1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2021 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Can't I eat what I want?

Discussion in 'Type 1 Diabetes' started by GBS_82_, Apr 6, 2016.

  1. GBS_82_

    GBS_82_ Type 1 · Well-Known Member

    Messages:
    70
    Likes Received:
    80
    Trophy Points:
    58
    Hi all

    As some of you will know from other posts I am new both to this forum and Type 1 diabetes. Really wonderful to have all of you to share stuff with and ask for wisdom.

    When diagnosed I was pretty much taught to carb count straight away (was in hospital for a week and a half following DKA so had plenty of time with the nurse). Since then I've been doing it - I think pretty successfully.

    My understanding has been that I can still eat plenty of carbs - I just need to adjust my nova rapid insulin dose. While of course there's been a few fluctuations and my insulin sensitivity has been evolving, generally it's been going pretty well. While (I think) I'm relatively healthy I've still felt able to have plenty of bread, bananas, potatoes and the occasional portion of chips. I don't check levels obsessively but I do check 2 and 4 hours after eating and generally I seem to get back within 4 - 7 mmoles/L. My insulin sensitivity seemed to decrease after 2 weeks but after upping my doses it's working again. I even had an Easter egg and (while I MASSIVELY upped my insulin) it was fine. I had cake on Saturday too (again, highish insulin dose).

    HOWEVER, I keep reading on the forums about people who are trying to restrict carb in take and really try and keep a low carb diet.

    So I guess my question is - am I missing something? Is a relatively high carb diet bad for me in other T1D related ways? Might i be having spikes I'm not seeing?

    Would appreciate your thoughts.

    Gareth x
     
  2. Jaylee

    Jaylee Type 1 · Moderator
    Staff Member

    Messages:
    13,692
    Likes Received:
    10,740
    Trophy Points:
    298
    My take on it is this..

    As good as modern "insulin therapy" is. It's not that easy for the dose to profile in sync with what you eat. Which can cause rapid highs then sudden lows..?
    Even with faultless carb counting, there are other elements involved. Timing of dose, the rate food is digested, insulin sensitivity & physical activity demands on any given day..? Even stuff like climate affects how insulin works.. Lol, I'm not a "clairvoyant" & my lifestyle can take my day in any direction..?!

    So you will find the general reasoning behind the lower carbing is to even out the peaks & troughs in the BS control. (Less carb = less bolus.)
    Thus lowering dangerous highs & the chances of those pesky & risky rapid lows.. ;)
     
    • Like Like x 5
  3. tim2000s

    tim2000s Type 1 · Expert
    Retired Moderator

    Messages:
    8,914
    Likes Received:
    11,782
    Trophy Points:
    198
    Hi @GBS_82_ People with T1 restrict carb intake for a couple of reasons.

    The first is that, unless you get your insulin timing spot on, the spike you get after eating easter eggs, cake, bread, some fruits (in fact it will be dependent on you) during the first two hours after eating can be much more than the level you are at at two hours. By testing at hourly intervals after eating, you may find that after an hour, your bg level is up in the 10-12 range.

    Whilst coming down to a better level after 2 hours is okay, there is mounting evidence that spiking like this (known as glycaemic variability) is a key indicator of certain types of complication, specifically talking about Retinopathy, Neuropathy and Nephropathy. As a result, many try to keep their levels lower in order to reduce this risk.

    The second is linked to the first, in that spikes are usually followed by dips and for some, this roller coaster effect can be difficult to predict and manage, result in many hypos and therefore have a direct impact on life. By keeping carb intake relatively low, the rises aren't generally as high and the drops, as you are using much less insulin, are also much less dramatic.

    As @Jaylee says, it's all about keeping nice smooth, flat lines. It just makes living life easier if your bg isn't fluctuating all the time.

    Ultimately though, it's up to each person to make their own mind up as to how they want to approach it.
     
    • Like Like x 6
    • Agree Agree x 3
    • Informative Informative x 1
  4. noblehead

    noblehead Type 1 · Guru
    Retired Moderator

    Messages:
    23,618
    Likes Received:
    19,617
    Trophy Points:
    278
    I wouldn't go high-carb but eating carbs in moderation is fine provided you bolus accordingly and keep your postprandial bg levels under control, maybe worth investing in the Fresstyle Libre so you can monitor your bg levels more closely and see what effect certain foods have on you.
     
    • Agree Agree x 1
  5. Daibell

    Daibell LADA · Master

    Messages:
    11,733
    Likes Received:
    7,084
    Trophy Points:
    298
    Hi. The NHS will often say you can eat what you want and Bolus for it but if you want to avoid weight gain and minimise blood sugar swings then keeping the carbs down will help a lot.
     
    • Like Like x 2
  6. iHs

    iHs · Well-Known Member

    Messages:
    4,602
    Likes Received:
    2,320
    Trophy Points:
    158
    @tim2000s
    Whilst coming down to a better level after 2 hours is okay, there is mounting evidence that spiking like this (known as glycaemic variability) is a key indicator of certain types of complication, specifically talking about Retinopathy, Neuropathy and Nephropathy. As a result, many try to keep their levels lower in order to reduce this risk.


    Has the above actually been told to you in person by diabetes consultants and dsns, or is it information that you have gathered from looking at different internet websites or reading textbooks or attending diabetes venues involving the DOC?
     
  7. tim2000s

    tim2000s Type 1 · Expert
    Retired Moderator

    Messages:
    8,914
    Likes Received:
    11,782
    Trophy Points:
    198
    It was presented at DPC 2016 by Nick Oliver, and was raised at my recent clinic at Guy's by Stephen Thomas.
     
    • Winner Winner x 1
  8. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

    Messages:
    2,831
    Likes Received:
    1,857
    Trophy Points:
    178
    For me its all about keeping the blood sugars at safe levels......that included in between meals......

    so if you can do that on a relatively high carb diet that's great......

    i think for teaching purposes the idea that yes, you can eat what you want, is made to make clear the behaviour and performance of the fancy analogue insulin's we now have available to us, like novorapid.......it can deal with whatever you throw at it.....

    however the higher the carb load, the higher the insulin dose and the more inaccurate and inconsistent it becomes.....

    so eating what you want is a good advert for these quicker acting insulin's but in reality the performance of them isn't written in stone....

    trial and error is the key.......

    ;)
     
  9. iHs

    iHs · Well-Known Member

    Messages:
    4,602
    Likes Received:
    2,320
    Trophy Points:
    158
    Just how high did Nick Oliver say that bg levels needed to go before any nerve damage occured? Also does this refer to analogue insulin instability or to all types of insulin? Also, what is the conclusion for diabetics like myself who have plodded along just trying to keep bg levels within a set target frame for many years and being ok as opposed to those who only know about insulin over the past 16yrs and use bolus/basal to control bg levels and know nothing more?
     
  10. zoze_j

    zoze_j Type 1 · Well-Known Member

    Messages:
    163
    Likes Received:
    323
    Trophy Points:
    103
    Yes, when I first got my pump & realised I could control my insulin all the time, I naively thought I could eat whatever I wanted, but after my weight started to go up, as did my sugar spikes, I realised this is simply not the case! I still have some carbs in my diet, and occasionally will have a carb blowout (usually when I'm feeling under the weather), but I've definitely learnt, especially recently, that the easiest thing to do it just cut down on the carbs! My blood sugars are waaay easier to control, and hopefully at some point I will notice a reduction in clothes size!
     
    • Agree Agree x 2
  11. Mrs Vimes

    Mrs Vimes Type 1 · Well-Known Member

    Messages:
    673
    Likes Received:
    1,518
    Trophy Points:
    158
    I eat lchf as I find mistakes are smaller and safer to deal with. I've also realised that the high sugars that I got on top of the food spike that I couldn't work out what the problem was was down to stress, hormones and other such stuff.
    It takes away the guesswork that's involved sometimes because the amount of insulin I inject of an evening for so many carbs wouldn't be enough for the same number of carbs in the morning.
    I'm of the KISS approach - keep it simple stupid. (Meaning me!)
     
    • Agree Agree x 1
  12. dbr10

    dbr10 Type 2 · Well-Known Member

    Messages:
    2,237
    Likes Received:
    1,183
    Trophy Points:
    198
    At the support group I go to, the type one's think they can eat what they like, so long as they stuff themselves with insulin. But there must be more chance of a mistake in the dose, as well as the insulin causing weight gain.
     
    • Agree Agree x 2
  13. tim2000s

    tim2000s Type 1 · Expert
    Retired Moderator

    Messages:
    8,914
    Likes Received:
    11,782
    Trophy Points:
    198
    I'd have to ask one of the guys to pull the full set of slides off the conference website so that I can take a look. I'm not sure they went into that level of detail in the presentation.
     
  14. iHs

    iHs · Well-Known Member

    Messages:
    4,602
    Likes Received:
    2,320
    Trophy Points:
    158
    I also now through using pump, find it easier to eat less of the starchy type carbs and substitute for more vegetables instead which doesnt bother me one bit as I was used to eating low carb when first diagnosed type 1 in the mid 60's (50g carb to last the whole day for an 11yr old wasnt that much and I started to look extremely thin and made my mum worry about my well being and eventually spoke to someone at The British Diabetic Association (now DUK) about how thin I was looking and miserable too and got told that I needed to see the consultant and have my insulin increased so that I could eat more food. My bodyweight then increased and my happiness also. As I got older, I then realised that insulin controlled bg levels and also bodyweight and so just adjusted my food and insulin accordingly.
     
  15. GBS_82_

    GBS_82_ Type 1 · Well-Known Member

    Messages:
    70
    Likes Received:
    80
    Trophy Points:
    58
    Thank you all very much for your wise words. I still have a lot to learn!

    I think I'm going to wait until June and get another HbA1c test and see how I'm doing. I had one done in mid-March and it was about 88 - however I didn't know I was T1D until 28th Feb when I was rushed into hospital with DKA.

    Once I see what my next HbA1c is like I guess I'll have a better idea of whether my good levels are misleading.

    Thanks again!

    Gareth x
     
    • Agree Agree x 1
  16. pinewood

    pinewood Type 1 · Well-Known Member

    Messages:
    781
    Likes Received:
    766
    Trophy Points:
    133
    Completely agree with this. I'm 16 months diagnosed and my hba1c has been steady around 5% - haven't really changed my diet and definitely still eat whatever I want. Freestyle Libre has been instrumental in that, together with appropriately timing bolus shots after realising how long NovoRapid takes to get to work.
     
    • Agree Agree x 2
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook