Low carb

[slikwipman]

Your avatar says you are type 1. Type 1 can't be secondary diabetes. What is your diabetes secondary to? Would you mind clarifying?

Personally, I can't really understand why a type 1 diabetic would be so emphatically distressed with the medical advice on carbs because the advice for type 1s is: eat however many carbs you want just so long as you are appropriate adjusting your insulin. So however many carbs you want to eat is entirely your personal choice. It's a little odd to be wanting or expecting medical advice on diet choices as a type 1 because the condition is not caused by, or managed by, diet. Any dietician input is usually on how to count carbs and how to anticipate the timing of the carb action, not whether or not to eat them.

It's secondary to pancreatitis, the doctor that diagnosed me said it is treat as type 1 but putting a label on it is not important to me. I am most certainly not distressed about advice on low carbing but was simply asking the question why so many people on this forum are. I don't worry about how many carbs I eat as I have a healthy diet

 

[slikwipman]

I think its underfunded, wasteful and top heavy. A nations health should be any governments number one priority.
If someone ever comes up with the answer to how to make healthy eating easy they will become very rich and a Noble prize winner. Hence why two thirds of the population are overweight or obese. The diets of most people are shockingly poor, but that has now become the norm. The idea that there would be many more shops selling fast food rather than meat, veg etc not so many years ago wouldn't have been entertained.

Couldn't agree more I can't remember the last time I bought a takeaway

 

[catapillar]

It's secondary to pancreatitis, the doctor that diagnosed me said it is treat as type 1 but putting a label on it is not important to me.

thats type 3c, here's a link to the type 3c section of the forum which might be of interest - http://www.diabetes.co.uk/forum/category/type-3c-pancreatic-diabetes.73/

My understanding is that some advice you might receive on the forum as a type 1 might not be appropriate for someone with type 3c who is likely to be on creon and have issues with fat digestion, so a low carb high fat diet might need to be approached with a little more caution.

 

[slikwipman]

thats type 3c, here's a link to the type 3c section of the forum which might be of interest - http://www.diabetes.co.uk/forum/category/type-3c-pancreatic-diabetes.73/

My understanding is that some advice you might receive on the forum as a type 1 might not be appropriate for someone with type 3c who is likely to be on creon and have issues with fat digestion, so a low carb high fat diet might need to be approached with a little more caution.

Type 3c does not exist. What I have is secondary diabetes due to pancreatitis. I take insulin four times a day

 

[Nidge247]

Your avatar says you are type 1. Type 1 can't be secondary diabetes. What is your diabetes secondary to? Would you mind clarifying?

Personally, I can't really understand why a type 1 diabetic would be so emphatically distressed with the medical advice on carbs because the advice for type 1s is: eat however many carbs you want just so long as you are appropriate adjusting your insulin. So however many carbs you want to eat is entirely your personal choice. It's a little odd to be wanting or expecting medical advice on diet choices as a type 1 because the condition is not caused by, or managed by, diet. Any dietician input is usually on how to count carbs and how to anticipate the timing of the carb action, not whether or not to eat them.

@catapillar

I would have liked the NHS to have offered me a lchf lifestyle rather than have me take multiple daily injections of insulin as I had to when diagnosed with D. However, even now with the huge different lchf has made to my life, my doctors and DSN who all acknowledge the improvement to my health from it, are unable to advocate it due to the current NHS guidelines. They do all however state that "whatever you are doing, keep it up as your health has improved dramatically on many levels".

Given that taking insulin used to give me huge swings in BGs, why on earth would I want to continue such treatment when such an easy lifestyle change was readily available, and would offer the opportunity to live insulin-medication free?

Note that I am T1 (diagnosed T1.5), and currently control my D solely with a lchf lifestyle. Hence your summary of management of T1's above is incorrect in my case.

 

[catapillar]

Note that I am T1 (diagnosed T1.5), and currently control my D solely with a lchf lifestyle. Hence your summary of management of T1's above is incorrect in my case.

Are you antibody positive? If not, I would seriously question whether type 1.5 is the correct diagnosis for you. If it is, then that's a very unique situation as >99.99% of type 1s cannot be managed by diet alone, no insulin is fatal.

 

[Nidge247]

Are you antibody positive? If not, I would seriously question whether type 1.5 is the correct diagnosis for you. If it is, then that's a very unique situation as >99.99% of type 1s cannot be managed by diet alone, no insulin is fatal.

I am currently producing enough insulin naturally to manage on a low carb lifestyle. I am not tested for GAD antibodies as far as I know as there were enough other symptoms to confirm LADA diagnosis as opposed to T2, and due to an HbA1c of 101 with severe hyper complications had to go onto insulin within an hour of diagnosis. I was told the GAD test is NOT 100% definitive for T1, and its results can be affected once you start on mdi insulins. Note: I am not the expert here - I can only go off what my consultant and DSN's tell me.

Where do you get your percentage figure from, as I have read it as being nearer to 75%? I agree it is unusual for T1s, but far from unique.

Having been taking basal and bolus insulin on mdi for 8 months, I was then able to slowly under supervision wean myself off it through careful use of lchf. Having been on a DAFNE course, carb counting through knowledge there taught was immensely useful for a safe transmission to safely coming off mdi insulin completely. I'm now approaching 2 years of being mdi-free.

As I have always said, T1 / T1.5 / T2 diagnosis is not of concern to me - D is simply a condition that I can manage myself and will do so that it impacts on my life as little as possible. I have enough daily challenges in my daily life already - D is simply an addition to those which now under lchf is managed on 'autopilot'. Yes, I do have to test several times a day, keep a close check on BGs and other health complications and issues - but hey, I am still here; and in my mind it is THAT what matters.

 

[dbr10]

I don't accept the argument that the NHS is under funded, just wasteful and top heavy. Changing ones diet is challenging for most people, I was myself ignorant to what a carb was until diagnosed with secondary diabetes.

Funding per head falls this year.

 

[catapillar]

Where do you get your percentage figure from, as I have read it as being nearer to 75%? I agree it is unusual for T1s, but far from unique.

It is highly unusual for a type 1 to be managed on diet alone.

To suggest that 75% of type 1s can be managed on diet alone, or even 25%, is ludicrous and suggests a misunderstanding of what type 1 is, perhaps based upon your unique experience of it. Frankly, it's dangerous to purport that a quarter of type 1s could come off insulin if they reduced their carbs. Great that it worked for you, you are either unique or misdiagnosed.

75% of type 1s are antibody positive. That could be what you are referring to. So yes, a negative GAD test is not definitive as about 25% of type 1s are GAD negative.

regardless, it seems that you are content with the dietary advice received on DAFNE, which for a type 1 is, you choose how many carbs to eat, this is how to adjust your insulin to accommodate it.

 

[Engineer88]

It is highly unusual for a type 1 to be managed on diet alone.

To suggest that 75% of type 1s can be managed on diet alone, or even 25%, is ludicrous and suggests a misunderstanding of what type 1 is, perhaps based upon your unique experience of it. Frankly, it's dangerous to purport that a quarter of type 1s could come off insulin if they reduced their carbs. Great that it worked for you, you are either unique or misdiagnosed.

75% of type 1s are antibody positive. That could be what you are referring to. So yes, a negative GAD test is not definitive as about 25% of type 1s are GAD negative.

regardless, it seems that you are content with the dietary advice received on DAFNE, which for a type 1 is, you choose how many carbs to eat, this is how to adjust your insulin to accommodate it.

I'm another t1 who has much better control with low carbing. My activity levels mean often if I have 20g or less per meal I need very little to no insulin bolus. My basal is reduced a lot also when eating no/little carbs

 

[ringi]

I think you've hit the nail on the head with this. The general population like biscuits more than their feet and the eyes. The people on this site are in the minority. Attend one of the educational courses and you will see what I mean. The NHS doesn't want to waste time giving out advice that will be ignored anyway so eat a healthy diet is usually all the information given with no real expectations that it will be followed.

I like being able to walk to the kitchen and see the double cream I am putting on my blueberries, likewise with good cheese. I am more than willing to give up biscuits for this. Most people have never been told what they can eat while still controlling their BG hence see "diet" as being 100% negative.

 

[ringi]

I am starting to expect that there is another type of diabetes that is not related to insulin resistance (Type2) where a small number of beta cells remain functional for a very long time (unlike Type1). Unless someone with it is on very low carb, it will look 100% like Type1. Maybe it is just that some people’s beta cells can regenerate fast enough that the immune system never kills off 100% of them. Given that stopping eating wheat is well known to slow down autoimmune processes this may have something to do with it.

There have even been a few case of children with Type1 getting 100% control with low carb and coming off insulin – only time will tell if it lasts. (I am concerned about children being starved by not having enough fat and protein hence maybe this should not be talked about much unless correct LCHF support can be provided.)

Provided someone only reduces insulin in response to good BG readings and keeps checking their BG readings often for the rest of their life, ideally with ready access to insulin if the BG readings every start to increase, I don’t see any great risk. We also know (from before insulin was discovered) that most people with |Type1 can not control BG without insulin, however, few carbs they eat.

 

[slikwipman]

I am starting to expect that there is another type of diabetes that is not related to insulin resistance (Type2) where a small number of beta cells remain functional for a very long time (unlike Type1). Unless someone with it is on very low carb, it will look 100% like Type1. Maybe it is just that some people’s beta cells can regenerate fast enough that the immune system never kills off 100% of them. Given that stopping eating wheat is well known to slow down autoimmune processes this may have something to do with it.

There have even been a few case of children with Type1 getting 100% control with low carb and coming off insulin – only time will tell if it lasts. (I am concerned about children being starved by not having enough fat and protein hence maybe this should not be talked about much unless correct LCHF support can be provided.)

Provided someone only reduces insulin in response to good BG readings and keeps checking their BG readings often for the rest of their life, ideally with ready access to insulin if the BG readings every start to increase, I don’t see any great risk. We also know (from before insulin was discovered) that most people with |Type1 can not control BG without insulin, however, few carbs they eat.

Totally agree I am sure that I still produce some insulin that varies from day to day. The dose of insulin that I use when eating and exercising the same way is wildly different.

 

[zand]

Type 3c does not exist. What I have is secondary diabetes due to pancreatitis. I take insulin four times a day

And secondary diabetes due to pancreatitis is called type 3c. There's a whole forum devoted to this which could be of use to you.

 

[Kristin251]

I'm another t1 who has much better control with low carbing. My activity levels mean often if I have 20g or less per meal I need very little to no insulin bolus. My basal is reduced a lot also when eating no/little carbs

I as well have MUCH better control low carbing but I still REQUIRE insulin. If I missed it at a meal I would go up but not into orbit thanks to low carb however I would continue to rise meal after meal until I was in orbit and never come back down.

I as well take very small doses with vlc meals and basal. Without them I'd be dead.

 

[slikwipman]

And secondary diabetes due to pancreatitis is called type 3c. There's a whole forum devoted to this which could be of use to you.

Not in the uk. I am not bothered about a number but when I get inducted onto a new construction site if I say I'm type 1 they understand if I said type 3c they would not have any idea what I was on about, also someone earlier in this thread called me 3c then followed it with wholly incorrect assumptions about my condition,

 

[Jaylee]

Totally agree I am sure that I still produce some insulin that varies from day to day. The dose of insulin that I use when eating and exercising the same way is wildly different.

There could also be other "variables" involved in the mix, such as fluctuating levels of insulin resistance or liver dump?
Then there could be factors thrown in with the meds like the insulin potency changing as one comes to the end of a cartridge??
Keeping the carb count lower does smooth out that "ride!"


Talking of rides....

Hi @slikwipman ,

Great thread! However it appears to be in the wrong subsection...
I would quite happily move it for you to diabetes discussions if that's OK with you?

Have you considered my offer of parking this thread in a more appropriate place away from the "zigzag zone."??

 

[slikwipman]

There could also be other "variables" involved in the mix, such as fluctuating levels of insulin resistance or liver dump?
Then there could be factors thrown in with the meds like the insulin potency changing as one comes to the end of a cartridge??
Keeping the carb count lower does smooth out that "ride!"


Talking of rides....


Have you considered my offer of parking this thread in a more appropriate place away from the "zigzag zone."??

Move it to a place you see fit. What is liver dump? I always keep in mind what carbs I eat as I see carbs as sugar and common sense says if you're diabetic try to cut down on carbs.

 

[Jaylee]

Move it to a place you see fit. What is liver dump? I always keep in mind what carbs I eat as I see carbs as sugar and common sense says if you're diabetic try to cut down on carbs.

Moved for you. Thanks.

Liver dump. Also known as "Dawn phenominom". Don't always happen in the morning.. (Though on waking it will cut in.)
In short, a "fight or flight" response of glycogen store in the liver dropped into the blood stream. (Like a reserve tank?)
Someone put me straight if I'm wrong. But excersise can trigger it too..? BS can rise (or be maintained at level.) due to a workout & stressful situations can spike a bit too...

I wouldn't disagree with you on the carbs, or type of carb. Insulins have come a long way since I was diagnosed over 40 years back. But it still isn't a magic bullet for modern diets...
To draw an analogy from personal experience, insulin dependency & carbs is like heating a house with the old "night storage heaters"? One needs to plan well ahead to get maximum efficiency out of them.. But even the "weather man" can't always get the forcast right for the following day..!

 

[CHIET1]

@Nidge247 @Kristin251

Nidge well done on your control with diet alone. I don't think this is uncommon among those not quite full T1 and not fitting into the T2 category either. I too am one of these diabetics, I know it is referred to as 1.5 or LADA, but there is nothing definitive on it that I have found to distinguish.

Like you I have at times since diagnosis 3.5 years ago, managed with no insulin and maintained a HbA1c in the range 5.3% - 5.8% for the last 3 years. I say at times, because if I ventured off the LC path at any stage (e.g. my wedding, friends weddings) then my BS went very high and I had to use an insulin basal/bolus regime to get my numbers back down to the 4-7 mmol/L range. As I advance on this journey, it gets easier not to be tempted by refined carbs etc... However, after reading Dr. Bernstein's book, I felt I should be targeting a HbA1c <5.0%, and so I think the only way I could do this is with a VLC and small basal / bolus does like @Kristin251 .

Obviously all of us so called 1.5's or LADA diabetics are all different in that we all have different levels of insulin production remaining. I am curious though if you can achieve a truly normal HbA1c, i.e. 4.5% - 5.0% (what I believe is the normal range anyway from Dr. Bernstein's book) with just diet alone? Also, do you do a lot of intensive exercise to help manage the BS levels?

@catapillar

I would have liked the NHS to have offered me a lchf lifestyle rather than have me take multiple daily injections of insulin as I had to when diagnosed with D. However, even now with the huge different lchf has made to my life, my doctors and DSN who all acknowledge the improvement to my health from it, are unable to advocate it due to the current NHS guidelines. They do all however state that "whatever you are doing, keep it up as your health has improved dramatically on many levels".

Given that taking insulin used to give me huge swings in BGs, why on earth would I want to continue such treatment when such an easy lifestyle change was readily available, and would offer the opportunity to live insulin-medication free?

Note that I am T1 (diagnosed T1.5), and currently control my D solely with a lchf lifestyle. Hence your summary of management of T1's above is incorrect in my case.