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Carbohydrate Advice

Lynz84

Well-Known Member
Messages
344
Type of diabetes
Type 1
Hi All

Learning great things since being on this forum
however I need advice about carbs. When I was first diagnosed 5 years ago, my nurse put me on a diet where i needed to eat 70g carb per meal. Needless to say I become quite chubby as I wasnt used to this!
Since then its always been in my head that we definitely need carbs for each meal to sustain my sugars but a lot of you talk about no carbs and low carbs. Can we go low carb and is it safe to do so?
 
There many type 1's on the forum who low-carb, mind I don't think many will eat a no-carb diet as that would be impossible to do if your eating veggies and fruit.

Why don't you give it a go and see how you get on.
 
Hi Lynz,

As someone who ate carbs all the time, I now eat low carb whenever I can, if you talk to the NHS they will advise against this, however I told my consultant what I was doing to try and improve and stabilise my blood glucose levels and he fully supported me. The only downside is that you can suffer carb withdrawal which can leave you tired and drained, otherwise it's absolutely fine to carry on low carbing. Couple of points though, you body will become more efficient at converting protein to sugar, so eating a big plate full of meat will raise your BG, beware of hidden carbs, I used to eat loads of lettuce but in doing so it would raise my BG without me realising it, look out for anything processed also, try to eat fresh and home prepared food whenever possible so you know what's in it.

Read up on the Paleo diet as there's lots of recipes in these books which are great inspiration and will stop you getting bored !
 

70g carbs per meal is more than I have and more than I was recommended to have when I was diagnosed more than 20'years ago. When I was diagnosed, I went through what I normally ate for my meals with a dietician. She then calculated the carbs and that helped set my doses of mixed insulin (I was started on that at diagnosis). So I was only eating what I'd normally eat.

Now I think about what I'd eat if I wasn't diabetic and then calculate the carbs and from that my insulin dose for that meal. I don't aim for a certain amount of carbs per meal or add more because I 'haven't got enough'. My carb intake works out at approx 180g per day, including snacks. Some meals I have a fair few carbs eg if I have guests and have a big meal and a (moderate) portion of dessert, other meals I might have something like Salade Nicoise which is low carb. I just inject accordingly.

So I think the 'right' amount of carbs is what works for you - 'works' as in fits with your life and keeps you at a good BMI, etc

Someone did a poll here once about how many carbs all we Type 1s eat per day. You could try searching for that. I found it interesting reading

If you're trying to lose weight, cutting your carbs should help
 
Thank you so much azure!! My bg is steady most of the time so im obviously not doing too bad ☺
 
I find the book Carbs and Cals has turned into my "bible" 1mg of Apidra for 10grms of carbs. And 16mg of Lantus before bed.
So far so good. The only time I go off track is at the week end when I am busy working in the garage, garden etc
 
Hello! This is such a nice topic!

I think that, a low carb diet, for a type 2/lada/mody/honeymoon diabetic who is not on insulin, is a fantastic way to keep his/her blood sugar levels within target. Having said that, I believe that a low carb diet for a diabetic who is on a basal/bolus scheme, can prove to be a tricky thing to master.

A low carb diet has several benefits including weight loss. But, first, you need to establish what “low carb diet” actually refers to. For example, I am at 30 grams of carbs per meal (90 grams of carbs overall per day) and that does not include carbs from vegetables and protein. For some, this is considered a low carb diet while for others it is just a normal carb intake (as there are diabetics who are on much lower carb intake levels).

A low carb diet has several difficulties, in my view:
1. You still need to take insulin. It will be less but, you still need to take it as your body will convert protein and fat into energy.

2. Finding the exact amount of insulin which corresponds to protein and fat can be a challenging thing. When it comes to carbs, most of us start with the rule of 1 rapid acting insulin unit per 10 grams of carbs and work our way from there. With protein and fat, things are not so straight forward particularly because these foods turn into energy at a much lower speed (which brings me to my third point).

3. Every time I tried a low carb diet while on a basal/bolus scheme, protein was converting into sugar after (around) 5 hours. (sometimes more... I felt that lamb, for example, takes a whole eternity and a day to break down to sugar.) Therefore, I had an insulin peak 1.5-2.5 hours after my meal, was led to a hypoglycemia, was treating it and then 4-5 hours later my blood sugar went sky high when protein started to break into sugar (and sometimes kept going high 8 - 10 hours later when it was time for my next meal.) So, unless you have a pump (and can adjust your insulin accordingly) or, unless you can master multiple Novorapid injections (and I don’t know how to) achieving the “strike” can be a difficult thing.

Another concern which I have is if a low carbs diet depletes our sugar storage/the liver. I wonder, because of the low sugar intake, in case of a hypo, if the liver does have enough sugar to react successfully to a hypo.

There are people in this Forum who have mastered the low carbs diets and are brilliant doing it. I admire them because they make it seem so easy. For them it is a walk in the park, literally! But, for myself, I am not confident yet that I can do it. I did try and I realized I am not ready for it yet.

As an alternative, I find that I can manage my weight through a very controlled diet and moderate portions. I take my carbs mostly from fruits and wholemeal bread and I avoid sweets, condiments, alcohol, pasta, rice, potatoes, sauces and dips of any kind. I allow myself 1 digestive biscuit 2-3 times a week (this is the only treat that I allow myself to have). I don’t use butter and I have a spoonful of raw virgin olive oil in my salad. It is a strict diet (for some) but, I am used to it and it works for me…

It is the nature of our condition, I think. We need to sacrifice something in order to gain something else.

I hope this helps.
Regards
Josephine.
 
Hi. Your nurse was naively trying to make your diabetes worse. What a wonderful NHS we have. The reality is you effectively don't need any carbs as the body can derive glucose from proteins and fats to get the 'sugar' it needs. In practice most foods contain some carbs - even veg and you need fibre so just keep the carbs down and use the meter to guide you and your BMI.
 
Hi Lynz, a low carbohydrate diet will keep blood sugars a lot more stable than high carbohydrate. I try and stick as closely as I can to Dr Richard Bernstein's methods. He bases his advice on his own journey with type 1 diabetes. As he was diagnosed in childhood and is now in his 80s, having reversed eye problems, advanced kidney disease and gastroparesis after adopting low carbohydrate in his late 30s, he really knows what he is talking about.

When it comes to it, you have complete control over what you eat. If you're smart, you will look into the relevant information. The most important information to discover is this: what blood sugar levels are safe. Unfortunately, the jury is perpetually out on this.

Dr Bernstein says that your blood sugars should be normal constantly. Normal is 4.8, and he does not allow his own blood sugars to rise above 5.5 after a meal. He also gets these results in his patients. Needless to say, his management is very, very rigorous.

Then there's Jenny Ruhl, who I think has type 2 diabetes. She advocates Dr Bernstein's methods, but is slightly less strict. Some have said Dr Bernstein is Old Testament, Jenny Ruhl is New Testament. She suggests staying in 'The 5% club.' That means an HBA1C under 6, with fasting blood sugars around normal (4.8), and not exceeding 7.8 after meals.

It's difficult to pinpoint when blood sugars become damaging to us, but following standard NHS/ADA and other world health bodies' organisations is likely to raise them above safe levels. That's why so many diabetics have laser eye surgery or end up on dialysis wards or having amputations.

So to summarise, look into different ways of eating, and research the benefits/risks of all of them. Essentially, that means choosing between high carb, medium carb and low carb.
 
@Bluemarine Josephine i think you have hit the nail on the head with the fat/protein making bolussing much more complicated. I doubt I would manage it just on BG tests and I rely very much on lessons learnt and keeping a close eye on my libre, not that either really help if you ate late and the protein/fat rise kicks in at 3am. I suspect this is something Bernstein handles better but I cant bring myself to that level of micromanaging my food, whereas just avoiding all the obvious carbs is fairly easy to do.
 
It is very certainly safe to do low carb!

The same thing happened to me, i was told i had to eat 3 meals a day, each with 60-80g of carbs! I was shocked, and after a week went back to my normal 2 meals a day - 20-45g of carbs lol

I don't CHOOSE to low carb, its just how i eat, so i guess it just worked out for me. I have never had any issues with protein affecting my sugars as some have (i like a protein shake post workout each day so perhaps its just a good time and the carbs get put to use), from what i have read its really a case by case thing - some people are more sensitive to it then others.

But long story short - Eat what you want, make sure you inject enough insulin to cover the carbs you do eat, and when your sugars are low eat the right amount of carbs to bring them back to normal (which is normal 5-15g depending on why they are low)

This is really all you NEED while being diabetic.. Obviously, the more carbs you eat the more insulin you have to give and the greater any errors in your injection or insulin dose will be - so lower carb is just safer.

Eating a healthy diet filled with the proper amount of macro and micro-nutrients is a different story, but can still be done on low/no carb, it just takes more research to figure out and maintain.

So eat whatever you like, dose accordingly, and be happy!
 
Last edited by a moderator:
noblehead said:
There many type 1's on the forum who low-carb, mind I don't think many will eat a no-carb diet as that would be impossible to do if your eating veggies and fruit.

Why don't you give it a go and see how you get on.
Click to expand...
Low carbs are ok for people that dont have a physical type of work load but always keep plenty of high carb snacks with you when driving or outdoors"see it as an Emergency backup pack" dont drive if blood sugars are below 4 and testing must be done every 2 hours if you are driving, this is a legal must do.
 
The thing is with any eating and any newly diagnosed is that they should not be told to eat xx amount of carbs at each meal unless they are for some reason put on a mixed insulin regime....

The whole concept of basal / bolus is to enable us to have flexibility around when and what we eat.

I am a lower carber and been so most of my 50+ years of life.

I have always been "told off" for having levels too low by NHS staff.. They are actually right.. I did almost lose my driving licence thru an incident. However, I too have been an odd person preferring only 1 meal a day... That I found easier than now when being encouraged to eat a 30g bowl of rice crispies each morning.....

Lower or low carb is definitely a way to minimise spikes and levels but you need to be fully aware of fats and protein too...
 
Thank you donnellysdogs! Weird how after 5 years i still have a lot to learn!x
 
I think we learn throughout our lives!!

Little things that other people don't even have to consider.. I was advised to change my tamoxifen tablet from morning to night.... Even just doing this has caused horrendous problems with my basal doses going from 3.5 at night currently up to 8.5 and still not under 8.0 when I wake up. Yet even on 3.5 basal units I was still going low overnight. No warnings on the tamoxifen tablets....

So as you can see-even 30 +years on from diagnosis..It doesn't stop our learning...I'm learning about this tamoxifen drug...

So carb counting etc..reducing carbs for a T1 - its ever evolving advice and changes...

And us diabetics learn all the time.....
 

Have you now tried to lower your carbs (and insulin-lol!!)

If you do lower your carbs its important to realise that you may well need different basal too. Some people find they need more basal due to more fat and protein... Some people find their basal will be less.

A lot of T1's have their total bolus and total basal in 24 hours equalling the same amounts.. This is called 50/50 bolus/basal ratio. Keep an eye on what yours runs at... If you lower carbs greatly then your bolus will be be less and this may mean that your basal /bolus ratio would go out of kilter..
 
Bluemarine Josephine said:
Another concern which I have is if a low carbs diet depletes our sugar storage/the liver. I wonder, because of the low sugar intake, in case of a hypo, if the liver does have enough sugar to react successfully to a hypo.
Click to expand...
Interestingly, there's a fair amount of research out there that shows that long term T1s (typically more than 10 years) that have basically no insulin production also don't get an alpha cell glucagon response to very low blood glucose levels as a result of loss of signalling between alpha and beta cells. Those with a minor amount of insulin production (tiny amounts) still maintain enough signalling for alpha cell reactions to hypos.
 
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