Is a Low Carb Diet Sustainable to Manage Type 1 Diabetes

I've been type 1 for 2.5 years and eat less than 20g carbs a day and LOVE it. Very sustainable. I have been vlc or 25+ years. The worst part of my journey was adding carbs back in. I had no control but some can manage it. I can't

I don't have a problem with mental sustainability - anything that beats the b@*#% diabetes gives me mental sustenance.

But for Type 1s lowering carbs beyond a certain level can cause big issues with physiological insulin resistance. I've read some shocking examples here and elsewhere. I think that concerns me as much as anything else. I don't want to potentially mess up my body.

So, I think we all have a level of carbs that work for us, and that level is usually somewhere in the middle rather than at the extreme ends.

A great talk. Low carb is totally sustainable, giving up bread and chips is far easier than managing roller coaster blood sugars.

CathP said:

A great talk. Low carb is totally sustainable, giving up bread and chips is far easier than managing roller coaster blood sugars.

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Yes, excessive carbs can cause the dreaded rollercoaster because I believe we all have a maximum amount of carbs that works for us in a meal. Too many and it makes control hard.

But personally I've not seen any rollercoaster sugars on moderate carbs so that also informs my choice. Pre-bolusing has basically stopped that. It's a fantastic tool, and shows the importance of getting insulin there at the right time (however many carbs you might eat). My BS/spikes now compared to shortly after diagnosis, when I knew very little about the way insulin works, are a revelation. Same HbA1C roughly but much smoother sugars.

azure said:

But for Type 1s lowering carbs beyond a certain level can cause big issues with physiological insulin resistance. I've read some shocking examples here and elsewhere. I think that concerns me as much as anything else. I don't want to potentially mess up my body.

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That's interesting.
Can you provide some links and examples?

I am always interested to read verifiable examples of people for whom low carb doesn't work. There is almost always a useful lesson to learn.

I would be happy to make it a new thread, in the Low Carb section, if you feel it will derail this one too much.

Jaylee said:

Hi,

I've seen this vid a good while ago.. It's a great talk.

To address "mentally sustainable". Lol, the alternative of chasing the tail of heavy carbs is pretty exhausting navigating the "rough seas" that can ensue..
Modern insulin tech & regimes are not a OSFA, but lowering the carb intake can certainly take the "edge" of diabetic associated R&R'ing..
(With carful blood monitoring of course!)

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This is a recent talk, though he has others on Youtube - it was posted by Low Carb Down Under today, so maybe you just dreamed you'd seen it before? Maybe you're psychic, @Jaylee

[Pardon my pedantry ]

It's very true that carb reduction does make management of glucose levels much easier. Insulin sensitivity is an interesting one as I've seen no issues when VLC, where I know others have, and it's far from clear whether it's VLC in general or specific types of foods eaten when VLC.

As with all these things YDMV and you have to undertake a bit of trial and error.

I don't follow a low carb diet but even before LCHF was a thing, I knew that reducing the carbs would be perfectly achievable and successful in getting BG down...

I love carbs though...not too many, but I do love them.....

I haven't watched the video but I expect a low-carb diet can be achievable if you set your mind to it.

Low -carb is anything below 130g a day so it's certainly within the reach of most, as is eating carbs in moderation, but a LCHF diet (as in <50/30g a day) may be too extreme for some and once you removed carbs from the diet it can become complicated when your having to take into consideration fat & protein when working out your bolus calculations, but that said many do overcome this with good results such as @robert72 who has followed the diet for the last 3 years.

But like all the other diets that get mentioned on forums there's no 'one size fits all' and its up to the individual to find a diet that best suits their own needs and keeps their bg levels in check.

novorapidboi26 said:

I don't follow a low carb diet but even before LCHF was a thing, I knew that reducing the carbs would be perfectly achievable and successful in getting BG down...

I love carbs though...not too many, but I do love them.....

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I used to love carbs, and I grew up believing that fruit and good bread and whole grains were healthy. When I got my diagnosis, aged 30, and was issued with the food pyramid recommendation I believed it was correct, no problem. However, I had to inject much higher amounts of insulin then than I do now on 50g carbs max per day. The roller coaster effect was something that I assumed was inevitable, and not due to the bad advice, though well-meant, that I received.
Before the discovery of insulin, a zero-carb diet was advised, though, for patients with a shot pancreas, there was not much hope. The very low carb dietary recommendations in the early years of insulin were gradually considered unnecessary, because look what we've got now : insulin! It was maybe understandable that doctors assumed that our problems were over. But though insulin was a life-saver, its proper use was still a problem and still is!
The answer surely is a low-carb diet and the correct amount of insulin at precisely the right time. Very difficult to achieve, and impossible to prescribe, and I can't expect my doctor to manage it.
I'm really glad, though, that the light is now visible at the end of the tunnel.

Shocking about the eating disorders @Jaylee I'm not sure what kind of dance you did but I once read an autobiography of a ballerina with a harrowing eating disorder.

I guess 'the middle' is up for discussion as I've seen various figures on various sites. Of course, it may also depend on gender, age, weight, etc etc so my personal dividing lines are approximate. I think the forum's own designation of below 130g as being low carb is about right. Ive also seen below 100, below 120 and below 150g. So all around about the forum's 130g

Following on from that then, moderate carb would be anything above that but below the excessive carb line. Perhaps a better guide would be percentage of calories as carbs? I think some of the older Type 1 diets used that as a measure to aim for.

I personally eat around 180g per day and consider that to come within the moderate range

Brunneria said:

That's interesting.
Can you provide some links and examples?

I am always interested to read verifiable examples of people for whom low carb doesn't work. There is almost always a useful lesson to learn.

I would be happy to make it a new thread, in the Low Carb section, if you feel it will derail this one too much.

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Thank you @Brunneria, I would be interested too @azure - I've only heard good experiences. It would be useful to try to understand what is happening for those it doesn't work for.

I've just completed the week long DAFNE course and have been on the LCHF for a fair few months (40g of carbs a day roughly all from veg/salad). Even having 0 carb meals and using bolus doses to correct I haven't managed to get my levels under control during this week of the course. All the nurses and docs believe that my liver is overcompensating and kicking out excess glucose because there are no 'readily avaliable carbs' meaning my levels are staying high no matter what. I'm reluctant to add carbs like they suggest so I am waiting to hear what the consultant suggests in a week or so!

xjessica.rose said:

I've just completed the week long DAFNE course and have been on the LCHF for a fair few months (40g of carbs a day roughly all from veg/salad). Even having 0 carb meals and using bolus doses to correct I haven't managed to get my levels under control during this week of the course. All the nurses and docs believe that my liver is overcompensating and kicking out excess glucose because there are no 'readily avaliable carbs' meaning my levels are staying high no matter what. I'm reluctant to add carbs like they suggest so I am waiting to hear what the consultant suggests in a week or so!

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Are you bolusing for protein if you're low carb? If not, that could be the reason you're still having difficulty controlling your sugars. We bolus my daughter 50% of protein, and count the carbs in all veges eaten.

Bebo321 said:

Thank you @Brunneria, I would be interested too @azure - I've only heard good experiences. It would be useful to try to understand what is happening for those it doesn't work for.

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There's a lot of info online. I've been googling/reading in my quest for 'the perfect diet' for years. I read, process and keep any interesting bits of information in my head to amend my own personal approach to Type 1. The only issue with googling is if you're googling specifically for Type 1 you still tend to get general and Type 2 results so it needs a bit of picking through to sieve out the information you're interested in. I use 'Search this page".

A couple of links that I remember:

http://freetheanimal.com/2014/10/physiological-resistance-carbohydrate.html

http://www.marksdailyapple.com/does-eating-low-carb-cause-insulin-resistance/#comment-3087940. (Read the comment and then scroll to the top of the page for the article)

Info about the effect of fat:

http://www.joslin.org/dietary-fat-can-affect-insulin-requirements-in-type-1-diabetes.html

As for personal examples of physiological insulin resistance in Type 1s, then there are many. I've seen some here - some implicit and some explicitly stated, and some on other major diabetes forums. The thing that struck me reading those was that the people used a lot of insulin even though their daily carbs were low and/or found that if they ate a small amount of bread or whatever their ratio was hugely increased from what it had been prior to the start of LCHF.

On moderate carbs my insulin doses are low - low basal, good ratios, excellent insulin sensitivity - and my HbA1C is very good.

Although I hope for a cure every single day of my fun (not!) Type 1 journey, I don't think it'll be for a few years and I don't want to add IR to my burden and mess up my insulin sensitivity.

As Tim says above, YMMV.

CathP said:

Are you bolusing for protein if you're low carb? If not, that could be the reason you're still having difficulty controlling your sugars. We bolus my daughter 50% of protein, and count the carbs in all veges eaten.

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I've only been on the basal bolus regime for a few months and therefore only really just learnt the ins and outs of it all. I ask the nurses and consultants if I should bolus for protein but they have advised against it (and also said to not count veg/salad/etc) as they think it's my liver especially as I'm on 34u of basal already which they think is pretty high...

xjessica.rose said:

I've only been on the basal bolus regime for a few months and therefore only really just learnt the ins and outs of it all. I ask the nurses and consultants if I should bolus for protein but they have advised against it (and also said to not count veg/salad/etc) as they think it's my liver especially as I'm on 34u of basal already which they think is pretty high...

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Your high basal could be due to physiological insulin resistance. Read my post just above. LCHF doesn't suit every Type 1 (or every person). Aim for a level of carbs that suits you and keeps your blood sugar in range. Think Like A Pancreas is an excellent book to get to grips with Type 1