Some Positive Effects

I took great delight in my extra fast yesterday. I feel like I have more energy - or, perhaps a more accurate description - I am less tired, and much less worn out by the children than usual. I feel a lot more alert, and I also slept better last night than I have done in ages. I'm hoping these aren't coincidences, because I could really use the extra energy!

I'm not convinced that my now 8:30pm to 8:30pm fast is working terribly well. My struggle yesterday was being fed some fish and broccoli at my Mum's house around 6pm (fitting in with my calorie count) and having insulin with this small meal. By 8:15pm I was only 6.7 but feeling extremely wobbly and like my body was desperate for sugar. I decided to be sensible and break the fast early to prevent the incoming hypo. However, because I came out of 'fast mode,' I ate a proper meal, quite large really for a breaking fast meal (fruit cake for the hypo, then some left-over stir fry, then scrambled eggs with toast), and ended up needing more insulin with this. I finished feeling extremely full and bloated, despite having felt exceptionally hungry - this was probably due to the hypo), and it was about 9:30pm that I had the insulin, which never really works for me (night times are still much of a mystery when it comes to my insulin requirements, and having novorapid shortly before bed never helps this!). I think this would have been a lot better had I had less or no insulin with the small tea, and then later treated the hypo only (i.e. take some dextrose tablets and have a cereal bar). So I will try this. Doing this may also mean I can switch to an AM to PM fast, which is easier to work out in my head, and will help me to eat less erratically, because I will be able to skip the late-evening meals and instead break my fast in the truly appropriate way - with breakfast.

What I have found interesting today is my lack of desire to eat loads of 'bad' things, a greater awareness of when I'm feeling full, and if I do have something 'unhealthy' I only want a little bit. I think that, overall, I have had lower sugar levels too. Just tallying up from my monitoring diary, over the past week I have had 22 tests where my levels were below 8 mmol/l, compared to the week before where there were 17, only 13 the week before that, and only 6 the week before that! That has to be a good thing. There have still been some very high readings, but overall much better control.

Another fast day tomorrow. I hope that I will start to see some weight change after a few weeks - so far I have stayed almost exactly the same!

An Extra Fast Day

Okay, so maybe I'm impatient, but three days of no fasting (between Monday and Friday) seems like an age. Having not seen any results yet (either visibly or on the scale - not that I would expect this after only two days of fasting but apparently it's quite common) I decided to fast today as well as Monday and Friday. I may only do this intermittently or I may do it every week; I will see how it goes. Alternate day fasting is another type of fasting talked about in Dr Michael Mosley & Mimi Spencer's book, The Fast Diet, where, as the name suggests, people fast every other day. It isn't hugely popular due to being quite full-on, plus it is extremely difficult to plan more than a week or two ahead of time. However, a 4:3 diet is fairly similar, an in between if you like, but with much more structure (always fasting on the same weekdays) and so I know it should be just as safe me to try this.

Yesterday, my third post-fast day, was very up and down in terms of blood sugars. In fact, it felt like one of my usual 'bad control' days usually do. These days just seem to happen, regardless of what I eat, inject, or do with my day - and one of my biggest struggles with diabetes. I ended the day with some yoga and weights exercise in an attempt to level the day out, since I usually find that exercise has nothing but a positive effect on my sugar levels as long as I am sensible with regard to hypos. This obviously had the desired effect because it helped bring my sugars down from a 15.

This morning started well with my first breakfast reading under 7 mmol/l in weeks, a 5.9. The day has continued well so far, with a 7.7 reading at 12:30pm. I am also managing fine on 'lighter drinks' - my usual is a milky tea with half a spoon of sugar (to take away the bitterness which I've never enjoyed in tea), but today I have had a cup of marginally-whitened red bush tea, a coffee (again with little milk), and just now a small cup of tea with much less milk than my usual and without sugar. I was surprised at how great this tasted! Fasting today has apparently enabled me to really taste the milk and enjoy the drink much more, and without finding it bitter. Great! This also works with food - everything just tastes so much more.

No sugar in tea is something I'd like to keep up even on non-fasting days, because it's always annoyed me that I just honestly don't like tea without that bit of sugar. Even a quarter-spoon makes a huge difference to the taste as long as it isn't made too strong, but I've never quite got to the point of having none at all. I simply end up throwing two thirds of the cup away.

I am hoping that the rest of the day will pass without any particular problems. I am anticipating needing a small snack at 3pm when I collect my son from nursery because we will then be walking up to my parents' house - a very large, steep hill to push a double buggy up with a 3 year old hanging on! Other than that I think I will find it fairly easy to stick to hot drinks (nice and filling) until we get back home, where I will break my fast before bed with a small (and hopefully nutritious!) meal. Because I didn't plan this day in advance as such, I had my usual basal injection dose of 28 yesterday. It will be interesting to see how my body manages this. Technically my blood sugar should remain stable, since the lantus dose is supposed to be how much your body needs without food, but seeing as I'm not certain about being on the correct dose (I seem to have a little too much in the day; not enough at night), it's hard to know. At least, for this week, I don't have two takeaways to deal with, but instead am having my usual food for which the doses are easy to calculate!

Fasting already gives me a feeling of energy and space; I have more time to do other things or just take a break from thinking about kids or food preparation. It's really nice.

Altogether Unrevealing

Fast day number 2: altogether unrevealing. At least, for now...

After my early-morning correction dose (from a 'Hi' reading) I managed to get a more reasonable 14.6 mmol/L before breakfast. I took my usual correction dose for the reading, 4 units (1 unit for every 2 numbers above 6, my target), and 1 unit less than my normal breakfast injection (usual is 4 units for 35g of cereal). These were guess numbers, of course. I was still fairly concerned about insulin sensitivity, despite having very little basal insulin by this time, hence not going the full hog with the breakfast dose. It seemed to be a good guess, though, because by 10:30am I was 7.9. By 11:30am, though, I felt as though I might be heading for a hypo. I checked my blood sugar, which was 5.1, and ate a cereal bar (85 cals). By 2:30pm, with no further food, my level was 7.8, a reasonable level, though revealing of how little insulin I had in my body. That was the end of the 'reasonable' sugar levels, though - by 5:30pm it was obvious that I needed more basal insulin, as I was an unexpected 16.3. Unfortunately I can't remember whether I had a tiny snack at this point or not, but I did have a correction dose of 5 units. I also took my usual lantus dose of 28 shortly after this (i.e. slightly earlier than usual) in the hope of holding out until the end of my fast without needing any more correction doses!

The one thing I am not struggling with at all is the actual fasting. I don't know whether this is due to my annoyance with often having to eat (a common thing amongst diabetics, so I am told), or from the delight in the focus it seems to give me. The hunger pangs are fairly few and far between, and are very short - easily overcome by having a nice hot drink and occupying oneself with some small task or other. My next step is to move from having tea with milk to having either green tea of some kind, or red bush (which I can happily drink black). I think this might make a difference to how easy I find it, but I am going to try that on my next fast day. If I don't count the calories in the tea, I've found myself easily under the suggested 500 calories, and with them, only around 560. I reduced my breakfast size to a small bowl of cereal about 9 months ago now (I used to have a HUGE bowlful every morning!), so that is now about 200 cals - easily incorporated into a fast day - and then I don't really eat anything else for the whole day, until I break fast between 8-9pm. I wonder if this matters?

At the end of my fast today (8pm) I was 10.4, and had a medium-sized meal of bread, cheese, oatcakes and grapes, with approximately half of the novorapid I would normally take (still not sure what was going on with insulin sensitivity and now back on my normal lantus dose I didn't want to take any chances!). Two hours later I was 11.8, and as I was offered a chocolate at the time, took the opportunity for another minor correction dose with it in the hope that I could get through the night without any extreme highs or lows.

All the struggle with my basal insulin today led me to wonder whether, in the future, I should ask my consultant about trying detemir (marketed as levemir) again which, I believe, lasts between 12-16 hours in the body. I used it while I was pregnant with twins, for two reasons: I needed so much basal insulin from about 6 months on that I had to do it in two lots, and as a plus it had been tested to have no detrimental effects on babies in-utero. (Insulin requirements can more than double during pregnancy so you can imagine the effect having twins has on the body!) I don't remember many differences between it and lantus, but the advantage would be that I would be doing an injection morning and night - lantus is a 24hr insulin - and could therefore reduce my basal insulin purely for the fast day, and nor have to worry about the night before. I could also take less for the night following the fast, if it turns out to be a necessary change, without having to worry about having less come the following day. This would be much easier with a pump...

Anyway, it is now 11:30pm and my level is 10.9. Let's hope it stays fairly sensible throughout the night, and bring on tomorrow!

Okay, so I think I was over-keen...

It's 5:45am and I just got this wonderful reading (see photo) which I haven't got in at least - oh, I don't know - ten years?! Whoops.

I decided to go for a hefty correction dose of novorapid rather than have lantus in my system that would overlap the next dose and make monday night a possible hypo-fest. I was expecting to be a bit high, but not quite this much...!

I'm not even sure why I thought I'd need as little as half (16 units) on a fast day, except that when I was barely eating anything for 3 months, I only needed 12 units. I mean, my levels were low-ish most of my first proper fast day, but I still didn't need to eat more than the required calories to keep it at a sensible level (not including drinks). Of course, by the evening I needed to eat loads, but maybe that could be combated by having no bolus at all with tea? I don't know.

Isn't diabetes fun?!

The Post-Fasting Effects

Again, without really thinking (diabetic habits are now fairly ingrained, I suppose!) I had a normal bolus with breakfast plus a correction dose for the 15. However, this was obviously the wrong thing to do because only 90 minutes or so after breakfast my sugar was low, and I had to snack. By noon it had only raised to 4.8 and I had more snacks while making lunch for the kids. By the time I got round to my lunch I was still only 4.3! The increased insulin sensitivity I was vaguely aware of existing was definitely serious stuff with immediate effect. I was feeling so wobbly that I actually skipped my lunch injection altogether. By 3pm I was 8.6 but still felt bad, so left it another hour, by which time I was 12.2 and felt safe having some correction insulin (with a snack). 

The rest of the day my sugar levels were great, around 7. Unfortunately I had another take-away to contend with (i.e., having to seriously guess my carb intake). By 11:30pm I was 7.1 (fine). At 2am I was 11.5 (acceptable-ish) but did not correct at all just to see what would happen by morning.

What happened today was a 22.2!

Here's one of the joys (read: pains) of diabetes. It can seem fine (maybe a little out of sync, but even if it isn't) it can hit you with a crazy sugar level. I don't know if that is what happened, or if it was because of some low-lying carbs or something... anyhoo, I decided not to worry about that too much!

Today my sugar levels have, again, been lower than normal, with lower insulin-requirements. Tea this evening was the first 'ordinary' meal I'd had since fasting (apart from breakfast cereal) and therefore knew exactly how many carbs I'd eaten. I had my usual dose, counting 1 unit to 10g of carbs, but despite my fast day being two days ago, it was still too much! I came down from 8.2 at tea to 5.9 an hour and a half later (unheard of for me in the evening), so had a snack (a ryvita, raisins and a mini chocolate roll). By half 9 I was feeling even lower, so had yet more food...

At some point I know that this will be really great, but it's going to take time, isn't it?

Fast Day no. 1

Having fasted a few times before, I already knew that the effects on the body were slightly more awkward when attempting as a diabetic - not just during the fast, but afterwards too. For example, in my case, food before bed (that is, before sleep) was essential for me to avoid a hypo. So already I knew I'd have to do the 24 hours from evening to evening, rather than morning to morning like you might otherwise choose.

I began, inspired, with no forward planning, and so my first fast was from about 10 pm (when I last happened to have snacked) til 8pm the following day. 22 hours - close enough for the first try! Because of the lack of planning, I hadn't reduced my basal insulin, so instead made sure the fasting food was medium/high in carbohydrates to keep me going. I ate a cereal bar when I first woke because my sugar was quite low. Maybe about half an hour later I got up, exercised (about 10 minutes of weight lifting) and then ate a normal breakfast (shreddies with milk, approx 200 cals), my bg being 7.4. I had half a cereal bar at about noon to keep my sugars up. At lunch my bg was 9.4. I think I ate 2 strawberries and a grape over the afternoon (14 cals). My bg was 5.9 mid afternoon. I had nothing else save cups of tea until after 8pm, when my bg was 4.4. I was fairly peckish by this time but mostly because of feeling the effects of low blood sugar. I remember my total calorie intake excluding cups of tea was 333 (women are allowed up to 500). I think it's up to you what you drink during your fast day. My cups of tea are about 40 cals each, but I choose not to count them in the calorie intake because i think, for the moment, they help stabilise my blood sugar. I may or may not switch to black tea in the future! However, even including my drinks, my intake was still only about 573 calories.

I broke my fast with a slice of cheese and then we had a takeaway, which was not how i planned it but made it interesting. I ate the whole lot which I don't often do despite the fact that we split the dishes (i have a curry portion, a popadom, half a rice portion and half a naan bread) plus a slice of fruit cake and a piece of chocolate, but i regretted this because I felt absolutely stuffed full for about two hours afterwards! Ideally i would hope to have a fairly ordinary meal after fasting, if not smaller than usual. However, i think the extras after the meal were because I still felt quite low. About half an hour after finishing my meal I thought I'd better bolus, since a takeaway has masses of carbs in and I reasoned that even after fasting I would need SOME insulin. I had about half the insulin I would normally have for the amount of carbs eaten (6 units less - it was a lot of carbs...). Interestingly, this was still too much. 90 minutes after the meal I was only 5.8, and before bed I was down to 4.6 and had to snack before sleeping. During the night I was 13.8 and had 3 correction units out of habit (hard to break, apparently!), though by morning I'm not sure what had happened because I was 15.6 but felt as though I was quite low. Whether I'd gone low and bounced back up or simply needed more food after fasting, I don't know. Ah well, onto the next day!