Delaying the Progression of Type 1 Diabetes

[kev-w]

Thanks Kev, for being so honest about your misconceptions with me.

I've no misconceptions here, a fallacy is a fallacy however it's presented.

 

[kev-w]

@Alexandra100 You can’t choose between low carb and carb counting as an insulin user - you have to account for every single gram of carbs when you eat low amounts of them, even if they are in broccoli, for example. Our higher carb friends can “lose” the veg among the pasta and their doses will cover all of it.

True that about the veg, but a carb free tin of tuna can cause a couple of points rise, which is strange, you mention pasta ? Now it's an odd one is pasta, take a supermarket brand and read the carbs, there can be up to 25g carbs per 100g difference penne to fusilli, even 10g difference whole wheat to whole wheat types, I can eat it occasionally with care, cooked, cooled and reheated with a smaller portion size.
'Rana' do a pre cooked one with spinach I could get on with at 60g carbs to a 250g portion but the last time I ate it it spiked me and when I dug the bag from the bin found the carbs had changed to 88g/portion.

Someone to tag about honeymooning could be @JoeT1 iIrc who's been diagnosed a year and was asking about insulin requirements changing.

 

[KK123]

The original topic I posted was research on T1. If this thread has wandered off-topic, I don't think I can be held solely responsible. I used the phrase "carb counting" as I have heard it used by eg Dr Ian Lake (T1) as a counterpart to "low carb". If you have a better phrase for what you do, please tell me. I'll be glad to use it in future.

Perhaps it would be better to use the term "insulin dependant"? Aside from this bickering about terminology, the important point is, there are two ways to use diet to manage diabetes. Recently diagnosed diabetics and those new to injecting insulin in particular should be made aware that they exist and that patients can choose between them.

Not sure I agree with the bit about those new to injecting insulin should be told about using diet to 'manage' diabetes, that's the wrong way round for a type 1, first and foremost you get told (quite rightly) that insulin is what 'manages' your diabetes and to begin with at least they probably see that as the safest way to prevent hypo's. Obviously food goes in tandem with that but with a newly diagnosed type 1 I could understand having low carb meals and then adjusting your rapid insulin downwards but what do you do about the basal? Does that not pump out insulin between meals? If your pancreas, in its honeymoon stage is doing the same thing with basal then you are seriously in danger of going low in between meals? I do agree that after the honeymoon period (whenever that is known), then maybe the advice about different diets might come in handy? I think we have to remember that when a type 1 gets diagnosed, most are in NO state to add extreme diets to the mix,by which I mean being left trying to gauge protein and fat with your insulin as well as prevent hypo's. This did happen to me, I kept going very low in between meals and I stopped taking my (2 units) of basal but then my levels shot up again between meals. Now I eat moderate carbs (as in anything between 50 to 100) and I am happy with that...for now.

 

[SamJB]

I've no misconceptions here, a fallacy is a fallacy however it's presented.

For the first time in our exchange, you do seem like you know what you’re talking about now!

 

[kev-w]

For the first time in our exchange, you do seem like you know what you’re talking about now!

Again?

We weren't having an exchange, you confused a maths law with something else and I was just pointing that out, I personally rate the dr as a bit of a goon from the snippets of information I've seen written by him, but if I ever start having nightmares about blowing up like a balloon I'll maybe revise my opinion.

Must dash as my porridge needs cooking....

 

[SamJB]

Again?

We weren't having an exchange, you confused a maths law with something else and I was just pointing that out, I personally rate the dr as a bit of a goon from the snippets of information I've seen written by him, but if I ever start having nightmares about blowing up like a balloon I'll maybe revise my opinion.

Must dash as my porridge needs cooking....

I don’t think I confuse maths laws, Kev. I’ve literally got a PhD in it, my career has been applying maths to calculate drug doses. The “smaller dose, smaller error” notion is because of the law of error propagation.

 

[kev-w]

I don’t think I confuse maths laws, Kev. I’ve literally got a PhD in it, my career has been applying maths to calculate drug doses. The “smaller dose, smaller error” notion is because of the law of error propagation.

Good for you, I clean windows...

And have a working knowledge of maths good enough to scorn the notion when it's applied to diabetes as an absolute, which is how it is put across and why I'll continue to scorn the fallacy of smaller dose, smaller error solution of diabetes.

 

[SamJB]

Good for you, I clean windows...

And have a working knowledge of maths good enough to scorn the notion when it's applied to diabetes as an absolute, which is how it is put across and why I'll continue to scorn the fallacy of smaller dose, smaller error solution of diabetes.

Great conclusion to our little conversation; you scorn away, whilst those who low carb are rewarded by the benefits of “low dose, low error”!

 

[SueJB]

Again we have experts who have researched and studied give or take 40% of the condition telling the people who live the condition 100% how it’s done.
Honeymooning in diabetes is a lot like honeymooning after marriage. It’s not the real world, it’s spontaneous, unpredictable and no matter how much exercise you do the honeymoon WILL end.

@therower "the honeymooon WILL end" This sounds like the sword of Damocles. I've been T1 a year, don't exercise and don't know how I'll recognise the end of the honeymoon but I'm now expecting something bad

 

[LooperCat]

So do you actually count carbs in vegetables and adjust insulin? I don't really count carbs and that's one of the reasons I like low carbing. I also don't have to bolus for proteins. I normally inject 2 units (but adjust by volume) for each meal and that works. I wonder if there are any other type 1s on very low carb diet who doesn't have to bolus for proteins. Is this because I'm still honeymooning but 2 units for low carb meal doesn't sound so. I don't quite understand but it works (so far)

I have to count every single gram of carb from whatever source, and some protein - only white fish, prawns and pea protein powder. Fatty fish and eggs don’t need any insulin (I don’t eat any other kinds of flesh, but many of my online friends who do LC have different ratios for different animals, and even cuts of meat) for now. My mealtime doses range from 0.1-1.5 units (plus any correction). But if your method works for you, that’s fantastic!

 

[Alexandra100]

I have to count every single gram of carb from whatever source, and some protein - only white fish, prawns and pea protein powder. Fatty fish and eggs don’t need any insulin (I don’t eat any other kinds of flesh, but many of my online friends who do LC have different ratios for different animals, and even cuts of meat) for now. My mealtime doses range from 0.1-1.5 units (plus any correction). But if your method works for you, that’s fantastic!

@Mel dCP Your post is SO interesting. I had read in "Diabetes Solution" that protein raises bg about half as much as carbs. I assumed all protein would have the same effect. I'm very surprised that you don't need any insulin for eggs, as of course they contain abut 0.6g carbs per egg yolk. Because of this I limit my egg consumption to lunch-times when I seem to be able to deal with more carbs. I would have ruled out pea protein entirely. I would never have imagined that white fish might raise bg less than oily fish - indeed I would have thought the fat would at least have delayed any bg rise. So, thanks to you, I foresee lots more experimenting and, alas, testing.

 

[LooperCat]

Good for you, I clean windows...

And have a working knowledge of maths good enough to scorn the notion when it's applied to diabetes as an absolute, which is how it is put across and why I'll continue to scorn the fallacy of smaller dose, smaller error solution of diabetes.

Bodies don’t work in straight lines, we can apply all the right maths, but it doesn’t always give the intended result! Like I say in my sig, “in theory, there’s no difference between theory and practice. In practice, there is.”

But I do prefer the smaller numbers hypothesis (as an ex scientist I can’t call it a law!), if I make a 20% error on a 1u dose, it’s not going to have the same risk of hypo as 20% on a 12u dose - 2.4u of extra IOB makes me a lot more uneasy than 0.2u too much. If the error were to go the other way, that would give me a rise of 6-8mmol compared to 0.6-1mmol.

But (an even bigger but) - it’s horses for courses. There’s many methods to manage T1, I’m just happy I’ve found one that works for me, after 20 years. I feel much more confident than I’m not going to have a bad hypo when I’m out and about than I did before, and that’s made a real difference to what I now feel capable of doing. I’ve been following your methods with great interest on the T1 stars thread, I may even try it one day if I can find a porridge I like

 

[LooperCat]

@Mel dCP Your post is SO interesting. I had read in "Diabetes Solution" that protein raises bg about half as much as carbs. I assumed all protein would have the same effect. I'm very surprised that you don't need any insulin for eggs, as of course they contain abut 0.6g carbs per egg yolk. Because of this I limit my egg consumption to lunch-times when I seem to be able to deal with more carbs. I would have ruled out pea protein entirely. I would never have imagined that white fish might raise bg less than oily fish - indeed I would have thought the fat would at least have delayed any bg rise. So, thanks to you, I foresee lots more experimenting and, alas, testing.

I only use pea protein when I am really short on my quota for the day - it’s the highest % plant protein source at ~80% and much higher than say hemp protein powder. I suppose it has an effect because it’s so high, and doesn’t have the other stuff in it to slow down it’s absorption. I think white fish and prawns raise it because they are so lean - maybe salmon and the other oily fish don’t because the fat slows it down and the protein is soaked up by my basal...

 

[kev-w]

Bodies don’t work in straight lines, we can apply all the right maths, but it doesn’t always give the intended result! Like I say in my sig, “in theory, there’s no difference between theory and practice. In practice, there is.”

But I do prefer the smaller numbers hypothesis (as an ex scientist I can’t call it a law!), if I make a 20% error on a 1u dose, it’s not going to have the same risk of hypo as 20% on a 12u dose - 2.4u of extra IOB makes me a lot more uneasy than 0.2u too much. If the error were to go the other way, that would give me a rise of 6-8mmol compared to 0.6-1mmol.

But (an even bigger but) - it’s horses for courses. There’s many methods to manage T1, I’m just happy I’ve found one that works for me, after 20 years. I feel much more confident than I’m not going to have a bad hypo when I’m out and about than I did before, and that’s made a real difference to what I now feel capable of doing. I’ve been following your methods with great interest on the T1 stars thread, I may even try it one day if I can find a porridge I like

Horses for courses is the one , you low carb and have the best control you've had, which is mint, I read low carb and think someone's trying to pinch my food but if next year I change my lifestyle/work I'd have to 're jig' my methodology towards carbs, I accept your maths above regarding smaller numbers, but would slip an offset into the sum in the form of the carbs to insulin ratio, so the larger dose would metabolise a larger weight of carbs.

Only one thing's for sure and that's it can go pear shaped whichever way you do it

 

[Alexandra100]

I only use pea protein when I am really short on my quota for the day - it’s the highest % plant protein source at ~80% and much higher than say hemp protein powder. I suppose it has an effect because it’s so high, and doesn’t have the other stuff in it to slow down it’s absorption. I think white fish and prawns raise it because they are so lean - maybe salmon and the other oily fish don’t because the fat slows it down and the protein is soaked up by my basal...

Thanks. I had misunderstood - I thought white fish didn't cause a rise. It makes sense that it should be the oily fish that doesn't. I'll bear the pea protein in mind in case I ever get really sick of the animal proteins I'm eating now.

 

[SueJB]

I've read this thread from start to finish in one sitting and followed the changes in direction. I should have read the article first rather than at the end. If I understand the basic idea is:
If you exercise in the first couple of months after diagnosis, you can extend the honeymoon period. Tough I didn't
During this period the pancreas is still working a bit but needs some help.
I suppose my question is how do you know when the delay has ended? When it comes to an end, does life change in some way?
If this question derails the original thread, I'll be happy to post it somewhere else

 

[KK123]

I've read this thread from start to finish in one sitting and followed the changes in direction. I should have read the article first rather than at the end. If I understand the basic idea is:
If you exercise in the first couple of months after diagnosis, you can extend the honeymoon period. Tough I didn't
During this period the pancreas is still working a bit but needs some help.
I suppose my question is how do you know when the delay has ended? When it comes to an end, does life change in some way?
If this question derails the original thread, I'll be happy to post it somewhere else

Sue, I agree with what you have said. I have exercised for the last 20 years and am now 15 months into my 'honeymoon' period, what am I supposed to do to extend it I wonder?, run a marathon every day?? I am a great advocate of exercise for all sorts of reasons (least of which is the diabetes actually) but I am not convinced it makes much difference to the honeymoon period per se. x

 

[KK123]

I've read this thread from start to finish in one sitting and followed the changes in direction. I should have read the article first rather than at the end. If I understand the basic idea is:
If you exercise in the first couple of months after diagnosis, you can extend the honeymoon period. Tough I didn't
During this period the pancreas is still working a bit but needs some help.
I suppose my question is how do you know when the delay has ended? When it comes to an end, does life change in some way?
If this question derails the original thread, I'll be happy to post it somewhere else

Sue, I agree with what you have said. I have exercised for the last 20 years and am now 15 months into my 'honeymoon' period, what am I supposed to do to extend it I wonder?, run a marathon every day?? I am a great advocate of exercise for all sorts of reasons (least of which is the diabetes actually) but I am not convinced it makes much difference to the honeymoon period.

 

[Rokaab]

I'm not sure I could've exercised more when I was first diagnosed - but then I was only two - don't even know if I had a honeymoon period or not.

 

[Alexandra100]

my question is how do you know when the delay has ended? When it comes to an end, does life change in some way?
If this question derails the original thread, I'll be happy to post it somewhere else

Seems relevant to me, and anyway we have permission from a Mod to go off-topic in the interest of conviviality etc. I am absolutely not well-informed in this field, but I assume that as the honeymoon period ends the person either goes from control by lifestyle to adding insulin, and the person already injecting insulin has to raise their dose for the same amount of carbs? And yes, it seems some LADAs do go a long time before starting insulin. It would be good to hear from more LADAs about this.