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Delaying the Progression of Type 1 Diabetes


Having actually just read the article in question - the title is extremely misleading. 1) They only looked at 17 people - not even close to statistically significant. 2) They looked at people who were already exercising in large quantities at the time of diagnosis - not people who got diagnosed and then started exercising. 3) They defined honeymoon as insulin dose adjusted Hba1c of 9 or less, but don't say how they chose it, which makes me suspicious that they were cherry picking a little bit - a big research no no. 4) Only adult males were investigated - hardly a representative sample of the diabetic population at point of diagnosis - and they did no antibody testing.

It's a mess. They do however say in the original article that no conclusions about causality can be drawn, so of course that's what the summary article goes and does.

Rant over!
 
Do you find your insulin:carbs ratio changes the more carbs you eat? For me it’s always been a constant 1:7 in the morning (when I’m most insulin resistant and carb sensitive) and a simple 1:10 for the rest of the day. That’s what I was set up with when I did DAFNE and ate all the carbs, and it’s still the same now. You’re a lot more active than me, though, I presume that makes quite a difference.
 
@KK123 How long have you been a diabetic?
 
Yes my ratio would change with more carbs or a higher carb meal, a 90g carb meal (l;ike on my pics but with a little less rice) has a sweet spot of 5u, to up to 120g would want 7 or 7.5u which isn't a proportionate rise and would more likely than not require a correction later on where the 'lower' carb one wouldn't, but over time the sweet spot meal is causing a little weight loss so I upped carbs and insulin for a couple of weeks to put the weight back on, changed insulin time, a couple of days drifting high and its gone again

If I wasn't as active I'd not be able to tolerate the complex carbs I eat in the quantities I eat them in for sure, and I don't drink alcohol, eat cake, crisps, pies, pastries or anything that remotely looks like being made with simple sugars.
 
How many carbs are actually in a "2 unit" meal for you? I've just had 3 units for around 50g (bit of guesswork as local sandwich shop) but about .5 unit of that was because my BG was 7.9

Currently at 9 two hours after eating but novorapid has a long and slow profile with me so that's normal.

I don't low carb so my normal intake is around 150g per day along with 24,000 steps per the fitbit. About 9 units novorapid for that but I'm definitely still producing insulin and I have a pretty active life. No idea if exercise is prolonging the honeymoon though.
 
@Alexandra100 Thanks, I have no idea how LADA and T1 differ but would like to know from someone with T1 how they knew their honeymoon had ended and the reality of what happened. I'm just wondering if I'm still in the delaying phase or what. Really, really would be good to hear from T1s who know please. And just as a naughty aside, I don't eat many carbs but when I fancy a bacon butty, I have one.
 
Rokaab said:
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.
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Thanks @Rokaab, nice humour cheers me
 

Seems almost everyone says they have to count and bolus for protein on low carb. I can totally see how that can be more complicated ... I guess I've been lucky so far. I do feel whatever is left (probably not much) of my own insulin production is helping me with the control
 
There does seem to be some debate about how is the Honeymoon period actually define.
Although it was mentioned to me, no one really explained when it ended.
However, my insulin to carb ratio did gradually increase over about 6 or 7 years.
I couldn't tell you what it was when i started because I was not carb counting (I was on an inflexible 2 fixed dose a day regime) but I remember a locum consultant suggesting I tried 1 unit of insulin for 15g carbs after about 3 years.
[I remember him well because he was a very large chap who had the nerve to lecture me about gaining weight when my BMI had gone up from 21 to 22 in 12 months.]
A few years later, I realised I needed a little more so increased my ratio to 1 unit for 12 carbs.
Then a couple of years later it increased to 1 to 10 and has stayed at this level (regardless how many carbs I eat or time of day) ever since.

Throughout that time, I have been pretty active.
I am never a long distance runner but 3 months after diagnosis, I did the Moonwalk (a 26 mile overnight walk around London for Breast Cancer) and didn't think much of it apart from lack of sleep.

There were some murmurs from the consultants that my insulin doses were low and it could be due to Honeymooning but that "usually only lasts a couple of years".
I don't know if this was based on experience with children rather than adults in their 30s (I vaguely remember reading/hearing something about type 1 coming on much quicker for children but thus may be my memory playing tricks) or whether it was complete ignorance or whether I managed to extend my honeymoon period because I was active.

I have never changed my diet. For the last 25+years I have eaten veg and fish but no meat. I enjoy bread, cakes, pasta, rice, potatoes, ...
 
SueJB said:
@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
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It’ll be bad, really bad, so bad no one talks about it. OR it’ll be a bit of a relief and offers up some stability. It depends on how your honeymoon period has been if in fact you’ve actually had one.
Will you recognise when it ends? Maybe not. It’ll be a gradual change. You’re not going to wake up one morning and find a whole new world.
Obviously once the soles of your feet are completely covered in hair then you will be a fully fledged type 1.
 
@therower I've just checked my feet and they're hairless so I must still be in limbo.

I get the feeling though that nobody really knows anything for certain and that all these terms have been coined by disease-free academics. The honeymoon phase makes it sound glam. I don't know if I'm in one or not but I don't feel any different than before I was diagnosed and have not changed my diet significantly except for giving up my fruit.

You say the change will be gradual but what does that mean exactly? I find ambiguity something quite hard to deal with and it seems to me that that is exactly what you have to deal with in T1
 

Sue - I'm not T1, so have zero experience of the honeymoon period (for diabetes anyway!), however, from observing many folks arrive and participate here, relating their experiences along the way, it's likely to be as diverse as the menopause. Some notice it, some have a bit of a nightmare time and others would say, "What menopause?"
 
Hi @SueJB . Can I ask how you were diagnosed as being diabetic. I think for a lot of us we notice some quite significant changes in our health prior to diagnosis.
Type 1 plays by no rules. It’s unique in how it affects each one of us.
Honeymoon period probably isn’t the best term to use. I guess a lot of old hands at being T1 , myself included can look back and say that yes things seemed easier with regards to insulin when we first started.
Who knows in a few years time you’ll look back and think wow it was so different when I started.
 
x Carol x said:
It's a carnivore diet with an emphasis on organ meats particularly brain and liver. It differs from Carnivore in that you have a 2:1 fat/protein ratio to keep you in nutritional ketosis.
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Hi @x Carol x I dont want to be the fly in the ointment here but what meat are you using?

The reason you eat the offal is to absorb the vitamins and nutrients that the animal has absorbed in its life time. Unless you are certain that you are eating animals that are free range / grass fed instead of grain fed then you are failing to get the advertised benefit.

That said I do like a bit of liver and onions and have been noticing sheep brains on the shelf in the local shop just need a good recipe to go with it.

Perhaps I should go back and watch Hannibal.
 
That's a very good point. Paleomedicina recommend organic where possible but at the least grass fed. I get my meat from my local butcher which is all grass fed and from a local farm and also I buy from online famers like Rosewood Farm in Yorkshire.

http://rosewood.farm
 
Scott-C said:
And that, KK, is the truest comment in this entire thread.
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Agree with the extreme part, but there needs to be far better education at diagnosis around the role of carbs. I think the default advice should definitely be lower carb / capping carbs per meal, it just makes it so much easier to manage and balance.

Explaining insulin is only half the equation. At diagnosis I was told eat what I want and inject 4 units of novarapid with each meal... how mad is that?!

The bottom line is that only 6.5% of T1s achieve the Hba1c target of <48. Normal carb intake just does not work for most T1s, people need to be told this at diagnosis.

Only a tiny, tiny, tiny number of T1s will be able to regularly eat what they want AND remain in range.
 
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