Delaying the Progression of Type 1 Diabetes

Alexandra100

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As a devil's advocate, how important is prolonging the honeymoon effect?
Quotation from the article:
" People who have type 1 diabetes are at risk of dangerously low blood glucose levels. During the honeymoon period, the body responds better to insulin and blood glucose regulation is easier. To extend this period is only beneficial to the patient. Dr. Parth Narendran of the University of Birmingham and lead study author stated, “We propose that exercise prolongs honeymoon through a combination of improving how the body responds to insulin and preserving the function of insulin-producing cells in the pancreas. This could have important benefits for people with type 1 diabetes, including improved blood glucose control, [fewer] episodes of [hypoglycemia] and a reduced risk of diabetes-related complications.” "
 

michita

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Like I've said, Michita, my only gripe is that it's sometimes presented quite forcefully as if it's the only option - see the Noakes twitter exchange as an example.

I recall some threads on this forum where people like me who dare to eat more than 100g per day have been called, "insane, lunatic, dangerous, in denial."

I'm delighted that your choices are working for you. All I'm concerned about is when people like Noakes, who is a prominent spokesperson for lchf, denies the possibility that there are other perfectly viable and safe other options. We must surely be able to agree on that.

But low carb diet is not presented as the only option on this thread or is it? For me this forum is the only place I've found that type 1s discussing low carb diet. Zero understanding from HCPs. We are minority. Can you give us a bit of space.... please
 

Dixon1995

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I personally hated the honeymoon period. A period on which you forget at times you are even a diabetic, until you go too low from too much artificial and your body splurts some out, until next time you think less artificial insulin and you skyrocket. I was glad when it ended, and now I have consistency, the only mistakes are the ones I make.
 
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Scott-C

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During the honeymoon period, the body responds better to insulin and blood glucose regulation is easier.

I think the point @kitedoc was making is that while the paper you quote from might sound like all honeymoons are nice and smooth, many can, in practice, be horrendously messy and unpredictable with the beta cells squirting out insulin when it feels like it, throwing out attempts at carb counting and bolusing.
 

Dixon1995

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Ive eaten the recommended daily intake of carbs as a type 1 and ill tell you, it makes me feel like utter sh**e. On days where I eat less carbs, I feel better, dont sleep as much, dont spike after eating etc. But I am only one guy, that might just work for me, not for others.

If lower carbs has even the slightest possibilty of living longer, happier, with more energy and as a result a better quality of life, as a type 1, and indeed type 2, isn't it worth trying it, or even be put forward as a possible health regime by the leading health authorities.
 
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zand

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I think the point @kitedoc was making is that while the paper you quote from might sound like all honeymoons are nice and smooth, many can, in practice, be horrendously messy and unpredictable with the beta cells squirting out insulin when it feels like it, throwing out attempts at carb counting and bolusing.
So if that is the case wouldn't low carbing be the best route for those people? Or does the pancreas just throw out insulin even when someone has eaten no carbs at all? Honest questions, not looking for an argument.
 

Scott-C

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So if that is the case wouldn't low carbing be the best route for those people? Or does the pancreas just throw out insulin even when someone has eaten no carbs at all? Honest questions, not looking for an argument.

It's not just the numbers, Zand. There's the social/psychological aspects of food too. I like bacon just as much as a low carber does, but I get more out of it if it's on a bit of toast - the textures, the crunch.

Being dx'd T1 is a big headspin, and one of my first thoughts (in pre-internet days when I couldn't google it) was that I would have to eat a very restricted diet. It played a big part in coming to terms psychologically with the condition when I learned that with careful use of insulin, there was relatively few limitations.

Low carbing to the extent advocated by Bernstein and Noakes would, for me, feel like giving up, like diabetes had beaten me, forced me to restrict my eating options. But I've found ways, none of them particularly complex, just timing of pre-bolus, food combinations to buffer simpler carbs, and a glance at my cgm every now and then, which means I can safely maintain a good a1c with no dangerous hypos whilst still eating pretty much anything on Dr Bernsteins "No" list.

Stephen Ponder's Sugar Surfing is of more relevance these days: there's a chapter in how to bolus for a burrito!

We do need to bear in mind how a newly dx'd T1 is looking at the world in the first few days after dx. Their entire life has changed. Chucking in an entire dietary change, basically excluding an entire food group, could be hugely damaging to their mindset. I would probably have jumped out the nearest window if someone had told me I could no longer eat x, y, z.

I'm not denying there is a place for low carb, not at all - as I've said earlier, I low carb in certain situations. But I do worry that enthusiasts sometimes present it as the only option, not just one of many, and can be quite disrespectful of contrary views. Bernstein is a case in point - he describes people like me who like a bowl of rice and a bit of cheesecake every now and then as using, "industrial quantities" of insulin. That's insulting.
 
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Scott-C

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We're going round in circles a bit on this thread.

I've said that there is a place for low carb, and, indeed, have done myself so in certain situations.

Time to put your cards on the table. Do low carbers accept that there is also a place for not low carbing?
 
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Alexandra100

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I think the point @kitedoc was making is that while the paper you quote from might sound like all honeymoons are nice and smooth, many can, in practice, be horrendously messy and unpredictable with the beta cells squirting out insulin when it feels like it, throwing out attempts at carb counting and bolusing.
Yes, I can quite see that. In fact, Dr B has said that latterly a little of his own capacity to make insulin had revived, and it was no use to him, just a nuisance. However the research is encouraging to the likes of me (I am probably pre-LADA) as no-one is going to prescribe me insulin any time soon, and I am keen on exercise, so I may as well hope to benefit from it.
 
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Alexandra100

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Time to put your cards on the table. Do low carbers accept that there is also a place for not low carbing?
The idea of carb counting as opposed to low carb if / when I start injecting insulin is really scary to me. I don't like the idea of al those potentially big mistakes. However I have learned from posts on this Forum that there are people skilful enough to be able to eat carbs and cover them with insulin more or less at will. Wow! When my time comes, I want to keep my life around food as simple as possible while also keeping my bgs as low as possible. Dr B's 30g daily will probably do me. After my current <20g which doesn't even give me the bgs I want, this would seem luxurious.

From Adam Brown's column on the Diatribe site, I learn that there is a sort of middle way. From memory I think Adam aims for under 100g carbs daily, preferring this to his previous carb counting.

It would be absurd to take issue with T1s who are what Dr B calls "survivors" after many years managing their carbs and insulin, when they say they are happy carb counting. It would be equally absurd to rubbish T1 enthusiasts who find they are much happier on VLC. It interests me that quite a few T1s who are keen on exercise find VLC liberating. eg Dr Ian Lake http://type1keto.com,
Dr Runyan https://ketogenicdiabeticathlete.wordpress.com/author/krunyanmd/
 
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michita

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It's not just the numbers, Zand. There's the social/psychological aspects of food too. I like bacon just as much as a low carber does, but I get more out of it if it's on a bit of toast - the textures, the crunch.

Being dx'd T1 is a big headspin, and one of my first thoughts (in pre-internet days when I couldn't google it) was that I would have to eat a very restricted diet. It played a big part in coming to terms psychologically with the condition when I learned that with careful use of insulin, there was relatively few limitations.

Low carbing to the extent advocated by Bernstein and Noakes would, for me, feel like giving up, like diabetes had beaten me, forced me to restrict my eating options. But I've found ways, none of them particularly complex, just timing of pre-bolus, food combinations to buffer simpler carbs, and a glance at my cgm every now and then, which means I can safely maintain a good a1c with no dangerous hypos whilst still eating pretty much anything on Dr Bernsteins "No" list.

Stephen Ponder's Sugar Surfing is of more relevance these days: there's a chapter in how to bolus for a burrito!

We do need to bear in mind how a newly dx'd T1 is looking at the world in the first few days after dx. Their entire life has changed. Chucking in an entire dietary change, basically excluding an entire food group, could be hugely damaging to their mindset. I would probably have jumped out the nearest window if someone had told me I could no longer eat x, y, z.

I'm not denying there is a place for low carb, not at all - as I've said earlier, I low carb in certain situations. But I do worry that enthusiasts sometimes present it as the only option, not just one of many, and can be quite disrespectful of contrary views. Bernstein is a case in point - he describes people like me who like a bowl of rice and a bit of cheesecake every now and then as using, "industrial quantities" of insulin. That's insulting.
Low carbing doesn't feel to me like giving up as you say. I'm lowcarbing but it has not beating me, I really wish you understand.
 

EllsKBells

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The problem I have when I low carb is that I don't actually end up taking any less insulin - it doesn't stop my DP or foot to the floor, gluconeogenesis becomes a massive pain in the bum, and I end up with more injections with the delayed spike from any fat. Other things that cause a need for insulin include exercise, thinking, and breathing. :)

Ideally there would be longitudinal studies - but these are expensive, and getting funding for them is essentially banging your head against a brick wall.

At the end of the day, T1 - any type of diabetes really, to my knowledge - is a very heterogeneous condition. I have met T1s who take 1 unit for 30 or even 50g of carb, and people at the other end of the spectrum. People who don't know what DP is, and people for whom it is the bane of their life.

I think what I'm trying to say is that if low carb works for an individual - great! But it isn't a miracle cure.

Will have to have a look at the original study - would be interested to see what they say about those who don't ever really get much of a honeymoon in the first place.
 
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JAT1

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As a newcomer to diabetes, the message coming through loud and clear here is that, each of us while listening to others and researching options, must find their own individual way. Also, not all honeymoons end, not even in love.
 

Alexandra100

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Low carbing doesn't feel to me like giving up as you say. I'm lowcarbing but it has not beating me, I really wish you understand.
I think you have hit on the essence of the conflict. We all write our own histories. For some of us eating low carb represents a success, for others a failure. Having read many posts, particularly from people new to diabetes, I think "failure" is a term to be avoided. In particular "outcome" goals where we vow to "reverse" our diabetes, or lower our A1c to a certain number, or shed X pounds, should be avoided in favour of "process" goals. A process goal could be eating only X amount of carbs daily, or successfully balancing carbs with injected insulin to achieve "time in range", or even taking time off from testing and thinking diabetes in order to relax or heal.
 

DCUKMod

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Yes, I can quite see that. In fact, Dr B has said that latterly a little of his own capacity to make insulin had revived, and it was no use to him, just a nuisance. However the research is encouraging to the likes of me (I am probably pre-LADA) as no-one is going to prescribe me insulin any time soon, and I am keen on exercise, so I may as well hope to benefit from it.

Alexandra, I'm not in the least sure why you consider yourself to be pre-LADA, when your current and all historic blood sugar levels have been in the normal range, as opposed to even pre-diabetes.
 

Alexandra100

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Alexandra, I'm not in the least sure why you consider yourself to be pre-LADA, when your current and all historic blood sugar levels have been in the normal range, as opposed to even pre-diabetes.
Isn't this in danger of going off-thread?
 

Scott-C

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Low carbing doesn't feel to me like giving up as you say. I'm lowcarbing but it has not beating me, I really wish you understand.

I do understand, Michita. That's why my post said, "for me". If, for you, it isn't feeling beaten but a workable way of dealing with it, that's admirable.

All I'm saying is that while low carbing works for you, there's lots of us who get by quite happily without low carbing but are frequently explicitly or implicitly mocked by low carbers for doing so.

I know that you are a moderate person who is willing to see another person's point of view but there are people in the low carb camp who demand toleration of their views and at the same time completely refuse to tolerate the views of others.
 

PaulAshby

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We can delay progression in t1 Diabetes? I thought we just had it. I use exercise help manage it. I enjoy excercise because it keeps me insulin sensitive.

But I don’t think we can stop it. T1 that is.

Maybe this is a prediabetes to t2 thread...