Can a diabetic 1 really eat anything?

Fra.ta said:

Is the food really the main reason for this values?

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No. Type 1 diabetes isn't trested by diet. It's treated with insulin. Management of type 1 diabetes is done by appropriate insulin use. A type 1 diabetic can eat whatever they want, if they have the right insulin management techniques to deal with it.

To learn more about carb counting, do the BERTIE online course - www.bertieonline.org.uk

Sure, in theory, it is possible for someone with type 1 to eat anything and their diabetes not to be adversely affected.
However, this can be difficult to manage - you have to count how many carbs are in every meal, calculate how much insulin to take ... and when to take it as different foods are digested at different speeds by our bodies (and every body is digests it at a different speed).
Many of us, do this.
Many others find it is much easy to limit their diet to, for example, a low carb diet.
I believe (but I may be wrong), those who restrict their carbs have lower Hb1AC.
However, it is a matter of choice and risk assessment about what diet you adopt.

There are people who have had type 1 diabetes for 50, 60 and, I think, I recently read about someone who had had type 1 for 70 years. Fifty, sixty, seventy years ago, very little was known about low carb diets or carb counting. They didn't have fast acting insulin so the concept of when to inject was alien. This shows me, it is possible to live a long life with type 1 diabetes and eat anything.

Totally!!
Type 1
48 yrs and.counting!!

Hello,

I have been a type 1 diabetic for 8 years now, currently almost 19 years old and I have to say that apart of little adjustments, I didn't much change my diet with Diabetes.
Now, after a hard period of diabetes management and some denial (I don't think I'm the only one out here that had a rough time in his teen years) I got back taking care of my Diabetes like I should.
The main reason of the hard period I had was that I wanted to be just like everyone else and not having to think about counting carbs, timing insulin, etc...
At the beginning of that period I had a great time and I was enjoying life and my bad BG levels weren't really bothering me at the time but when the time passed by I was often tired, couldn't concentrate and I was getting sick of the hypo's and hyper's I was having, so I decided to ACCEPT my diabetes and wanted to understand it so that I could maybe combine a great quality of life AND great diabetes management (Is that even possible ;') ? ) That basically was my motivation for changing and so I started working my way up to a better Hba1C, which was at 7,9 at the time and you might say that's not that high but let me remind you that going up and down from 3 mmol to 13 mmol also counts up to a Hba1C of 7,9.

Now you might be thinking why I'm telling you all this but one of my 'goals' was to achieve better Diabetes management without changing my diet too much because I didn't thought, and I still don't, that I was eating bad or too much.
I started keeping track of my BG'S (I got my hands on a libre sensor that helped me so much!!) which was something I haven't had done for a long time and I started fine tuning my basal rates and my carb ratio...
The only thing I changed is that I started eating the same amount of carbs at a meal to make it a bit easier but that amount was based on what I ate before, I didn't reduce any carbs, besides the low sugar treats that I didn't need so often anymore, which is positive!!
Now, around 9 months and 3 Hba1C tests later, my Hba1C is back at 6.4!! (7.9 - 7.5 - 6.6 - 6.4) with few hypo's, better moods, less tired and fitter! that allowed me to take cycling to a higher level!!

All of this has been achieved without changing my diet, basically by learning to understand how to match your insulin with the carbs you eat and understand other factors such as the influence weather, stress, sickness, etc... has on your BG
And I think I'm even happier than I was when I wasn't taking care of my Diabetes.
I know it can be hard and I did have to skip some meals due to a rough day or just one of those typical days I lost track of my diabetes and nothing worked out but whenever that occurs you should ask yourself this ; would you rather eat Mexican food with a couple of beers/drinks or have a great night (Blood sugar wise) and get up fresh in the morning.
Because for me (and it might not be Mexican food in your case but other foods or something else) having Mexican food and a couple of beers is a guaranteed 'horror night'
I don't know what it is but whenever I eat Mexican food I get so freaking insulin resistant and I end up waking every hour to pee, to drink and to bolus...

Hope this helps you!

Fra.ta said:

Is the food really the main reason for this values?

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Basically his Hba1c results tell us he is not taking the correct amount of insulin for the food he eats. He needs to inject more.

Can a T1 eat anything? Hmmm in theory yes - you match the the insulin to the carbs based on your ratios - in practice this would be hugely difficult due to the profile of how our injected insulins work over time (eg they don't marry up well to drinking a full sugar coke), and a dozen other variables we have to control for. To consistently achieve good bs control with an unlimited diet will only be achieved by a tiny handful of T1s.

But equally he doesn't need to be on a "strict" diet for the rest of his life. A well managed diet might better describe it. The general health guidelines are that people can eat 225g to 325g of carbs per day. For myself I probably eat around 180g of carbs per day and with no meal bigger than 50g of carb. This makes control much easier for me - balancing that amount of carbs versus the insulin needed works for me. And while not excluding them, really limiting sweet, fast sugar release treats as they rapidly spike bs.

With things like Libre / Dexcom, techniques like pre-bolusing, and super fast acting insulins like Fiasp it's getting easier...

While your partner needs to manage his diabetes himself, well done for taking an interest and supporting him.

I can't.
I can barely eat anything anymore.
My dsn said I should be able to go out for a meal or to costa for a coffee and a cake if I want to but I wouldn't even contemplate doing either of those things.
If I eat only 2 or 3 slices of low carb bread a day I can largely keep my sugars below 7 or 8mmol but also not go hypo. If I eat anything else I end up higher and then inevitably lower as I get a spike as then a drop.

For me it's just easier not to eat.

catapillar said:

A type 1 diabetic can eat whatever they want, if they have the right insulin management techniques to deal with it.

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While this is theoretically true it is rather like saying that walking a tightrope over boiling lava is completely safe so long as you don't fall off.

Lots of people with type 1 diabetes like to say they can eat anything because they want it to be true. It is at the very least a very very risky thing to do and lots of people are quite careful what they eat because of that.

OK everyone is that fair?

Fra.ta said:

Hi everyone,
my boyfriend has diabetes type 1 since he was 16y old.
Now he is 28 and in the last few years he had a Hba1c between 8.0 and 8.9%.
Now we live together and I am trying to cook healty for him (low carb and full grain). I also recently stopped drinking alchool, so that he also have less occasion to drink beer (we are from Germany, so that's a big thing for him! ).
Yesterday he had his doctor appointment and he had a Hba1c of 7.9%, which is a good resoult, because it wasn't under 8,...% for a long time. I know it schould stay always under 7%, and I know that sometimes we didn't have healty meals (like in weekends, where he still has few beers and sweets).
Is the food really the main reason for this values? He is sporty and not overweight.
If really it's the food that influence so much the Hba1c, does it mean that he has to be on strict diet for all his life in order to arrive and stay at 7%?
I often ear that nowdays with insulin terapy, diabetic people can have a 'normal' life and eat normaly. Is it really true on your experience?
Thank you for who will take some time to write me his experience.

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The important thing is to develop insight into what causes highs and lows and work from there. For years I just dosed, ate, tested on a schedule or when I felt like it and corrected when necessary. It worked well enough and I maintained a reasonable A1C, but really had no insight into all of the different variables (such as stress, dawn phenomenon, etc.) and how different foods affected me. I really recommend a Libre or Dexcom and think it's hard to really understand what is going on without one. I eat mostly what I want but try to avoid things I know I will have a hard time with, or at least keep them to a minimum. I wouldn't drink regular Coke for example, why do that when Diet/Coke Zero is available and requires no insulin? I certainly enjoy a good beer now and then, but try to avoid IPAs and have 1 or 2 at most at a time since they are loaded with carbs and difficult to dose for without going high or low. I am also careful about what I eat in the morning since dawn phenomenon is powerful, but I'm not always perfect at this. Remember that going low carb, while it can make things way easier, poses its own challenges because protein will start converting into carbs and needs to be dosed for slowly (through regular insulin/actrapid, multiple shots of rapid-acting insulin, or extended boluses on a pump).

Insulin therapy is a poor attempt to replicate the third order differential feedback system of your body. I say poor because the reaction time of "fast" artificial insulin is slow compared to normal pancreatic insulin/glucagon response. Therefore, we have to predict exactly how much and how fast we are going to metabolise various carbohydrates when we eat. With dietary sugars, starches and other low-complex carbs, that is almost always too fast. The result is peaks of BG that we try to correct, with the inherent risk of hypos. Long term, this takes its toll.
So until we can better replicate the pancreas, it simply makes control easier to have less carbs and less insulin....a steady as she goes approach.
Doing just that personally allowed my A1C to go from 152 mmol/m to 40 in 3 months with no hypos (and still none yet!)

I go through periods where I eat whatever I want and match insulin to carbs etc. The first day or two are relatively fine assuming I've been exercising and I rarely get spikes initially.

If i continune this trend I start getting night time highs to ~ 10 mmol during my sleep. My weight starts to increase and then I need more insulin and I enter a vicious circle. By 'eat what I want' means high carb food such doughnuts, chocolate bars , ice cream etc etc.

For me moderation is the key, nowadays I tend to have a few treats on the weekend and low carb throughout the week. This keeps me flatlining on both BS and weight.

As long as your carb counting and bolus ratios and timing of your jabs is good then, yeah, you can eat what you want.

NoKindOfSusie said:

While this is theoretically true it is rather like saying that walking a tightrope over boiling lava is completely safe so long as you don't fall off.

Lots of people with type 1 diabetes like to say they can eat anything because they want it to be true. It is at the very least a very very risky thing to do and lots of people are quite careful what they eat because of that.

OK everyone is that fair?

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That is life in general thou

Technically, you can eat what you want, but I’ve found it much easier to restrict my carbohydrate intake to keep my blood sugars steady and within range.

So for example, yes, I could eat a bag of chips and bolus for it, but getting the timings right, guesstimating the amount of fat and how much it would affect the uptake of the starch, the possible delay in eating the food until the insulin kicks in would mean cold chips and probably not eating at the same time as the rest of my family... It’s too many variables, I can’t be doing with it. I’d rather have slightly different food and eat with my family, mealtimes are an important social bonding thing for us. So if they want fish and chips for dinner, I’ll have a piece of fish, peel the batter off and have it with some veggies fried in butter or a salad, and will prepare that while they collect the food.

We all have to find a solution of managing our insulin and food intake that works in real life

Fundamentally I eat what I want. Granted I don't stuff my face with big mac meals milkshakes and chocolate bars all day long but when I do decide to eat something it will be something I wish to eat regardless of what it is.

Breakfast I will inject anything from 4 - 8 units (Novorapid), Lunch will be anything from 6 - 12 units and Supper anything from 10 - 18 units.... My Lantus always stays the same though at 16 units.

Also sometimes I may inject more Novorapid if I fancy a treat or someone brings a tray of cakes to the table after I've just Bolussed and eaten my main meal.

Obviously my 36 years experience of living with the condition helps greatly but generally speaking I chose to eat what I fancy when I fancy it..

Some might disagree but it is how I have managed my Type 1 for many years. My Diabetes Consultant knows how I manage my Type 1 and he always states that as long as I keep my sugars in range then it is being managed well. And it has been for a while now.



.

Bertyboy said:

Insulin therapy is a poor attempt to replicate the third order differential feedback system of your body. I say poor because the reaction time of "fast" artificial insulin is slow compared to normal pancreatic insulin/glucagon response. Therefore, we have to predict exactly how much and how fast we are going to metabolise various carbohydrates when we eat. With dietary sugars, starches and other low-complex carbs, that is almost always too fast. The result is peaks of BG that we try to correct, with the inherent risk of hypos. Long term, this takes its toll.
So until we can better replicate the pancreas, it simply makes control easier to have less carbs and less insulin....a steady as she goes approach.
Doing just that personally allowed my A1C to go from 152 mmol/m to 40 in 3 months with no hypos (and still none yet!)

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Agree totally but don't you just sometimes want a cream cake

SueJB said:

Agree totally but don't you just sometimes want a cream cake

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Of course, but that's why God gave us hypos - as an excuse to eat cake.
Seriously though, what I really really miss is ***** sweets. Pistachios and almonds deal with savoury cravings, but there's nothing to replace a good dessert (Fage and berries can only go so far) or midget gems. I wrote to Tangerine confectionary last week to try and persuade them how great stevia based midget gems would be.

NoKindOfSusie said:

While this is theoretically true it is rather like saying that walking a tightrope over boiling lava is completely safe so long as you don't fall off.

Lots of people with type 1 diabetes like to say they can eat anything because they want it to be true. It is at the very least a very very risky thing to do and lots of people are quite careful what they eat because of that.

OK everyone is that fair?

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I think there is a caveat that applies to @Catapilla's statement; this assumes you have the tools needed to do the job. For the particularly insulin sensitive, even half unit pens aren't up to the job.

Reading between the lines, I do wonder if @NoKindOfSuzie falls into this category? If so, I sympathise with the challenge of matching exercise and carbs to insulin. Yes, that is the wrong way round, but what would more typical people do with a pen that dosed in, say, 4 unit increments?

Shiba.

Shiba Park said:

I think there is a caveat that applies to @Catapilla's statement; this assumes you have the tools needed to do the job. For the particularly insulin sensitive, even half unit pens aren't up to the job.

Reading between the lines, I do wonder if @NoKindOfSuzie falls into this category? If so, I sympathise with the challenge of matching exercise and carbs to insulin. Yes, that is the wrong way round, but what would more typical people do with a pen that dosed in, say, 4 unit increments?

Shiba.

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Good post. I have a 1/2 unit pen because I was so insulin sensitive when I was diagnosed that even gentle exercise was causing problems. My metabolism has adjusted but the nurses still home about me being on doses smaller than the kids.

In theory I can eat what I want, but the timing of eating it is a bit more of a struggle. Chocolate for breakfast? No problem - my body hoovers up glucose in the morning. Pasta for tea? Nightmare. If i take my normal ratio my BG just keeps rising. If i up the ratio then 5 hours later I will be in hypo land. So pasta is off the menu.

But I think it's important to play around to see what works / doesn't work.

I use a half unit pen now, only got it last week. I love it, it’s meant I can make really quite fine adjustments now.