5:2 with Type 1 Diabetes

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  • I have been well-controlled on an intensive regimen since diagnosis in 1990. Humalog/Lantus since about 1996. Six weeks on 5:2 (2 adjacent days) so far. Not difficult. Starting the evening before fast days and on the second fasting evening I split my Lantus 8 u evening and 7 u in the morning to avoid having too much insulin hitting me between 03:00 and 11:00 on fasting days.

    Blood sugar is really easy to control with less food and less insulin ! Less insulin is always good !

    I am doing 5:2 not to control my weight (which has been stable at about 78 kg summer and 80 kg winter forever), but because it seems evolutionarily and common sensewise like a Good Idea, because it consumes less of everyone else’s food (and saves money!) and because it might result in a net lower HbA1c, blood pressure and possibly even lower recurrence rate of bladder tumours.

    I also have progressive BPH, but it will be difficult to assess the 5:2 effect because I started 2.5 mg finasteride a few months ago after after 1 mg finasteride for years for hair loss and then cutting it to 1 mg/week over the last couple of years.

    No problem doing my three/week 500 m mtn bike climbs up Lookout Mountain even on fast days; I just take only 5-6 u of Humalog with my normal breakfast about 45 mins before.

    I am not doing this yet, but am certainly considering it. I’ve had T1D since 1978 and have good control and excellent health in general.
    I lost 17kg over 18 months by sticking fanatically to 1300cal/day (I’m kind of short, and that’s approx my BMR, all carefully calculated etc etc) and exercising, but have slowly gained back 4kg over the past 7 months, with more relaxed eating and some athletic injuries. Am not frantic to drop weight, as I feel quite good at this weight, but would like to if it’s not all too hard.

    My question is – do all the magical biochemical effects disappear if one gorges on glucose to fix a nasty hypo on a fast day? I’m not entirely sure I can accurately count calories while hypo, so may go accidentally well over the fasting calorie limit…. Does one then give up, eat normally, and try again later?

    Oh, and I use a pump with Novorapid.

    Very interested to hear from other T1s who manage this and get the clever biochemical things to happen.

    Although I am Type 2 I am insulin dependant on Levemir, Apidra and Metformin SR. I am fasting completely thoughout the day and intend only to eat my 500 cals in the evening which is when I will take my insulin as I normally do.

    My concern is what to do if my blood sugar starts to rise during the day as a result of fat breakdown (rather than food intake). Do I take a small amount of insulin to counteract this or not? Anyone got any ideas??

    I have T1D,since 1984. I’ve started yesterday with this program. I’m using an insulinpomp. I thought it would be wise to cute my basal insulin to half and that workes out fine. Today i’m back to normal.
    I never heart of bloodsugars rising as a result of fat breakdown, I’ve tried modifast a few years ago and didn’t notice it then. If its rising I would give myself a very small amound of insulin to make it even.
    (I hope that was written correctly, I’m dutch so this is a bit difficult for me)

    I have type 1 diabetes on an insulin pump and have put on 14-18lbs over the last year which I would like to lose. Has this diet worked for anybody with T1D for weight loss and if so any tips?
    Thanks Jo

    I’m a Type 1 and have been for 30 years. I’m 51 and female, using Novorapid and Lantus. I’m well controlled with a HbA1 of 6.2 usually, and am somewhat overweight. I’ve been doing the diet for three weeks now and have found it a grind at times, but what they say is true – you get used to it. I eat three meals a day and also two snacks to keep the hunger at bay, but I think I’ll soon be able to give them away.

    In diabetes terms, I think eating three meals rather than two (or one) is sensible simply because it makes management easier – you just take less insulin. But on the other hand, this means that you are not actually ‘fasting’ for any prolonged period so I wonder whether I will reap the other health benefits that they speak of. Does anyone know?

    In terms of hypos, I have 2tsps honey (30cals per spoon!) and just put up with it. You have to really. But taking less insulin means that you are much less likely to have one, and I’ve found this to be true.

    So I’d recommend it as a system for sure.

    As a Type 1 for 50 yrs, I would like to hear from Michael in terms of the science and veracity of Type 1’s on The Fast Diet. I’ll find a way to manage my low’s/highs but because we don’t produce insulin and our insulin resistance is totally altered, will we benefit from the 5:2 plan?
    And I fully acknowledge that I am soley responsible for my health and diet.

    Hi jdtaos, At the moment as there is not enough research available (yet) to be able to advise you sufficiently about the benefit and safety of intermittent fasting in Type 1 diabetes, I would definitely recommend you talk to your specialist about if and how you might do it.

    You may already know about the interesting research recently published from Newcastle into Type 2 diabetics which demonstrated that in people who have had type 2 diabetes for 4 years or less, major weight loss returns insulin secretion to normal.

    ‘It has been possible to work out the basic mechanisms which lead to type 2 diabetes. Too much fat within liver and pancreas prevents normal insulin action and prevents normal insulin secretion. Both defects are reversible by substantial weight loss.
    ‘A crucial point is that individuals have different levels of tolerance of fat within liver and pancreas. Only when a person has more fat than they can cope with does type 2 diabetes develop. In other words, once a person crosses their personal fat threshold, type 2 diabetes develops. Once they successfully lose weight and go below their personal fat threshold, diabetes will disappear.’
    Overweight patients with type 2 diabetes who were put on a diet of just 800 calories a day were free of the disease within a few weeks of following the strict regime:
    http://www.express.co.uk/news/health/452220/How-a-strict-diet-of-800-calories-a-day-can-cure-diabetes-in-weeks
    Interesting to see above how maysi01 and others are getting on with IF.
    In general as you know weight reduction and reducing refined carbohydrates is key whether you are Type 1 or 2

    Good luck with managing your diabetes. I hope this is of some help and that more research will be available soon!
    Clare (Gp and Michael’s wife)

    I am on week 1 of 5:2, after getting back from 7 weeks holiday and discovering my flight suit pants don’t quite fit so well (I spend a lot of time in small aeroplanes doing aeromedical retrievals).
    I have not reduced my basal rate at all during my fast days, as it is generally correct for me if I don’t eat anything – that is how it is tested after all, and I suspend or remove my pump if I exercise on fast days (sometimes I do during regular days, but mostly not).
    Things are going ok, with a few unexpected BSLs of 12 – I have never closely examined the carb content of a cup of carrots before – mistake.
    I am struggling with workouts on fast days (circuit or 3km run). I can’t find my normal strength and feel a bit lightheaded at times. I think more water may help. I mostly drink diet coke. Very unhealthy etc, but it is nice.
    I am avoiding carbs on fast days as I am finding that any bolus insulin makes me ravenous.

    Thanks so much for your info morrisminor72. I very much appreciate hearing from other TYPE 1’s (no insult meant to Type 2’s or Clare but we are not at all the same). I’ve been on the Pump for 6 yrs but still looking for a Doctor that can help me get well correlated with my pump. So I’m trying temp basals on IF days.
    I have found that wearing the Sensor on IF days is a necessity ā€” even when it isn’t correct.
    I also tried Birsays 2 tsp of honey and find that to be very helpful. I’ve had enough Glucotabs to last, ok not a lifetime but plenty of it, so the honey is easy and nice. Any thoughts on the pump, Birsay? Took me a very long time to go on it but now I love it!!

    I have to say I was absolutely stoked to come across this thread! I attempted the 5:2 a while back but gave up after a couple of weeks because of the hypo issue. Seemed so unfair to go to all that effort to fast yet have it stuffed up by stuffing your face.

    I can so relate to your comment morrisminor72 about counting hypo treatment calories! Not always easy – especially if you have one of those hypo’s when you really are gorging just to keep up. I decided to hold off trying again until I could get my basals perfect – ie: to avoid the hypo’s and so not end up discouraged and/or not have to reduce my allotted calories because of the already consumed glucose calories.

    I am now on a pump with smaller increments so have no excuse for not getting stuck in. Well …. there was the excuse of Christmas …. and then the excuse of all the Christmas leftovers …

    No mind. I started again yesterday (Tuesday). I guess I shouldn’t have been in such a rush and tested the basals first. But doing a basal test is all but the same as doing a fast day so I just called it my first fast day. Hypo’d at 3pm and really struggled. Hmmm, perhaps I should have just had some glucose tablets and not mucked around but I’d just bought some new season nectarines and one of them was calling to me. Another time, that might have done the trick but not this time. Then I remembered I’d got some of the Co-Yo which I had yet to try. Had some of that and read the label – not much use for a hypo. šŸ™ Ended up having a mouthful of ginger crunch (no, that’s not normally in the house!) and then I finally had the energy to put together some nice grilled salmon & a salad. Pretty sure I blew the 500 calories but I figure that the 500 is just a number and if I end up with 555 or more, it’s not the end of the world.

    morrisminor72 and Birsay, I’m working on the premise that the magical biochemical effects are still there even if we need to treat a hypo. Logically, if a non-diabetic faster’s glucose level falls and they get the munchies, they may opt for a small snack as a part of their calorie allowance. Just that our choice of ‘snack’ might not be nutrient dense. I’m reckoning that my 3pm hypo was better than an early morning one on the premise that the longer you fast, the better the magical biochemical effects.

    anssies and jdtaos – if you need a helping hand with sorting out your basals, you could do worse than to have a read of Pumping Insulin by John Walsh & Ruth Roberts ISBN 1-884804-77-2. I have no idea if they have done a subsequent edition nor if there is any other book that is better – just that that was the book that helped me. I have found that unless you’re pregnant, you can’t rely on the medics to hold your hand. You need to take ownership of your own health.

    As you might have picked up, I differ from you Birsay, I far prefer to do just one meal on a fasting day because, theoretically, the basals get you through the rest of the day without having to do anything. Then you only need bolus for the one meal. As it is, Iā€™m tending to not bolus for meals as I am making them very low carb (just the veges ā€“ although I cracked up at your comment about the cup of carrots morrisminor72).

    Just for the record: Iā€™m Type 1 and have been for 45 years. Iā€™m 53 and female, using Humulin in an Animas Vibe pump. Avg TDD is anywhere between 7.8 (my basal) and 15 odd (when you can tell my eating is out of control). I am also doing the CGMS thing. I am a shortie and have 18kg to lose (although I suspect I might settle for less when I get closer to the goal weight). Oh, and I am hypothyroidal which is making losing weight harder than it need be. Working through that one at the moment.

    I am finding myself having more unexpected lows in the days following my fast, and they don’t seem to be related to my cycle (sorry – TMI), my food intake or exercise.
    I get the same phenomenon when trying a new sport or activity (latest hobby is iaido – Japanese sword drawing and cutting). I was low for days after my first few classes, but all good now.
    There is some evidence that insulin production can occur sporadically even after 50y of T1D – I wonder if fasting in some way provokes that release? Or seriously sensitises tissues to the effect of our injected exogenous insulin?
    I have not fasted this week due to an overwhelming schedule and fatigue – I do not do well when hungry AND tired. Next week is good to go though! I have some nice days off, in which I shall fast and exercise.
    My uniform pants are getting more comfortable – yay!

    Actually I think hypos following a fast day are your body restocking its glycogen supplies – at least that’s what my endo told me can happen a long time ago. On fast days (or days of high activity) you release and use up your glycogen stores and then some time later your liver/muscles etc grab glucose from your blood to replenish the stores, resulting in a hypo! I’m coming up to my 6th fast day and haven’t had this happen, but I’ve been low carbing for years so I don’t really think I have much in the way of glycogen stores šŸ™‚ I’m loving the flatlining blood sugar levels on fast days – I seem to just be able to forget about it! Yay for the looser pants, I hope I see some results soon šŸ™‚

    I don’t really know the science but I definitely find after starting a new exercise regime or changing my diet significantly for the better, I get quite a few more hypos – at the time, but a day or even two days afterwards, too.

    I started this diet last week and after my first fast day I found I needed less insulin for the next two days. My second fast day didn’t work out so well – I tried halving my basal insulin but it didn’t work out very well for the night time period (I had a reading of ‘Hi’ at 5am, something which I’ve not had for many years!) so the rest of the day was fairly normal once I’d corrected that, and the following day seemed normal too. I am logging everything that happens at http://www.fastinganddiabetic.blogspot.com to help me remember everything as I go, but also for any other diabetics who are interested in this.

    What I really want is to go on the pump but I am having a monitor thing for a week to check my lantus dose is correct, because I really don’t feel like it is…

    I have had Type 1 Diabetes for 29 years. I have been on the 5:2 diet for 4 weeks and I’m finding it great so far. I started because my cholesterol started to climb recently and I want to avoid going on statens. I have yet to recheck my cholesteral but I have been visibly losing weight and feeling good!

    Here is how I fast and manage my diabetes: I use an insulin pump with apridra and a dexcom glucose monitor. On fast days I reduce my basal rate about 35 percent from .9 to .65. I eat mainly protein and veggies for my 500 calories and therefore do not take any insulin when I eat. If I eat something sweeter like a piece of fruit I take a bolus of 2 units. I have been able to keep my blood sugars in a normal range on fast days but I also monitor very closely on those days. If I do end up going low I eat an extra piece of fruit and maybe up my calories to 600 for the day.

    I think this diet is great for Type 1 diabetics who have good control over their blood sugars. A continuous glucose monitor is also invaluable to me in this process. I hope this helps anyone looking to start the diet!

    I use a pen with Humalog as required and 14-16 u Lantus in the evening. I am very well controlled: my HbA1C has always been 5.9 – 6.7%, mainly around 6.4%. The evening before fasting I take my normal (16 u in the winter at the moment) Lantus dose. Then my normal muesli & yoghurt breakfast with 7-8 u Humalog. On the first fasting day my blood sugar is much easier to control than on an eating day because I have a decreasing amount of food in my gut (I have concluded empirically that it seems to contribute sugar for up to 12 hours after eating) and no insulin other than my declining Lantus. On the middle night I take 4 u Lantus. On the second fasting day blood sugar control is even easier. Normal breakfast with 7-8 u Humalog. During the fasting days I check my blood sugar only infrequently and once clear of the breakfast noise, it changes Very Slowly and consistently (very little input, very little insulin). On the second fasting day I take another 4 u Lantus late morning. If my blood sugar is moving up (and high) on a fasting day I take an extra unit or two of Lantus; if it is moving down (and low) I eat a really small (because I have very little insulin around) fibre-carbo snack.

    In the evening of the second fasting day I take only 4 u Lantus because I have very little food in my gut.

    My exercise is fairly intense for about an hour (riding up 500 m every couple of days), and for this period I find no difference between fasting and eating days, except that on an eating day I must be sure not to have too much insulin in my system (and not too much food in my stomach) as I start to exercise.

    In summary, on fasting days my blood sugar just drifts slowly and is easy to monitor and control; on eating days it is buffeted much more by larger amounts of food and insulin, takes more excursions and requires more monitoring.

    Yes. I started the 5:2 diet in May 2013 the day after watching Michael’s program. I did it because it seems more natural than eating whenever you want and because of the possibility of long-term health benefits.

    But as a side-effect I lost 7 kg. I am now in the middle of the BMI range. Exercise is easier because I am lighter !

    Blood sugar control is easier on fasting days because you have little food pushing it up and little insulin pulling it down. It moves more slowly. Cut back on food and insulin together. Watch the middle and last nights because you have almost no food in you; don’t take too much insulin.

    Thanks AnnieNZ, I just ordered Pumping Insulin, 5th Edition.
    Also just wanted to recommend Eating Well, the magazine or online @ eatingwell.com. There are many recipes that come in at calories that work on a 500 calorie day. And I just switched to the 530G and Enlight sensor by Medtronic. CGMS is the way to go!
    Here’s to all of us IF’s and our health! We’re worth it.

    morrisminor72 I’ve now been doing the 5:2 since January 1. I can’t say the pounds are falling off of me but things are shifting. I figure if I’m comfortable doing this from now on, even if I have a low and have to do some kind of sugar, I’m benefitting and am not going to wait for science ro give me the go ahead. I went for my retinopathy check up and the results were better. I feel better and am shifting.
    I’m also having some difficulty with exercise and Fast Days but am trying to use a temporary basal ot help. Are you trying that?

    FYI for people like me: I just discovered the Pattern (Medtronic pump:other pumps alternate basal rate ā€” thank you AnnieNZ!) technique for my Fast days. At this point, i’m trying 50% of my basal rate.

    I am a 25 year old mother of two and type 1 diabetic. my baby is 6 months and i am really struggling to lose the baby weight and control my blood sugar levels after an awful pregnancy. i feel as though i get no support or actual medical advice from the doctors- instead i am made to look like a careless person. i always feel lethargic and moody and cannot give my children my all and its all very upsetting.

    there seems to be no pattern to sugar levels no matter what i try. i am afraid to exercise in case i hypo which i hate and have a slight fear of.

    does anyone have any advice on where to start and how i should progress without become heavier and perhaps even dropping excess weight ( around 14 pounds).

    Your posting tugged at my heart. I don’t have Type 1 Diabetes, but my son does. I managed his diabetes each day from when he was dx’d at 3 until he went off to college – maybe not so much while he was in high school.

    There are some folks on this forum who have Type 1 and have lost weight by fasting. (I would do a google search on 5:2 fasting and Type 1 to find the postings).

    Personally, I see it as a wonderful opportunity to verify that your basal insulin is correct. If your sugar readings are all over the place, I would think that doing a fasting basal test would be a great way to get these set as these are usually suspect with out-of-control sugars. I imagine your body with the hormones going wacky plays havoc with the blood glucose levels.

    With exercising, I would eat prior to exercising or shortly thereafter with reduced insulin for the food to keep the blood glucose level up.

    Thank you for the advice, it’s feels wonderful that there may be a solution and the first thing I’m going to do is check my fasting basal dose.

    I will keep you posted on my success!

    Again, thank you xx

    Although I have not been successful losing weight on 5:2, I believe it is a positive change in my diet. One suggestion I have about exercise; I bought a stationary bike and have been doing the Fast Exercise routine. I’m a walker but know that I don’t get my cardio up and usually have low BS after. When I do a 14 min routine on the bike, I don’t get low and I feel really good after.
    Also are you on a CGM?
    I ordered the Kindle edition of Pumping Insulin and am really impressed with the material.
    http://www.amazon.com/Pumping-Insulin-Everything-Success-Smart/dp/1884804861
    Hope something helps!

    Hi, by cgm do you mean continuous blood sugar monitoring? If this is what you mean then yes I do it at least 4 times a day but I just can’t seem to find a pattern.

    If I excercise my sugars are fine but I dip really low during my sleep which frightens me.

    But I will read the book you have recommended for sure! Thank you for your input, I really appreciate it!

    Jasdeep:

    A CGM isn’t testing four times a day, it is a device you wear that tests your blood sugar every 5 minutes. My son has one and finds it invaluable.

    Testing 4 times a day is the minimum amount for a Type 1 diabetic and often is not enough data to determine a pattern – as you discovered.

    You need more data to find the pattern. If you could test every hour, you would see the pattern.

    Going low at night after exercise is very common. I would have my son eat an 30 gram snack and not have any insulin for it to keep the sugar up at night after exercise.

    This is a standard management technique for Type 1. I am surprised your endo doesn’t know recommend this. Is your primary doctor an endocrinologist with other Type 1 patients.

    It looks to me like you get your insulin through injections. The Pumping Insulin book has good techniques for using injections like you would a pump.

    Oh! I never knew this device existed!! I am not currently under any diabetes specialist care as the doctor who’s care I was under gave me a horrible time through my pregnancy and I am waiting to be transferred but I really do feel on my own.

    The biggest thing that indicates the lack of profeasional and suitable care is the fact I didn’t even know this device existed!!!

    I’m so glad I know now!

    I need to do quite a few things this week by the looks of it.

    Again thank you soo much… I will let you know if I have any luck with getting a cgm device

    Here’s an update after 20 months on a 5:2 diet with adjacent days. HbA1c 6.3% in September and 6.4% the previous September, in line with previous values.

    My compliance has continued to be fairly easy. I omitted a fasting day at Xmas 2013 and both days during an exercise-filled trip to Moab.

    I retired in June 2014, and my extra time combined with my lower 5:2 weight prompted me to start running again. Apart from 3-4 orienteering meets each year, I had not run much for 20 years. The final factor in my big switch from cycling to running was buying a pair of Hoka One One running shoes. I have run more distance from June to November than in the previous 10 years.

    I usually avoid running on the second fasting day, but this time of year in Colorado I must use the dry-trail warm days as they present themselves.

    I encountered one potential adverse side-effect of fasting when at my first fluorescein-enhanced retinal exam my venipuncturist was inexperienced. As a diabetic I am accustomed to venous and occasional arterial blood draws, but after she missed two elbow veins and blew one in the top of my hand, while remaining consciously calm, at some level I panicked and experienced severe vagovagal syncope (I fainted). I had never actually done this before during a medical procedure. The fasting may have adjusted my physiology to make this more likely.

    Three years I quit smoking and have gained 30-40 pounds. I will also be going back on my insulin pump again in the next month or so and I know insulin makes you gain weight. I was on the pump years ago and as my blood sugars began to get more normal and my A1c came down my weight went up. I cannot afford to gain any more weight. Please help!! Becky S

    Here is my 24 month update. I have decided that significant exercise (> 5km run) on the second fasting day is probably not a good idea. It stresses my body too much by suddenly using glucose at a high rate, requiring eating sugar/fast carbs and thereby partially negating the “fast”, even if I take no additional insulin.

    I am down to 2-3 units (non-fasting: 13-15 u) of Lantus in the evening of the first fasting day. Second day: normal breakfast with 6u Humalog, FOLLOWED IMMEDIATELY BY A 20 MINUTE WALK. For me the walk is essential to get the insulin distributed from the depot before the food raises my blood sugar. This is generally true for all my meals.

    During the second (contiguous) fasting day, after the breakfast noise and adjustment with a unit or two of Humalog or some carbs, my blood sugar drifts slowly. Most of the time it is flat most of the day. If it drifts up I take a unit of Lantus. If it drifts down I eat a small amount of carbs. Moderate exercise also flattens or lowers a rising blood sugar.

    Evening of the second fasting day: ONLY 2 u of Lantus. By this time there is almost no food in my gut and so no external glucose input.

    The final part is to take about 10 u of Lantus after breakfast on the first eating day to restore a non-fasting basal inflow and reduce the amount of Humalog required through the day.

    My blood pressure is still controlled with only 40 mg Enalapril (60 mg before 5:2 diet).

    Simon

    I am 56 yr – t1d for 20 yrs. Out of control at the moment highs and lows . more highs. gained significant weight. usually quite active walker but no energy now. Interested in trying the 5 – 2 but scared of the lows. Helpful to read through other comments to reduce lantus on the fast days and monitor humalog

    nucolorado, are you on a pump and CGM?

    I’m just getting started today, and would like to talk to others in my position. I’m Type 1 – diagnosed 40 years ago – and am trying to lose 20 pounds. Just saw this blog yesterday. Have fasted all day. Testing BG every 2-3 hours. Haven’t done this for a while. and am adjusting basal in the process. All’s going well. Loosing weight (20 lbs) is a priority. Has anyone done that?

    Coming late to this thread, but see that a few others are adding, too, so I thought I’d go ahead. I’m a female Type 1 diabetic, age 55, diagnosed 43 years ago. I have been very lucky and healthy most of these years in spite of some challenges. I have hypothyroidism, which makes weight issues even worse, and I have been gradually gaining about 2 pounds a year over the past decade. It has to stop somehow, but every year I lose the pounds then gain them back with more. (I am a university professor and my spring semesters are always impossible and my exercise and self-care much more of a challenge in those months, so I always lose weight over the summer, maintain over the fall, then add it all plus more in the spring.)

    I was so excited by the 5:2 idea and started it just last week. I am finding it easy so far, and I match the fast days to days when my schedule doesn’t allow as much exercise anyway. I’m on an Animas Ping pump. Don’t yet have CGM, but test my bg a lot on fast days, and it’s worked fine. Though I have to occasionally eat a glucose tab or two to keep on an even keel, the lowered blood sugars of fast days feel really good. (I’ve been able to prevent the terrible lows by increased testing.)

    Honestly, I’m excited by this because a) I think it will match well to my variable schedule, b) I will be able to keep it up without that horrible “never eat normally again” kind of thing most diets seem to entail, and c) it will keep my metabolism from adjusting to the lower calorie intake. I have had the issue of my weight loss flattening out after a few weeks even though I keep calories restricted, and I know it’s because my body adjusts to the lower calories. I’m hoping that this intermittent fasting will prevent that. It just makes sense to me, though I will talk with my endo about it next time I see him.

    I have to say that those who try this without a pump are braver souls than me, but with a pump it doesn’t seem that complicated.

    I’m Type 1 and I have just begun the 5:2 diet. I am recording my progress on my blog DiabetesFirsthand.com (I’m not sure I’m allowed to link to the particular post).

    For progress I am recording Date, Weight and Comments. I wonder if you, Dr Michael & team would like me to add anything else to my records?

    I don’t think blood sugar readings would be much use since having done DAFNE I measure before meals and the reading would tend to be untypical.

    been on pump for 7 years. I think great care in regulary monitoring blood sugars whilst doing this diet but we do that anyway especially on fast days. i dont worry if my blood sugar drops re my calorie intake for the day. on fasting days i have found reducing my basal levels by 10% works for me and for bolus i’m usually on a 1:1.5 and on fasting days reduce to 1:1 this seems to reduce risk of hypoglycaemia. I have found my weight increasing insiuously since being on the pump as i can seem to eat with impunity and keep good control but at risk of becoming sumo like especially on all inclusive holidays! think the watchword is even more regular monitoring and i eat thing which release slowly eg porridge oats for breakfast

    I very much agree that you should consider reducing your basal levels. I think each of us needs to work out our individual requirements.

    Fasting yesterday, last night I took no basal insulin (I took it this morning) and yet at 3am I awoke with a BG of 4.7mmol/l. Yesterday I exercised whilst fasting and I find that lowers BG levels more than usual.

    Also I probably produce some insulin myself so that is why I say we all have to work out our own methods. So good luck to you.

    I have lost a stone and I feel great. I am charting my progress at http://www.diabetesfirsthand.com/diet-food/the-52-intermittent-fast-diet-with-type-1-diabetes/

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