Low Carb diet problems Type 1

sudsandsoda

Active Member
Messages
44
Type of diabetes
Type 1
Treatment type
Insulin
Hello,

I was originally misdiagnosed as Type 2, now officially Type 1 with Lantus & NovoRapid.

When I had my original diagnosis 5 weeks ago, I immediately went onto a strict LCHF diet. This was amazing for my BG levels. However I was continually in Ketosis and loosing weight. This was after an already large weight loss pre diagnosis (5 months, 10kg). I’m a skinny chap already! I was also knackered all the time. There is no way I could have eaten more to keep the weight loss off and enough calories coming in.

When I saw the diabetes specialist nurse last week, and received my proper T1 diagnosis she was happy with what I’d managed to do with my BG levels but concerned about my high Ketosis and constant weight loss and suggested the LCHF wasn’t for sustainable long term for me.

She has recommended I reintroduce carbohydrates. Which I am doing gradually, and compensating with the NovoRapid.

Just wondered what people think about this. I’m happy to reintroduce carbs personally, but I will do it cautiously of course. I’ve never eaten an obscene amount of carbs.

I do feel though that the standard LCHF diet just isn’t compatible with me. Has anyone else had to go for a more gentle approach to the diet?

Thanks,
Jx.
 
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There are people with type 1 diabetes who follow a low carb diet but I think the motivation is different than for people with type 2.
With type 1, the low carb diet helps to avoid the risk of insulin dose miscalculations. Or at least, it you do make a mistake, the impact is much less.

However, there are many people with type 1 who do not need to reduce their carb intake as long as they dose with fast acting insulin.
 

michita

Well-Known Member
Messages
479
Type of diabetes
Type 1
Treatment type
Insulin
Hello,

I was originally misdiagnosed as Type 2, now officially Type 1 with Lantus & NovoRapid.

When I had my original diagnosis 5 weeks ago, I immediately went onto a strict LCHF diet. This was amazing for my BG levels. However I was continually in Ketosis and loosing weight. This was after an already large weight loss pre diagnosis (5 months, 10kg). I’m a skinny chap already! I was also knackered all the time. There is no way I could have eaten more to keep the weight loss off and enough calories coming in.

When I saw the diabetes specialist nurse last week, and received my proper T1 diagnosis she was happy with what I’d managed to do with my BG levels but concerned about my high Ketosis and constant weight loss and suggested the LCHF wasn’t for sustainable long term for me.

She has recommended I reintroduce carbohydrates. Which I am doing gradually, and compensating with the NovoRapid.

Just wondered what people think about this. I’m happy to reintroduce carbs personally, but I will do it cautiously of course. I’ve never eaten an obscene amount of carbs.

I do feel though that the standard LCHF diet just isn’t compatible with me. Has anyone else had to go for a more gentle approach to the diet?

Thanks,
Jx.

Hi, I was diagnosed 3 years ago and went on a strict low carb high fat diet straight away and I’m still on the diet and I feel it’s the right diet being T1 for me. The lchf diet suites me well, my bs level is good and I have less to worry about. But after 3 years I am less strict... If you are type 1 you have the option in terms of how much carbs to eat and it’s entirely up to you to decide the amount of carbs you eat and feel comfortable and be in control.

You can gain weight on a lchf diet. I gained 7 or 8kg. You just need to up your fat and protein intake, fat especially.

Personally I believe strongly that HCPs should recommend a lchf diet as an option to manage type 1 but sadly that’s usually not the case.

Good luck and all the best :)
 
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sudsandsoda

Active Member
Messages
44
Type of diabetes
Type 1
Treatment type
Insulin
Hi, I was diagnosed 3 yeas ago and went on a strict low carb high fat diet straight away and I’m still on the diet and I feel it’s the right diet being T1 for me. The lchf diet suites me well, my bs level is good and I have less to worry about. But after 3 yeas I am less strict... If you are type 1 you have the option in terms of how much carbs to eat and it’s entirely up to you to decide the amount of carbs you eat and feel comfortable and be in control.

You can gain weight on a lchf diet. I gained 7 or 8kg. You just need to up your fat and protein intake, fat especially.

Personally I believe strongly that HCPs should recommend a lchf diet as an option to manage type 1 but sadly that’s usually not the case.

Good luck and all the best :)

Thank you, great to know it works for some people. I just don’t seem to be compatible with it.

I was eating a lot of high fat food. Cheese all the time, and avocados, cream, nuts, full fat yoghurt. Obviously along will loads of fresh veg for nutrients. I felt like I was eating all the time.
But the weight was still dropping off and I felt like junk.

Never mind, it was worth it for the initial BG control!
 

Resurgam

Expert
Messages
9,849
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
As you are type one you would be unable to make use of the foods you ate before being provided with insulin to correct the problem.
Your nurse obviously doesn't know her subject.
I'm just a BSc - but the function of insulin and the reason for its use to treat diabetes was 'A' level Biology stuff 50 years ago. Was I the only one paying attention?
 

sudsandsoda

Active Member
Messages
44
Type of diabetes
Type 1
Treatment type
Insulin
As you are type one you would be unable to make use of the foods you ate before being provided with insulin to correct the problem.
Your nurse obviously doesn't know her subject.
I'm just a BSc - but the function of insulin and the reason for its use to treat diabetes was 'A' level Biology stuff 50 years ago. Was I the only one paying attention?

She does know her subject very well, she was incredibly informative and knowledgeable and a renowned expert in the area. I apologise if I implied otherwise.
Her, and my dietitian simply suggested that a strict LCHF may not be suitable for me and they wouldn't recommend it long term at the levels I was aiming for - I was eating less that 20-25g per day.
 

Resurgam

Expert
Messages
9,849
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
It just seems strange that the weightloss is blamed on the diet rather than the lack of insulin.
 
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kitedoc

Well-Known Member
Messages
4,783
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
black jelly beans
Hi again @sudsandsoda if you look up dietdoctor.com you will see that people tend to suffer from what is called ketoflu when they change their main metabolism from sugar to fat burning.
And that tends to occur in the forst week on a very low carb diet.
And the explanation if this time also includes the fact that as insulin doses fall according to the lowering of carbs so we retain less sodium and magnesium.
Thus increase in sodium say by eating saltier food or adding salt and using magnesium supplements help to ease the flu and stop the longlasting tiredness.
But in your case i agree with @Resurgam, to gain weight insulin is needed.
And the usual thing is to also allow for the fact that 50% of the grams of protein eaten are counted as carbs.
The more cheese you ate the more insulin would be needed.
Being underweight could very well have reset your appetite but that increase in protein intake needed insulin, a tyoe of growth hormone, to be present.
My understanding of ketones is that as long as one is hydrated and has sufficient insulin on board that nutritional ketosis as it is called is not dangerous , but you need perhaps to discuss that further with your health team.
It certainly sounds like any ketosis should not be aimed at achieving weight loss in your current state and i infer this may be what your health team is telling you.
Whether you are totally unsuited to liw carb/ keto diet in the future is a moot point. Lots of TIDs survive quitecwell on such diets longterm. I susoect your health team may not see mant Tids on such diets. They seem almost nervous of such diets. At least that is my sense of what you describe.
Low carb diet is variously defined as eating less than 120 g carbs per day, but my understanding from people like Dr Bernstein is that when one gets below 30 g carbs per day, counting 50% of grams of protein as carbs becomes important.
Before low carb and keto diet became popular i gather few people realised that insulin made the body retain sodium. So now the fact that type 2 diabetics have excess insulin releases at thevwring tine helps explain why they may suffer from high blood pressure as sodium retention can kead to raised blood pressure.
So for us and any health professionals who have bothered to remove blinkers and read up and even learn from patients. The effects of low carb/ keto diet can hold some surprises.
 

sudsandsoda

Active Member
Messages
44
Type of diabetes
Type 1
Treatment type
Insulin
Hi again @sudsandsoda if you look up dietdoctor.com you will see that people tend to suffer from what is called ketoflu when they change their main metabolism from sugar to fat burning.
And that tends to occur in the forst week on a very low carb diet.
And the explanation if this time also includes the fact that as insulin doses fall according to the lowering of carbs so we retain less sodium and magnesium.
Thus increase in sodium say by eating saltier food or adding salt and using magnesium supplements help to ease the flu and stop the longlasting tiredness.
But in your case i agree with @Resurgam, to gain weight insulin is needed.
And the usual thing is to also allow for the fact that 50% of the grams of protein eaten are counted as carbs.
The more cheese you ate the more insulin would be needed.
Being underweight could very well have reset your appetite but that increase in protein intake needed insulin, a tyoe of growth hormone, to be present.
My understanding of ketones is that as long as one is hydrated and has sufficient insulin on board that nutritional ketosis as it is called is not dangerous , but you need perhaps to discuss that further with your health team.
It certainly sounds like any ketosis should not be aimed at achieving weight loss in your current state and i infer this may be what your health team is telling you.
Whether you are totally unsuited to liw carb/ keto diet in the future is a moot point. Lots of TIDs survive quitecwell on such diets longterm. I susoect your health team may not see mant Tids on such diets. They seem almost nervous of such diets. At least that is my sense of what you describe.
Low carb diet is variously defined as eating less than 120 g carbs per day, but my understanding from people like Dr Bernstein is that when one gets below 30 g carbs per day, counting 50% of grams of protein as carbs becomes important.
Before low carb and keto diet became popular i gather few people realised that insulin made the body retain sodium. So now the fact that type 2 diabetics have excess insulin releases at thevwring tine helps explain why they may suffer from high blood pressure as sodium retention can kead to raised blood pressure.
So for us and any health professionals who have bothered to remove blinkers and read up and even learn from patients. The effects of low carb/ keto diet can hold some surprises.


Thanks very much for this! And @Resurgam I now see your point. I think I may have not explained myself very well in my original post. My team weren't implying that the diet was causing my weight loss as such. I was being very strict with myself, and I think to be honest they were more concerned about the emotional strain it may be adding onto me at the moment.
My keytones were ++++, so I also think they wanted me to avoid anything that could add to that and be confused with ketoacidosis.
I'm certainly not throwing low carb out of the window, I'm just allowing myself to be a little more flexible.
Since starting insulin, I've just had my first completely negative ketone test in 6 weeks, which as you mention for me simply from a weight loss point of view is positive news!
Thanks both.
 
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Mathewted

Well-Known Member
Messages
51
Type of diabetes
Type 1
Treatment type
Insulin
Hello,

I was originally misdiagnosed as Type 2, now officially Type 1 with Lantus & NovoRapid.

When I had my original diagnosis 5 weeks ago, I immediately went onto a strict LCHF diet. This was amazing for my BG levels. However I was continually in Ketosis and loosing weight. This was after an already large weight loss pre diagnosis (5 months, 10kg). I’m a skinny chap already! I was also knackered all the time. There is no way I could have eaten more to keep the weight loss off and enough calories coming in.

When I saw the diabetes specialist nurse last week, and received my proper T1 diagnosis she was happy with what I’d managed to do with my BG levels but concerned about my high Ketosis and constant weight loss and suggested the LCHF wasn’t for sustainable long term for me.

She has recommended I reintroduce carbohydrates. Which I am doing gradually, and compensating with the NovoRapid.

Just wondered what people think about this. I’m happy to reintroduce carbs personally, but I will do it cautiously of course. I’ve never eaten an obscene amount of carbs.

I do feel though that the standard LCHF diet just isn’t compatible with me. Has anyone else had to go for a more gentle approach to the diet?

Thanks,
Jx.

Hello

I have been treated as living with T1DM for 30 odd years and have always been given healthcare advice that pretty much mirrored what my standard diet was before diagnosis and attempted to balance sugars with insulin - albeit first with mixed insulin twice a day and then with the not so 'rapid' and not so long lasting basal/bolus.

I started a Ketogenic lifestyle to get healthy and to balance glucose levels as part of this and it has worked superbly with my Freestyle Libre glucose meter estimating my current HbA1c at 5.0% (31mmol/mol) - I'm told that this is better than most people who do not live with T1DM and my suggestion is that maybe those people risk insulin resistance and T2DM as a consequence so perhaps they should adopt Keto / LCHF.

Im not keen to add carbs back in to my diet for the simple reason that in ketosis there are ill-defined but very real cognitive and energy benefits - it seems mitochondria are well suited to ketones as fuel rather than glucose. My only real concern is the weight and so i do a small (and I mean really small at the moment) amount - but increasing - of High intensity Interval Training every other day and immediately after have about 20 grams of a mix of carbs - half from a source of glucose like kombucha or a slice of gluten and whet free bread and half fructose like juice. The i eat much more fat than is usual on the keto diet and hope that this is going to help give me a calorie surplus and build muscle rather than fat.

One other thing i've noticed and this - like all the above - should not be used for your own therapy and treatment is that my cognitive and muscular-skeletal functioning while in ketosis is better even when my glucose level drops down below 3.0 mmol/l - i couldn't believe it at first but - while i don't really want this it has been off the scale LO at times because I have not noticed it; i did have diminished warning signs but if ever I was below 3 I used to get somewhat confused, panicky, and shaky until necking 100ml of juice!

Having said all that it is paramount that you understand your own body, consult with the HCPs - even if you disagree with them so that they can still monitor progress - and listen to your body. My question if my nurse had told me to re-introduce carbs is "Why?" and if it was in order to put fat back on then it feels like I wouldn't want that as most would be probable that it would be around my organs thus putting strain on all my metabolic functions not to mention increasing the amount of insulin that would increase insulin resistance and drive other metabolic disease consequences but also give me a renewed risk of hypos while carbohydrate adapted thus being risky in comparison to my current clinical hypos which cause neither the previous bad feeling not the catastrophic seizures, and I would be asking for a better solution.

That's some of my journey and I hope it helps you to look into all the ups and downs in order to get things right for you.

Mat
 

michita

Well-Known Member
Messages
479
Type of diabetes
Type 1
Treatment type
Insulin
Hello

I have been treated as living with T1DM for 30 odd years and have always been given healthcare advice that pretty much mirrored what my standard diet was before diagnosis and attempted to balance sugars with insulin - albeit first with mixed insulin twice a day and then with the not so 'rapid' and not so long lasting basal/bolus.

I started a Ketogenic lifestyle to get healthy and to balance glucose levels as part of this and it has worked superbly with my Freestyle Libre glucose meter estimating my current HbA1c at 5.0% (31mmol/mol) - I'm told that this is better than most people who do not live with T1DM and my suggestion is that maybe those people risk insulin resistance and T2DM as a consequence so perhaps they should adopt Keto / LCHF.

Im not keen to add carbs back in to my diet for the simple reason that in ketosis there are ill-defined but very real cognitive and energy benefits - it seems mitochondria are well suited to ketones as fuel rather than glucose. My only real concern is the weight and so i do a small (and I mean really small at the moment) amount - but increasing - of High intensity Interval Training every other day and immediately after have about 20 grams of a mix of carbs - half from a source of glucose like kombucha or a slice of gluten and whet free bread and half fructose like juice. The i eat much more fat than is usual on the keto diet and hope that this is going to help give me a calorie surplus and build muscle rather than fat.

One other thing i've noticed and this - like all the above - should not be used for your own therapy and treatment is that my cognitive and muscular-skeletal functioning while in ketosis is better even when my glucose level drops down below 3.0 mmol/l - i couldn't believe it at first but - while i don't really want this it has been off the scale LO at times because I have not noticed it; i did have diminished warning signs but if ever I was below 3 I used to get somewhat confused, panicky, and shaky until necking 100ml of juice!

Having said all that it is paramount that you understand your own body, consult with the HCPs - even if you disagree with them so that they can still monitor progress - and listen to your body. My question if my nurse had told me to re-introduce carbs is "Why?" and if it was in order to put fat back on then it feels like I wouldn't want that as most would be probable that it would be around my organs thus putting strain on all my metabolic functions not to mention increasing the amount of insulin that would increase insulin resistance and drive other metabolic disease consequences but also give me a renewed risk of hypos while carbohydrate adapted thus being risky in comparison to my current clinical hypos which cause neither the previous bad feeling not the catastrophic seizures, and I would be asking for a better solution.

That's some of my journey and I hope it helps you to look into all the ups and downs in order to get things right for you.

Mat

I remember reading posts from a type 1 member on keto diet on this forum talking about exactly the same with regards to what happens at low level. Interesting, although personally I wouldn’t want to go below 4 and I eat too much veggies to call my diet keto :-D
 

ringi

Well-Known Member
Messages
3,365
Type of diabetes
Type 2
Unless your BMI is high, and clearly yours is not, with LCHF you need to eat more fat then most people consider to be healthy. Ideally this fat comes from natural sources like ribeye streaks and 20% fat mince along with lots of olive oil.

Personally if I was you, I would increase carbs to about 150g per day until you have learned enough to manage your type1 yourself, then research low carb diet for type1 in detail.
 

sudsandsoda

Active Member
Messages
44
Type of diabetes
Type 1
Treatment type
Insulin
Hello

I have been treated as living with T1DM for 30 odd years and have always been given healthcare advice that pretty much mirrored what my standard diet was before diagnosis and attempted to balance sugars with insulin - albeit first with mixed insulin twice a day and then with the not so 'rapid' and not so long lasting basal/bolus.

I started a Ketogenic lifestyle to get healthy and to balance glucose levels as part of this and it has worked superbly with my Freestyle Libre glucose meter estimating my current HbA1c at 5.0% (31mmol/mol) - I'm told that this is better than most people who do not live with T1DM and my suggestion is that maybe those people risk insulin resistance and T2DM as a consequence so perhaps they should adopt Keto / LCHF.

Im not keen to add carbs back in to my diet for the simple reason that in ketosis there are ill-defined but very real cognitive and energy benefits - it seems mitochondria are well suited to ketones as fuel rather than glucose. My only real concern is the weight and so i do a small (and I mean really small at the moment) amount - but increasing - of High intensity Interval Training every other day and immediately after have about 20 grams of a mix of carbs - half from a source of glucose like kombucha or a slice of gluten and whet free bread and half fructose like juice. The i eat much more fat than is usual on the keto diet and hope that this is going to help give me a calorie surplus and build muscle rather than fat.

One other thing i've noticed and this - like all the above - should not be used for your own therapy and treatment is that my cognitive and muscular-skeletal functioning while in ketosis is better even when my glucose level drops down below 3.0 mmol/l - i couldn't believe it at first but - while i don't really want this it has been off the scale LO at times because I have not noticed it; i did have diminished warning signs but if ever I was below 3 I used to get somewhat confused, panicky, and shaky until necking 100ml of juice!

Having said all that it is paramount that you understand your own body, consult with the HCPs - even if you disagree with them so that they can still monitor progress - and listen to your body. My question if my nurse had told me to re-introduce carbs is "Why?" and if it was in order to put fat back on then it feels like I wouldn't want that as most would be probable that it would be around my organs thus putting strain on all my metabolic functions not to mention increasing the amount of insulin that would increase insulin resistance and drive other metabolic disease consequences but also give me a renewed risk of hypos while carbohydrate adapted thus being risky in comparison to my current clinical hypos which cause neither the previous bad feeling not the catastrophic seizures, and I would be asking for a better solution.

That's some of my journey and I hope it helps you to look into all the ups and downs in order to get things right for you.

Mat

Thanks very much for your story Mat, really interesting!
My short stint at the Keto diet was very positive generally. My BG levels were incredibly stable, although generally a touch high.
I’ve certainly not ruled anything out. I’ve always been one to decide what’s best for me rather than just be told. This is the very start of a long journey for me, and I’m enjoying learning from everyone’s experiences.

All the best,
Jules.