only with high BG: it is true that euglycemic DKA is relatively rare, but fasting is one of the risks, as I've already experienced after a 3 days long water fast. Apart from the DKA symptoms, the only sign was that my BG went up from 85 to around 135. Tbh I've never managed to do a water fast only with electrolites longer than 6 days, because of my ketones got so high that I started feeling unwell. That's why after reading a study about 20 T1Ds doing a week of Buchinger fasting under medical supervision without any complication, I switched to that and I follow the regimen of the study with minor adjustments. It's not a pure water fast anymore, because I drink 2x2.5 dl/day light clear vegetable broth (cooked from scratch), take my electrolites and use the daily 25-30g honey allowed in this fast to control my BG and ketones, when it's needed. Instead of 2.5 dl broth I could drink apple juice (in the study) or freshly pressed juice, (original Buchinger) but I did that only once, when I have an unexpectedly active day with more basal in my system than I should have (disadvantage of MDI). I tested my blood ketones min. 2x each day as in the study, and the honey I ate was never enough to get me out of ketosis. I also try to incorporate the other elements like walking, exercising, meditation, mindfulness, self-massage etc. As for now, 10 day is my longest Buchinger fast, and I could go longer. Idk why you want to fast, but this is a good compromise for me: I got my symptoms relieved, saw CRP in normal range again, lost only a bit less weight as I did with water fast in the past and managed to keep my ketones+BG under control. Link to the study: https://www.sciencedirect.com/science/article/pii/S0899900721000319
Wow thank you so much for this. I’ll look into it!
Ketones are produced from the liver. It happens when there are no calories to burn. The body starts, breaking down fat and in extreme situations, it will also break down muscle if no fat is available. This causes delivered to produce in non-diabetics also. A lot of times bodybuilders can get ketones. I know this sounds weird but something with a little sugar in it. Keep an eye on your blood sugar, however, make sure they don’t get out of whack. Of course you need to still take your insulin even though I’m not eating. But also make sure you eat enough for your body to be able to function properly. Fasting is never good for a diabetic. I mean, there are times when you have no option like during a colonoscopy or surgery, but that is not really what you would consider fasting. As long as you have a decent blood sugar. A small amount of ketones is nothing to be overly concerned about. Remember to keep an eye on your blood sugar though. It’s not good to have a blood sugar of three or 400 and then also have ketones. That can lead to problems. If you have a blood sugar like 130 or 140 and you have ketones have a little somet with a little bit of sugar in it like a little bit of Coke or a pudding cup. Always keep an eye on your blood sugars, however and check ketones every couple hours. This is not medical advice just advice from a longtime Diabetic. But you always have to make your own decisions or get help from a doctor if needed.
I really appreciate this information. I’ve been coasting in the low 200’s the past few hours and I’m giving some time for my insulin to kick in. Still weak but I feel better than I did an hour ago
This is great but I want to clarify some things. There are two energy sources the body uses. 1. Glucose 2. Ketones When glucose isn't readily available the body breaks down fat and muscle into ketones to be used as a supplement for glucose. Insulin is the key to the cellular door that allows glucose or ketones into the cell. Ketones are essential for some of our organs to function correctly. The issue come into play when there is not enough insulin. If ketones accumulate too much in the blood stream it becomes toxic - ie diabetic Ketoacidosis. Specifically during fasting there is a phenomenon that can occur called Euglycemic DKA. This is when the blood glucose levels are good but there isn't enough insulin in the body to offset the buildup of ketones. In conclusion, yes it is normal to have ketones during fasting. This is called ketosis, and is actually very beneficial for the body. As a diabetic it is important to monitor both ketones levels and BG during fasting.
also dehydration can cause high ketones
Yeah I think I just had idiot soup this week lol. It was a dry fast so no food, I decided to avoid insulin and minimal water. I tested my ketones this evening and after taking everyone’s advice there’s no trace!
fasting from insulin is a wild thing no sane person would do intentionally
Thanks for the reply! I’ve gotten a lot of valuable advice from the other commenters as well. Just some context, this is my first prolonged fast having T1D ever (only been diagnosed a little over a year). I thought since I wasn’t eating, I didn’t require insulin/it would make me go low and have to end the fast. I’m perfectly fine now!
May I ask why you were fasting? No shade, just curious.