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Carb and insulin balance

Gardevoir

Well-Known Member
Messages
51
Type of diabetes
Type 1
Treatment type
Pump
Hi!

I'm newly diagnosed and very interested!

- How many grams of carbs do you aim for per meal and how many grams per day at most?
- What made you decide on that specific maximum carb intake? (e.g. weight-related, other health issues, not wanting to inject as often etc)
 
Hi @Gardevoir, I suspect the answers you get will vary massively. There really isn't one right answer here.

I don't aim for a specific amount per day or per meal, but in practice I usually low carb,probably usually less than 100g a day.
My reasons for this are partially weight related (I find I tend to gain weight if I have a lot of carbs) and partially insulin related. (My insulin ratio is more like 1unit for 3g and it's just easier to get the dose right when I have less carbs). I probably ate more carbs when I was younger and lighter and needed less insulin for my carbs. (Note I'm technically overweight but not obese and have a T2 father).

During my two pregnancies in the 90s I followed the NHS guidelines and ate plenty of low glycemic index carbs as recommended by the NHS dietician, and my control was good, albeit with too many hypos. (This was pre-cgm and I suspect if they had been available I would not have had that issue.)

Also bear in mind when you read the answers that there is a very strong low carb contingent on this forum, which may (or may not( mean there is a relatively high number of low carbing T1s here. Also, many of the late onset LADA T1s come via a T2 diagnosis, so they are often low carbing when they start.

My advice would be to experiment and see what works for you, bearing in mind that your choice of dietary regime may change with time and activity.
 
For me, it's very different on different days. Sometimes I don't want carbs and I can eat about 50g a day, and sometimes I really want cake or pizza and the amount of carbohydrates exceeds 300g. Sometimes I want to eat cottage cheese, salad and eggs all day, and sometimes I eat donuts with sweet coffee. In fact, when I eat fast-digesting carbohydrates, it's easier for me to dose insulin, but it's very individual for different people. I need 1 unit of bolus per 5g of carbs, so due to the fact that my pancreas is not working, eating practically does not lead to weight gain and my bg is mostly in the target range. It's actually a little sad because I don't have the motivation to eat healthy, but I try to keep my diet balanced.
 
I eat low-carb most days mainly because I’d like to keep my insulin doses lower as when I first started my BSL would go high before going too low (hypo). Now that I’ve got a handle on my insulin to carb ratios that’s less likely to happen but I quite enjoy low-carb so have stuck to it mostly. My low-carb is about 90-100g a day, but if I feel like a high carb meal I now feel safer with the higher insulin requirements so will not avoid the meal if it’s something I really want
 
@Gardevoir you mention you are newly diagnosed.
Are you on fixed insulin doses or are you carb counting and adjusting your dose?

The healthy diet for someone with Type 1 is no different to a healthy diet for someone without diabetes.
If you are carb counting and adjusting your insulin dose, you can eat as many carbs as you want and vary this by day and meal.
For example, one dinner maybe pizza whereas another maybe omelette. They carbs vary huge between these.
There is no maximum insulin dose - you need as much as you need. So there is no need to keep your dose low.
There is often some confusion because over 90% of people with diabetes have type 2. This is a very different condition. It is often recommended for people with diabetes to eat low carb. What this means is it is recommended for people with type 2 diabetes to eat low carb.
A few people with Type 1 have chosen a lower carb diet because, with lower carb comes lower insulin which means errors are lower.
However, getting the insulin dose correct is most important. And with a very low carb diet this can be challenging because you need to worry about dosing for protein.
However, it is common to start on fixed doses which assume a certain number of carbs which can be very restricted but useful to keep things simple. If this is the case for you, you need to ask your DSN how many carbs the dose requires.
 
Thank you for your responses! I'm aware of it varying per person and simply wanted some insight on what it's like for others
I also learned a few more things thanks to your replies so thank you for that!

@In Response I am currently on fixed doses. I've received a higher dosage on the 17th and an even higher dosage on the 19th. I have another appointment on Monday (22nd) so I'll presumably receive an even higher dosage then as well. Due to being restricted on how much insulin I'm allowed to take/am taking, I try my best to be very careful with my meals which has worked pretty well so far.
I mentioned carb counting on my 2nd appointment and the specialist was surprised I was that "ahead" and mentioned that the rule of thumb for me would be 1 unit per 15g carbs but that I wouldn't be doing that yet. I do still count as I want to get used to doing so but I do not take more or less insulin yet. I have another appointment on the 30th with a dietician. It was very briefly discussed that I'd be talking about carb counting and insulin intake more then.
 
I'm another Type 1 who low-carbs usually under 50 carbs per day but if I'm losing weight, I up it to over 50 and less than 75 (also upping my bolus) to bring me back to target weight. The reason I low-carb is because this keeps my blood sugar stable whereas anything over the 50 carb/day causes me to spike and crash, no matter all the different strategies I have tried such as pre-bolusing, dividing my meal within the effective duration of the bolus . . . I need to maintain the balance between stable blood sugars and getting too thin. So I have max 15 carbs at noonish, 15 carbs at 4:00 pm and 10 for evening meal. By staying at 10 carbs or less at evening meal, my blood sugars overnight remain stable (excepting nightmares). I don't bother doing calculations for protein but I regularly measure my blood sugar and found that on low-carb my ratio is 1 insulin to 5 carbs, whereas on higher carbs it can go up to 1:10, due to the protein conversion I'm sure.
 
I have to say that I didn’t like fixed doses of bolus insulin at all. I was eating to satisfy the amount of insulin I was on; i.e. I was counting carbs and increasing them just to cover my insulin. It seemed back to front to me as I was eating more carbs than I normally would have. The biggest contributor of carbs on the days I don’t do low carb are milk and cereal (breakfast) and to go low carb that’s just about the only thing I change. Lunch has been salad and salmon/ham/meat for at least 5 years and sandwich (bread) roughly once a month, so no changes there. I’ve not changed dinner at all — I don’t like potato or sweet potato etc but was adding them when on fixed insulin doses. The actual insulin I need for dinner is very low and I wasn’t adding enough carbs to cover the fixed dose because I’d measure out the potato and leave half on the plate because I don’t like it haha. I think the fixed doses were the source, at least partially, for my constant hypos after my diagnosis… apart from breakfast they were much higher than they are now that I adjust my insulin doses. As a side note my breakfast insulin ratio is different to my lunch and dinner ratios. My ratios were worked out in consultation with my DN but between carb counting and noting how x amount of insulin affected my BSL I’d already guessed what the ratios would be for the most part but I got dinner wrong
 
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