Diet And Carbohydrates

Susan_Cass said:

Hi
I have been a type 1 diabetic for 44 years . On the whole I manage it well that is until I attempt to go on a diet. I believe I need to eat some carbs at each meal otherwise my insulin has nothing to work on ? Can anyone advise if this is correct ?

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Not wholly correct, no. It's possible to,eat meals with no carbs if you have Type 1. However, if you do so you will need to be confident in adjusting your insulin dose to match.

What insulins do you take, and do you take set amounts for meals?

In theory, if you missed carbs out completely in a meal, your basal insulin would hold you steady.....are you saying this doesn't happen?

It really depends what your insulin regime is - are you on a basal bolus and carb counting? Or are you on fixed doses of mixed insulin?

Susan_Cass said:

I take Novorapid and lantus. I can adjust my Novorapid easily but I think its more psychological that I think I need carbohydrates ?

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Certainly I find my blood sugar easier to control with some carbs in a meal, so, for example, if I was having a tuna salad I'd probably add a small amount of carbs just to make things easier. If I didn't have that and only had the tiny amount of carbs in the salad, I woukd then have to bolus a tiny amount of insulin to cover the protein in the meal (whereas I wouldn't have to bother to do that if I'd added a small amount of carbs). Many people find they need to bolus for protein even if there are no carbs in a meal.

If you're nervous, you could reduce rather than remove the carbs.

How many carbs do you normally have a day?

Susan_Cass said:

I believe I need to eat some carbs at each meal otherwise my insulin has nothing to work on ? Can anyone advise if this is correct ?

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There's type 1's on this forum who follow a very low-carb diet, you'll likely find you will still need to bolus but with some testing and adjustments you should find a way.

I am T1 and eat less than 20 carbs a day and all in salad veg, avocado and a few nuts and seeds. I do have to bolus for my protein. I use the Bernstein method of calculating half my protein as carbs. I eat small meals and bolus 1/2 unit for 2 oz protein and some veggies and avocado.

Just as an example. For BF I eat 1/2 an avocado with celery sticks. Lunch is 2 oz protein with a few bits of chopped scallion radish and onion topped with Evoo or mayo . sometimes on a lettuce wrap. On the side is a slice of avocado and a few celery stick. If I have the lettuce wrap I just chunk the avocado slice on top and skip the celery. Dinner same as lunch. Snacks are a few pumpkin seeds or pecans, a couple olive or some celery or a piece of lettuce dipped in a fatty dressing. I don't bolus for my snacks. Meals are all 1/2 unit novolog and basal is 1 unit, 2 if I'm over 100.

You don't HAVE to eat carbs but you will have to adjust your insulin. In the absence of carbs gluconeogenisis proceeds rapidly which is why I have to bolus for protein.

novorapidboi26 said:

In theory, if you missed carbs out completely in a meal, your basal insulin would hold you steady.....are you saying this doesn't happen?

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In the majority of cases this doesn't happen. The body still produces glucose as muscles and the brain need a certain level, and to do this it uses protein - the Gluconeogenesis effect that Kristin talked about. For muscles to store glucose as Glycogen, insulin is still needed. If you dig through the Volek and Phinney books, they state somewhere that those eating VLC typically have 60% of normal glycogen stored in muscles, so as hard as you try, your body still needs to replenish that.

Also to add, if I don't eat anything in the morning and not take insulin my bs will continue to rise even though lantus was taken only 9 or 10 hours ago even though it's SUPPOSED to last 24 hours. I can't up lantus or I will hypo by morning.
I could however skip lunch and stay relatively the same as long as I have morning insulin. Not sure about dinner as I always eat it.

tim2000s said:

In the majority of cases this doesn't happen. The body still produces glucose as muscles and the brain need a certain level, and to do this it uses protein - the Gluconeogenesis effect that Kristin talked about. For muscles to store glucose as Glycogen, insulin is still needed. If you dig through the Volek and Phinney books, they state somewhere that those eating VLC typically have 60% of normal glycogen stored in muscles, so as hard as you try, your body still needs to replenish that.

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This may be true for those already established into a low carb diet....is that what you mean....when I miss out carbs my blood sugar hold steady [within 2mmol], but I am not on a low carb diet...

novorapidboi26 said:

This may be true for those already established into a low carb diet....is that what you mean....when I miss out carbs my blood sugar hold steady [within 2mmol], but I am not on a low carb diet...

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I don't need to be. If I eat carbs at breakfast and dinner, but no carbs at lunch, and lunch has protein, I still see a rise, but I've titrated my background levels to account only for fasted production. I consider a 2mmol/l rise from lunch without carbs to be too much so I'd bolus for it.

tim2000s said:

I don't need to be. If I eat carbs at breakfast and dinner, but no carbs at lunch, and lunch has protein, I still see a rise, but I've titrated my background levels to account only for fasted production. I consider a 2mmol/l rise from lunch without carbs to be too much so I'd bolus for it.

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2mmol rise is too much for you....dont be so hard on yourself....

novorapidboi26 said:

2mmol rise is too much for you....dont be so hard on yourself....

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15 years a type 1? Much for you to learn still, young padawan....

tim2000s said:

15 years a type 1? Much for you to learn still, young padawan....

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17 now, I will always be learning.....

I am aware protein has an effect for some, but for me protein turning into glucose is too slow a process for your Novorapids and Humalogs to deal with....

novorapidboi26 said:

17 now, I will always be learning.....

I am aware protein has an effect for some, but for me protein turning into glucose is too slow a process for your Novorapids and Humalogs to deal with....

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I'm not sure that I'm using it to use the glucose that is converted. I think (although I'm not 100% sure of this) that a significant part of the action is using the insulin to stop the liver undertaking the process in the first place.