Is a low carb diet OK for Type 1

[runner]

I'm pretty new to this site and to the issue of low carb diets. I am a long term Type 1 - diagnosed 1976 - with a recent history of coronary heart disease - 2010 - but who now does a lot of endurance running, mostly half marathons with the relevant regular training regimes, but who even with exercise is finding trouble in maintaining weight loss and in maintaining a consistently lower Hba1c return. I've read about how low carb diest can help in both those areas but mainly with reference to Type 2. Does anyone know, or can anyone point me to where I can find out more about whether low carb diets are OK for Type 1 diabetics and especially for someone who does a little more exercise than the norm and who therefore needs a higher than usual energy source, especially when running longer distances?

 

[robert72]

I've been doing very low carb (<30g) for the last couple of years and I find it much easier to control BGs. I did work my way down in steps of about 50g so I could make adjustments to basal. Now I'm in ketosis, I don't count carbs anymore - just bolus for the size of the meal.

 

[Mrs Vimes]

I do lchf and love it. I weight lift, do hiit and spin class. I haven't ran a marathon. I hate running. I'm type 1 and did something similar to robert72.

 

[Wolfhelm]

not to hijack this thread, but ive been told any ketones over .6 is bad, and ive read that low carb diets (or even no carb) cause ketosis. is it true they cause ketosis, and is that ketosis bad for a type one?

 

[robert72]

not to hijack this thread, but ive been told any ketones over .6 is bad, and ive read that low carb diets (or even no carb) cause ketosis. is it true they cause ketosis, and is that ketosis bad for a type one?

Ketoacidosis is bad for T1. That's high blood sugar lack of insulin and ketones.
Ketosis is perfectly harmless - ketones with normal blood sugars and sufficient insulin.

 

[ButtterflyLady]

not to hijack this thread, but ive been told any ketones over .6 is bad, and ive read that low carb diets (or even no carb) cause ketosis. is it true they cause ketosis, and is that ketosis bad for a type one?

According to this page, 0.6 - 1.5 needs further testing but it is not necessary to seek medical advice unless the level is over 1.5.
http://www.diabetes.co.uk/diabetes_care/testing-for-ketones.html

 

[Mrs Vimes]

I've had ketones of 2 or more with normal as in non-diabetic blood sugars. Ketosis is not a problem. DKA is a whole other ball fame, this is ketones caused by a lack of insulin combined with high blood sugars. Ketosis gives ketones caused by a lack of carbs. They are used as fuel instead of sugar.

 

[runner]

I've been doing very low carb (<30g) for the last couple of years and I find it much easier to control BGs. I did work my way down in steps of about 50g so I could make adjustments to basal. Now I'm in ketosis, I don't count carbs anymore - just bolus for the size of the meal.

Thanks for this Robert. I'm on a pump using Novorapid. As I said I'm new to the idea of a low carb diet and have really just started investigating the option as my doctors, GP and Consultant, don't encourage a discussion on the issue. On a practical question how do you calculate your bonus doseage? Although my pump will allow me to give a manual bonus its normal set up is to give a bolus relative to the amount of carbs to be consumed.

 

[runner]

I do lchf and love it. I weight lift, do hiit and spin class. I haven't ran a marathon. I hate running. I'm type 1 and did something similar to robert72.

Thanks for this. So what do you use to provide/maintain energy levels when you are exercising and what do you do when or if you encounter low BG levels during exercises?

 

[robert72]

Thanks for this Robert. I'm on a pump using Novorapid. As I said I'm new to the idea of a low carb diet and have really just started investigating the option as my doctors, GP and Consultant, don't encourage a discussion on the issue. On a practical question how do you calculate your bonus doseage? Although my pump will allow me to give a manual bonus its normal set up is to give a bolus relative to the amount of carbs to be consumed.

To start with, I counted 100% of carbs, 50% of protein and 10% of fat, but after a while it became apparent that I needed either 5 or 6 units for a meal, so now I just have a good idea by looking.

 

[runner]

To start with, I counted 100% of carbs, 50% of protein and 10% of fat, but after a while it became apparent that I needed either 5 or 6 units for a meal, so now I just have a good idea by looking.

Thanks again Robert.

I get the carbs calculation, as that's what we're all advised to do, but I don't understand the protein and fats bit. Is there a reference source somewhere about calculating insulin amounts to volume or weight of protein and fat to be consumed or did you just do it by trial and error? Reducing carbs on a pump shouldn't be a problem as the pump will just give me a reduced insulin bolus, when asked and programmed with reduced carbs level and it is capable of delivering very low doses but I'm still unclear about how to calculate the insulin which might be necessary to maintain a low BG from other food sources.

The pump allows quick correction bolus when BGs are raised but requires frequent blood testing to stay on top of them but I suppose that would answer the trial and error approach combined with copious note taking I guess until you get to your stage as we all do eventually of just knowing what is required for particular meals.

 

[robert72]

Thanks again Robert.

I get the carbs calculation, as that's what we're all advised to do, but I don't understand the protein and fats bit. Is there a reference source somewhere about calculating insulin amounts to volume or weight of protein and fat to be consumed or did you just do it by trial and error? Reducing carbs on a pump shouldn't be a problem as the pump will just give me a reduced insulin bolus, when asked and programmed with reduced carbs level and it is capable of delivering very low doses but I'm still unclear about how to calculate the insulin which might be necessary to maintain a low BG from other food sources.

The pump allows quick correction bolus when BGs are raised but requires frequent blood testing to stay on top of them but I suppose that would answer the trial and error approach combined with copious note taking I guess until you get to your stage as we all do eventually of just knowing what is required for particular meals.

I can't remember the sources for bolusing for protein or fat but those figures came up a number of times whilst googling. You get glucose via gluconeogenesis form protein and fats. More noticeable when carb intake is low. It would be worth reading Dr Bernstein's Diabetes Solution. I don't follow a diet as strict as his but it's a good reference book for low-carbing T1.

 

[donnellysdogs]

I lower carb best part of 50 years and 30+ years as a T1.

Some persons and NHS people tried to steer me towards bread, porridge etc. Made my life harder to be honest.
I can't eat any of that type of food anyway now.

Lowee carbing kept me lean and mean. Higher carbs for that period if time when encouraged to eat them put me in to what I would say was fat (for me).

I go the gym, I'm quite active with gardening. Was on a pump for 5 years but now back to MDI. Don't do intensive gym workouts like I see others do. Although they are intense to me.

Think I'm strange though as I am active all day and can keep my bloods good just with my basals. I dislike eating daytime and prefer to eat just a meal in the evening. I guess my body may just have evolved to accept this. I'm also strange I think that I find activity easier on MDI than the pump provding I think about my workload or timing to go to tbe gym before I decide how much to give for my basal.

Lower carbing has always been good for me.

 

[runner]

I can't remember the sources for bolusing for protein or fat but those figures came up a number of times whilst googling. You get glucose via gluconeogenesis form protein and fats. More noticeable when carb intake is low. It would be worth reading Dr Bernstein's Diabetes Solution. I don't follow a diet as strict as his but it's a good reference book for low-carbing T1.

Thanks Robert. I'll take a look at that.

 

[Mrs Vimes]

Hi runner, if I go low I use a 4g sugar sweet or a swig of lucozade. I'm on the pump so I change my basal rates depending on the exercise.

 

[runner]

Hi runner, if I go low I use a 4g sugar sweet or a swig of lucozade. I'm on the pump so I change my basal rates depending on the exercise.

Thanks for the reply.

Sounds as though when exercising I would just do as I do now and, like you, take the necessary free carbs when BG is low. Like you I adjust my pump basal rate for the period I'm likely to be exercising and perhaps also for a period after depending on the exercise. Just out of interest how low do you reduce your basal for exercise?

I know it's a slightly daft question, as everyone is different and the reduction would also be dependant on the type of exercise you do, but I reduce mine to between 10% and 5% of my usual basal rate depending on the length and intensity of the run I'm doing but I still find I have to consume about 25g of carb gel every 30 to 40 minutes of running and I wonder whether this would change, eventually, after adjusting to a low carb diet?

My BG is usually about 5mmol/L at the finish of runs but I can sometimes get a huge BG spike about 30 minutes after finishing which I'm currently trying to understand and deal with......

 

[noblehead]

@runner, I was also told that you should use a TBR 1-2 hours before any exercise.

 

[Mrs Vimes]

I reduce by 50% half an hour before, mostly works - but adjust with glucose / insulin as needed. Sometime

 

[zand]

This link from the BMJ answers your question re T1 and a low carb diet generally, but not necessarily T1 with exercise. Sorry I'm T2, so can't help.

www.bmj.com/content/351/bmj.h4023/rapid-responses