type 1 - wls - enough carbs to avoid DKA
I'm looking into the lapband, but I'm concerned with the extremely low carb intake and what that might cause in regards to DKA.
5 cho a day in 1 protien drink a day post op is not really all that much. How is a person suppose to avoid having DKA issues with that low amount.
My dietician said that 5grams of cho or less is adviseable - not do to anything more. Well that is per 8 oz serving.
would appreciate some info here.
Thanks
5 cho a day in 1 protien drink a day post op is not really all that much. How is a person suppose to avoid having DKA issues with that low amount.
My dietician said that 5grams of cho or less is adviseable - not do to anything more. Well that is per 8 oz serving.
would appreciate some info here.
Thanks
(deactivated member)
on 6/30/09 5:45 am - Woodbridge, VA
on 6/30/09 5:45 am - Woodbridge, VA
I'm confused - I assume by DKA, you mean diabetic ketoacidosis. This is caused by HIGH blood sugars, not low. Limiting your carb intake should help to keep your sugars lower. What am I missing?
Yup, talking about DKA. If a diabetic is spilling keytones, they run the chance of getting acidic blood. You can go into DKA with high sugars, not having enough insulin to deal with the sugar load, so the body burns fat. But you can also have keytones when your not eating enough, say when a diabetic has the stomach flu. Yup, can go into dka.
So having WLS and being diabetic, I was concerned.
Now as for type 1s not being able to have lapband? I don't know about that. My doctor knows i'm type 1 and knows that i want the lapband.
I would rather go that route for a couple of reasons. 1 - don't want my plumbing re-routed. and 2 - fear that the high levels of weight loss causing issues with over loading the kidneys when loosing weight so rapidly especially if kidneys are compromised such as having diabetes for 24 years.
Thats my own personal reasons.
Guess i still need to find out how much carb a person needs to have to avoid dka.
So having WLS and being diabetic, I was concerned.
Now as for type 1s not being able to have lapband? I don't know about that. My doctor knows i'm type 1 and knows that i want the lapband.
I would rather go that route for a couple of reasons. 1 - don't want my plumbing re-routed. and 2 - fear that the high levels of weight loss causing issues with over loading the kidneys when loosing weight so rapidly especially if kidneys are compromised such as having diabetes for 24 years.
Thats my own personal reasons.
Guess i still need to find out how much carb a person needs to have to avoid dka.
Ok, so it is ketosis that I'd have to watch for. But suppose it shouldn't be an issue, just something I'm going to have to work with.
Had a meeting the other night, and my doctor came as guest speaker. Wow, it was nice of him to come. Since no one else was too talkative, I asked all the questions I have had regarding the keytone issue.
I also found out why they were saying no lapband for diabetics. Really its the type twos that do better with the RNY because of the nature of things, it gets routed passed the pancreas and they can take care of their diabetes from that point on. When your type 1 however, insulin is always going to be a factor and the pancreas isn't working for us, so the routing issue won't change. I'm giving you the shortened answer - talk to your doctor for more detailed information. I am nto quite sure about it all, but the jest of it made sense to me.
The lapband - you got to work it. If your not going to work it, then its not for you. HOWEVER the RNY - all folks loose wieght with it. But that is at first - after 2 years if you don't work with it, then the weight will return. Thats according to the doctor - put into my own words.
Hope thats helpful to someone
Had a meeting the other night, and my doctor came as guest speaker. Wow, it was nice of him to come. Since no one else was too talkative, I asked all the questions I have had regarding the keytone issue.
I also found out why they were saying no lapband for diabetics. Really its the type twos that do better with the RNY because of the nature of things, it gets routed passed the pancreas and they can take care of their diabetes from that point on. When your type 1 however, insulin is always going to be a factor and the pancreas isn't working for us, so the routing issue won't change. I'm giving you the shortened answer - talk to your doctor for more detailed information. I am nto quite sure about it all, but the jest of it made sense to me.
The lapband - you got to work it. If your not going to work it, then its not for you. HOWEVER the RNY - all folks loose wieght with it. But that is at first - after 2 years if you don't work with it, then the weight will return. Thats according to the doctor - put into my own words.
Hope thats helpful to someone
(deactivated member)
on 7/5/09 5:30 am - Woodbridge, VA
on 7/5/09 5:30 am - Woodbridge, VA
Almost all WLS patients enter ketosis after surgery, whether they have diabetes or not. Ketosis and Ketoacidosis are VERY different. Being in ketosis is not typically dangerous, even for a diabetic.
My recommendation: research online in medical journals and clinical studies. Most doctors are NOT very well educated on these specific topics.
DKA: "Diabetic ketoacidosis, aka DKA, is a serious complication of diabetes, which occurs when a very high blood sugar level (above 300 mg/dL) is coupled with a severe shortage of insulin in the body. This is more common in Type I diabetes because the body produces very little or no insulin on it's own. The body starts to break down fat for energy and ketones (toxic acids) develop. People with DKA usually complain of nausea, vomiting, abdominal pain, rapid breathing, and sometimes a fruity odor on their breath. This can lead to coma or death and should be treated by medical personnel immediately."
Ketosis: "Ketosis is a natural process that occurs when fats are converted into energy by the body -- usually when there is not enough glucose (carbohydrates) to provide for the body's energy needs. Instead, the fat is broken down into energy, and "ketone bodies" are the molecular by-products of this metabolic process.
Ketosis may occur during fasting, after an extended period of exercise, or when a high-fat/low carb diet is followed. It can also happen during an illness when nausea and/or vomiting make it difficult to keep food down.
Ketosis in and of itself is not a harmful process and occurs among diabetics and non-diabetics."
My recommendation: research online in medical journals and clinical studies. Most doctors are NOT very well educated on these specific topics.
DKA: "Diabetic ketoacidosis, aka DKA, is a serious complication of diabetes, which occurs when a very high blood sugar level (above 300 mg/dL) is coupled with a severe shortage of insulin in the body. This is more common in Type I diabetes because the body produces very little or no insulin on it's own. The body starts to break down fat for energy and ketones (toxic acids) develop. People with DKA usually complain of nausea, vomiting, abdominal pain, rapid breathing, and sometimes a fruity odor on their breath. This can lead to coma or death and should be treated by medical personnel immediately."
Ketosis: "Ketosis is a natural process that occurs when fats are converted into energy by the body -- usually when there is not enough glucose (carbohydrates) to provide for the body's energy needs. Instead, the fat is broken down into energy, and "ketone bodies" are the molecular by-products of this metabolic process.
Ketosis may occur during fasting, after an extended period of exercise, or when a high-fat/low carb diet is followed. It can also happen during an illness when nausea and/or vomiting make it difficult to keep food down.
Ketosis in and of itself is not a harmful process and occurs among diabetics and non-diabetics."
Had gotten my wires crossed in the translation.
I had red posts about folks being hospitalized with what turned out to be keytone issues, and reaching acidic levels in the blood. But now I can not find the postings _ i know it was from non diabetic people. And i know I can have keytone issues if i have a stomach virus and haven't eaten for a long time. (Typically never ever have keytones when bgs are high)
So wanted to know how someone who is only starting of with 5 cho in an 8oz protien shake going to function normally. Guess thats actually going to be a few grams more - when your drinking 2 oz every 2 to 3 hours for the first week post op.
Lived a long time always focusing on carbs, and how much insulin I was going to require to cover myself. Now thats going to be changing. Getting there
I had red posts about folks being hospitalized with what turned out to be keytone issues, and reaching acidic levels in the blood. But now I can not find the postings _ i know it was from non diabetic people. And i know I can have keytone issues if i have a stomach virus and haven't eaten for a long time. (Typically never ever have keytones when bgs are high)
So wanted to know how someone who is only starting of with 5 cho in an 8oz protien shake going to function normally. Guess thats actually going to be a few grams more - when your drinking 2 oz every 2 to 3 hours for the first week post op.
Lived a long time always focusing on carbs, and how much insulin I was going to require to cover myself. Now thats going to be changing. Getting there
Hey Mishelle,
The answer is unfortunately going to be different for each person with type 1. I had gastric bypass back in 2004 and got really sick afterwards because of DKA even though my blood sugars were fine, (never higher than 110)!
Anyway, once my doctor's and I figured out what was happening I left the hospital with the instructions to take at least thirty units of Humalog a day, (in addition to the 12 units I get from my pump basil rates), so that added up to 42 units/day.
For me, that was eating/drinking ~200 carbs a day. Needless to say I drank a lot of 1/2 water 1/2 apple juice drinks just to get to that!
It's really important for you to work with your doctor's to make sure you'll be all right and ready to go after surgery. Only eating 5 grams of carbs a day for a person with type 1 is unrealistic and can kill you. I was really sick, almost dead after surgery so trust me I know.
Let me know if you have any other questions!
Michelle
The answer is unfortunately going to be different for each person with type 1. I had gastric bypass back in 2004 and got really sick afterwards because of DKA even though my blood sugars were fine, (never higher than 110)!
Anyway, once my doctor's and I figured out what was happening I left the hospital with the instructions to take at least thirty units of Humalog a day, (in addition to the 12 units I get from my pump basil rates), so that added up to 42 units/day.
For me, that was eating/drinking ~200 carbs a day. Needless to say I drank a lot of 1/2 water 1/2 apple juice drinks just to get to that!
It's really important for you to work with your doctor's to make sure you'll be all right and ready to go after surgery. Only eating 5 grams of carbs a day for a person with type 1 is unrealistic and can kill you. I was really sick, almost dead after surgery so trust me I know.
Let me know if you have any other questions!
Michelle
Well, I've not had DKA - dropped my insulin requiremenst by 100 units a day.
I know lots of folks on here are very pro protien and anti carb. but i feel yes get the protien in, but also get in some carb with each meal. Been working for me quite well. I'm using about 34 units a day with basal and boluses. No issues with low bgs, and been avg about 170 for my sugars. been keeping it higher so i don't go low, requiring sugar and dumping. I'm 7 weeks post op as of today and down a total of 66 pounds 59 since surgery.
I know lots of folks on here are very pro protien and anti carb. but i feel yes get the protien in, but also get in some carb with each meal. Been working for me quite well. I'm using about 34 units a day with basal and boluses. No issues with low bgs, and been avg about 170 for my sugars. been keeping it higher so i don't go low, requiring sugar and dumping. I'm 7 weeks post op as of today and down a total of 66 pounds 59 since surgery.
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