Type 1: Dr bernstein diabetes solution book / diet

[dbr10]

A HbA1C of 39 in a type 1 often raises questions as to whether the good result is achieved by running hypo more than anyone would want. Sounds like @Kerryannhogan (just like me) has a low HbA1C by putting up with a lot of hypos, which hide the nasty spikes & complications.

Thanks for explaining that. I am quite ignorant about type 1 I'm afraid. But that obviously makes sense and explains why the doctor would have been concerned. There must be others with more experience here who can offer advice.

 

[Kerryannhogan]

A HbA1C of 39 in a type 1 often raises questions as to whether the good result is achieved by running hypo more than anyone would want. Sounds like @Kerryannhogan (just like me) has a low HbA1C by putting up with a lot of hypos, which hide the nasty spikes & complications.

I haven't tried low carbing yet @Kerryannhogan , it's something I'm looking into. The low carb bit of the forum has lots of tips about doing it on a budget.

@mentat are you able to give any advice on insulin adjustment when going low carb? If I were to jump in both feet low carbing tomorrow is there anything I should be looking out for, could there be an impact on my ratios or basal rates? I'd be worried that removing all carbs would also remove my (already pretty flimsy) resilience against hypos so any tips would be much appreciated.

Hi you have hit the nail on the head I'm having more hypos than anyone could imagine and I have horrible blood sugars after meals too! I think lantus doesn't suit me either but I'm going on a pump so my basal should be corrected soon, as for my meals I hardly eat much but when I do it has healthy carbs.. but just like you I'm considering the diet from the book... let me know how it goes for you !

 

[Kerryannhogan]

Hi @Kerryannhogan Do bear in mind that some of the replies here are from Type 2s who may treat their diabetes with diet only.

Yeah thanks for the heads up

 

[azure]

Hi you have hit the nail on the head I'm having more hypos than anyone could imagine and I have horrible blood sugars after meals too! I think lantus doesn't suit me either but I'm going on a pump so my basal should be corrected soon, as for my meals I hardly eat much but when I do it has healthy carbs.. but just like you I'm considering the diet from the book... let me know how it goes for you !

A pump should help a lot Once you get your basal right, then you can concentrate on any spikes if you're still having them. I think I suggested having your bolus earlier (sorry if I've got confused and that wasn't you).

For meals, I found it really helps to eat the same thing for a few days, and find a bolus dose that works for that meal, then you can move on and sort the other meals. Doing one segment of the day at a time is good because it can be overwhelming and stressful if your sugars are running mad all the time.

 

[Kerryannhogan]

A pump should help a lot Once you get your basal right, then you can concentrate on any spikes if you're still having them. I think I suggested having your bolus earlier (sorry if I've got confused and that wasn't you).

For meals, I found it really helps to eat the same thing for a few days, and find a bolus dose that works for that meal, then you can move on and sort the other meals. Doing one segment of the day at a time is good because it can be overwhelming and stressful if your sugars are running mad all the time.

Hey yeah we spoke before I started bolus insulin 20 mins before and they went fab but then hypo 2 hours after and then the rollercoaster begins haha! hopefully this pump will sort me right out... I know brown basmati rice with nuts in is so good for my blood levels, but they run so low after.. I think my dosages are far to high but I'm on such little doses! I have 5 units with every meal and I still hypo but then cause I overtreat it goes shockingly high

 

[robert72]

Hi @Kerryannhogan - I've been low carbing for about 2.5 years and found it's the best way to keep HbA1c low whilst avoiding hypos. I did have laser treatment for retinopathy at the end of the 90s but it has been stable ever since - there are no guarantees but it's not necessarily progressive.

 

[Kerryannhogan]

Hi @Kerryannhogan - I've been low carbing for about 2.5 years and found it's the best way to keep HbA1c low whilst avoiding hypos. I did have laser treatment for retinopathy at the end of the 90s but it has been stable ever since - there are no guarantees but it's not necessarily progressive.

it does seem that low carbing is the best way, what type of carbs do you eat can I ask?

 

[azure]

Do you have a half unit pen? Ideal if you're only on tiny doses.

I'm ok with basmati rice but my DSN said that it's got the lowest GI of all rices and recommended I use an extended bolus on my pump for it (not having all then bolus at one time). The pump is great for boluses too

 

[robert72]

it does seem that low carbing is the best way, what type of carbs do you eat can I ask?

They mainly come from vegetables and mostly with my evening meal, otherwise I get a few from berries, yoghurt, cream etc.

 

[catapillar]

Hey yeah we spoke before I started bolus insulin 20 mins before and they went fab but then hypo 2 hours after and then the rollercoaster begins haha! hopefully this pump will sort me right out... I know brown basmati rice with nuts in is so good for my blood levels, but they run so low after.. I think my dosages are far to high but I'm on such little doses! I have 5 units with every meal and I still hypo but then cause I overtreat it goes shockingly high

O gosh it sucks doesn't it? I agree with @azure , hopefully a pump will be really helpful (I have my heart set on one too).

Are you carb counting? Cos 5u with every meal sounds like maybe you aren't? I'd be amazed if everymeal had exactly the same amount of carbs in. It is a pain in the bum, but worth doing a bit of weighing so you can be confident you know the carb content of your favourite meals - you might find that you can drop a unit and maybe avoid the hypo later on?

Are there any patterns to your hypos? I find im most at risk of dropping in the morning when I'm most insulin sensitive, so I need to vary my ratios through the day. If you can spot patterns you might be able to figure out some sort of coping mechanism.

If you are going to low carb it might be worth discussing with your DSN. I just mention this because I have read that fast tightening of control can lead to worsening of retinopathy which then goes on to improve with the better control (it's just the sudden change can cause it to get worse before the improvement). So if you already have complications it is worth talking through any big changes with your diabetic team to avoid any sudden shocks.

 

[Wurst]

I followed his regime diet for 3 years strictly i.e. less than 30 grams of carbs per day. I had to stop the high fat part due to a cholesterol problem. Around 1 year ago I started eating a higher carb intake in the evening and keeping to a low carb, low fat, medium protein during the day. I still stick to Bernstein exercise recommendations i.e. daily and strenuous and try to attain his HBA1C recommendations of 4.6 %.

Overall my HBA1C has slightly improved with the higher carbs , last one was 4.9% and I've only had 3 hypos in 2016 and rarely exceed 5.5 mmol. After reading Bernstein I was scared of carbs and stayed well away from anything with >7 grams of carbs , only by accident did I discover I could handle higher carbs in the evening.

Ultimately you should find out what's best for you.

 

[Kerryannhogan]

O gosh it sucks doesn't it? I agree with @azure , hopefully a pump will be really helpful (I have my heart set on one too).

Are you carb counting? Cos 5u with every meal sounds like maybe you aren't? I'd be amazed if everymeal had exactly the same amount of carbs in. It is a pain in the bum, but worth doing a bit of weighing so you can be confident you know the carb content of your favourite meals - you might find that you can drop a unit and maybe avoid the hypo later on?

Are there any patterns to your hypos? I find im most at risk of dropping in the morning when I'm most insulin sensitive, so I need to vary my ratios through the day. If you can spot patterns you might be able to figure out some sort of coping mechanism.

If you are going to low carb it might be worth discussing with your DSN. I just mention this because I have read that fast tightening of control can lead to worsening of retinopathy which then goes on to improve with the better control (it's just the sudden change can cause it to get worse before the improvement). So if you already have complications it is worth talking through any big changes with your diabetic team to avoid any sudden shocks.

Hey no i do carb count but ive been making all my food make up for 50grams including snacks like a yogurt... i use to be on 2-3 units a meal but i was underweight so now ive gone to 5 units but now all these complications are coming on and i just wonder if its the carbs that are bringing it on cause ive only had diabetes 2 years and I'm suffering? thought it was long term... I'm definitely going to take on board everyones advice and try, all it can to is be a hit and miss... its usually dinner/tea time i drop a lot but my night time insulin makes me hypo 2 hours after (lantus) and that's maybe 5 hours after my fast acting insulin so i doubt its that... i am definitely going to rely on this pump to make me healthier and in control ... oh wow i had no idea it can make things worse before improving, thanks for the heads up

 

[catapillar]

its usually dinner/tea time i drop a lot but my night time insulin makes me hypo 2 hours after (lantus) and that's maybe 5 hours after my fast acting insulin so i doubt its that...

I think quite a few people find lantus to be somewhat unpredictable. I'm certainly not a fan of lantus & am much happier on a split dose of levemir. It might be worth looking into an alternative background insulin while you wait for your pump, especially if lantus is putting you at risk of night time hypos. I think @tim2000s would be able to point you to more information on issues with lantus, if you are interested.

 

[Juicyj]

I can vouch for the stability of Tresiba/Degludec, only 1 injection a day and it lasts around 36 hours, it reduces night time hypos due to its stability, very flat profile. I was on this before I went onto the pump and recommend it.

I have been diagnosed 4 years and have had background retinopathy for the past 2 years, I believe my issues were bought about due to the time I was undiagnosed although I was very poorly for a week and onset very sudden I think I went a long time undetected, I read Bernsteins book and although adopt low carb pretty much 5 days a week I relax a little at weekends and will eat choc, have a glass of wine, but have stabilised my bg levels much more, at one point early on I was yo-ing a lot high and low, low carb has helped hugely, I have only recently had my eye test come back as normal. The book to me was a revelation in self management, and comforting also to be written by a type 1 who is now in his 80's living a complication free life.

Watch out for hidden carbs tho like milk, and protein also converts to sugar so you still need to inject some quick acting to cover it, there isn't necessarily a free lunch with lo carbing

 

[Kerryannhogan]

I can vouch for the stability of Tresiba/Degludec, only 1 injection a day and it lasts around 36 hours, it reduces night time hypos due to its stability, very flat profile. I was on this before I went onto the pump and recommend it.

I have been diagnosed 4 years and have had background retinopathy for the past 2 years, I believe my issues were bought about due to the time I was undiagnosed although I was very poorly for a week and onset very sudden I think I went a long time undetected, I read Bernsteins book and although adopt low carb pretty much 5 days a week I relax a little at weekends and will eat choc, have a glass of wine, but have stabilised my bg levels much more, at one point early on I was yo-ing a lot high and low, low carb has helped hugely, I have only recently had my eye test come back as normal. The book to me was a revelation in self management, and comforting also to be written by a type 1 who is now in his 80's living a complication free life.

Watch out for hidden carbs tho like milk, and protein also converts to sugar so you still need to inject some quick acting to cover it, there isn't necessarily a free lunch with lo carbing

Aww haha thankyou for that little info with the milk and protein, ive been eating low carbs for 2 days and found my blood sugars are so steady but I also get hungry so quickly cause I eat a piece of meat and then loads of veggies, but somehow after 2 hours I feel hungy again ... I'm still reading some of the book I'm halfway through although I did have a huge skip to the diet part when I first got it haha! its really good!

 

[Juicyj]

The hunger will pass, it's almost like weaning yourself off carbs type of feeling, well done it is a really good read, I couldn't put it down

 

[jcdevine]

I've just read this with interest as I have only recently discovered Dr Bernstein and am in awe of his achievements. Armed with a Freestyle Libre sensor, I decided to try his approach for one week and see what effects it had on my terrible control (type 1 for 42 years since the age of 4). In just a few days I had stabilised so much, my average came right down and I feel great. I have chickens, so the diet includes a lot of eggs, which makes it very cheap to do for me. I also grow my own veg, so whatever is harvestable goes in the frying pan with an egg and a bit of cheddar. It always seems delicious to me! I am going to continue...just wish I could afford the Libre full time, as this is a huge help. Would love to hear how you are getting on now Kerry Ann Hogan. Hope its worked for you.

 

[Kristin251]

I have been vlc and follow bernsteins recommendations for years. I take very small doses of insulin and don't hypo anymore. When I ate carbs I was always on a roller coaster. I love his laws of small numbers principles. I have found my meals and macros to match my dose so I rarely have a meter surprise. I do eat a higher fat calorie diet, I keep carbs under 20 day and moderate amounts of protein as they can raise bs too but just later, usually after my insulin is gone.
I need a fatty low / no carb, no protein bf as this time of day I am very insulin resistant.
I eat avocado with celery and radish slices for bf and bolus 1/2-1 depending on my fasting. One hour later I take 1/2 unit to stop the morning rise.
Lunch is more avocado and lately smashed into a slice of turkey and wrapped up either just like that or on a large piece of lettuce and a handful of veggies
Dinner is more avocado ( I'm the avocado queen!) some veggies and a small salad with some protein.

I love tuna, chicken, turkey, egg salad with mayo on a large lettuce wrap.
I do eat lamb, beef, and often fish.
All my carbs come from above ground veg, avocado ( the fat and fiber help stop the spikes and drops and keep my super steady) and a few nuts.
My fats are mostly avocado, nuts, pumpkin seeds, mayo, olive oil.

If you're used to higher carbs it will be an adjustment but all delishous food. You will see your bs drop so will have to make sure you adjust your insulin accordingly. Best to talk to your diabetes team before changing your diet!

I prefer to eat 4 small snack size meals a day and a few nuts in between for snacks. Then I take very small doses of insulin. This helps my digestion too
We are all different , have different goals, different schedules etc. I
Just found eating smaller more often allowed me to take tiny doses and stops the rollercoaster. But you need to talk to your team and decide what works for you and how to avoid those hypos!!!

 

[Kristin251]

Another thing I like about Bernstein is to eat the same macros each day at different meal and keep bf VERY low carb.
I take twice the insulin in the morning for my smallest lowest carb meal of the day. I take 1/2 u it at 8. Wait 15 min and eat my avocado and celery
At noon I have 1/3 of my lunch eat the same amount of protein, 2 oz, and some veggies with avocado and at 3 I eat the other 2/3 but with a few more veg. 1/2 u it at each
At 6:30 I eat 3 oz protein, more veg and 2 handfuls salad greens and still 1/2 unit.
I'm very insulin resistant in the morning and far more sensitive as the day goes on.
Bernstaein helped me find my macros to insulin at each meal. I don't eat the same food, just the same macros. Random eating didn't work for me but it does for others. I think pumper will do much better random eating. The fat, fiber, protein and carbs all digest at different speeds and times and I could never match my insulin right so I'd rollercoaster.

Lastly, if I eat more than 3 oz protein at a meal I have to split my bolus and take 1/2 with the meal and 1/2 an hour or so later. So I prefer to spread it out throughout the day rather than have a large portion at once. It's tough when we eat out though. We don't eat out often though

 

[jcdevine]

Another thing I like about Bernstein is to eat the same macros each day at different meal and keep bf VERY low carb.
I take twice the insulin in the morning for my smallest lowest carb meal of the day. I take 1/2 u it at 8. Wait 15 min and eat my avocado and celery
At noon I have 1/3 of my lunch eat the same amount of protein, 2 oz, and some veggies with avocado and at 3 I eat the other 2/3 but with a few more veg. 1/2 u it at each
At 6:30 I eat 3 oz protein, more veg and 2 handfuls salad greens and still 1/2 unit.
I'm very insulin resistant in the morning and far more sensitive as the day goes on.
Bernstaein helped me find my macros to insulin at each meal. I don't eat the same food, just the same macros. Random eating didn't work for me but it does for others. I think pumper will do much better random eating. The fat, fiber, protein and carbs all digest at different speeds and times and I could never match my insulin right so I'd rollercoaster.

Lastly, if I eat more than 3 oz protein at a meal I have to split my bolus and take 1/2 with the meal and 1/2 an hour or so later. So I prefer to spread it out throughout the day rather than have a large portion at once. It's tough when we eat out though. We don't eat out often though

Hi Kristin
Wow! It seems you have everything really fine-tuned. Its what I am hoping to achieve eventually.. Can you just tell me what you meant by vlc, and also macros? Is this in Dr Bernstein's book? Please forgive my ignorance!
Jude