@tina46 your 1st post didn’t say you were diabetic but I assumed you were since you take insulin. Is it Type 1? Type 1 can lead to a complication of autonomic neuropathy such as gastroparesis over time. Type 2 often involves an insulin resistance. When I saw your 1st post the first thing I thought of was gastroparesis. Do you have two doctors that don’t agree on whether or not you have gastroparesis? There is a stomach emptying test that can be done to confirm whether you do or don’t. Your providers need to work together as a team & get on the same page in order to coordinate a health plan that will be beneficial to you. I’ve been diabetic for 44 years and have a history of gastroparesis. What I’ve learned is that carbs are your body’s 1st fuel choice. If you can’t metabolize them properly because of some type of diabetes your body will use fat but that is not the preferred first source. It does take longer to be utilized and too much of it is toxic in your system. (Ketones & acetones or ketoacidosis.) Really heavy exercise can lead to ketoacidosis, especially if you are diabetic and getting too much fat. Gastroparesis is an autonomic neuropathy. The nerves that help operate your internal organs are damaged. In this case it is your stomach and it doesn’t empty properly or in a timely fashion. That can wreak havoc on your blood sugar. Have you ever been instructed to do pre and post prandial blood sugar tests (before & after eating)? It is a way of finding out how what you eat effects your blood sugar and how effective your insulin is. Those tests are a bit unreliable because of the lack of stomach emptying in gastroparesis. In gastroparesis your food sits in your stomach and rots. If it gets bad enough you can develop all sorts of GI troubles: severe pain, nausea, vomiting, constipation, diarrhea (quite wretched)! I’ve been hospitalized twice from it. The first time I had the tests, got diagnosed, got some medication and got dietary counseling. From dietary I learned that normally fiber is great for diabetes because it helps moderate blood sugar. If you are counting carbs you can subtract some of the grams of fiber carbs from the total because you don’t absorb them as readily as more simple carbs. Fiber carbs can improve satiety. You are satisfied with less. But these are the things that make them intolerable for gastroparesis. So I came away with a very bland, not highly nutritious meal plan that consisted of very small but more frequent snack like meals. The medication worked like a charm but turned out to have neurological properties that caused a movement disorder. (That resulted in a 3 year nightmare!) The second hospitalization I ended up with a prescription of an antibiotic “off label” (prescribed for something other than what it is usually intended for) because of its stomach motility properties. I don’t have an infection but the antibiotic helps my stomach to empty properly. I’m sorry that this is long. I really think you need to get your providers to work together to figure out what is wrong and what to do about it.

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