Is low carb useful for diabetes type 1?

[Trishhh]

What are your experiences with low carb (if you have it). How does it compare with "normal diet" in keeping your BG in check?
My husband's type 1 for over 30 years and his BG seems to fluctuate so much. I'd like him to try low carb, but would like to know if it would be useful for him, especially since I might not be able to eat exactly the same as him, as I've always been underweight so not sure if cutting too much carbs would be healthy for me.
It's also difficult to convince him to do any changes due to diabetes, as he hates having to do anything differently from "normal people" as he calls us.

 

[Antje77]

I find it much easier to dose for low carb foods than for high carb foods. Others find a higher level of carbs easier to dose for.

The main thing with T1 is learning how to dose for what you eat, so keeping a close eye on your before and after meal numbers, connecting those with what you have eaten, and drawing conclusions on how to adjust your doses in both timing and amount the next time you have a similar meal. Of course also keeping in mind activity level on that day and again adjusting your doses to that. And adjusting for the type of meal: 20 grams carbs with lean protein needs different timing with insulin than 20 grams of carbs with a more fatty component.

All those factors in play won't change if you switch to low carb, it's still a lot of factors that together make the correct dose, hard to get it right.

his BG seems to fluctuate so much. I'd like him to try low carb, but would like to know if it would be useful for him

It might be useful, but only if he is willing to put in a lot of work to learn what different foods and doses do to his levels, just like with higher carb eating. It's in no way a magic bullet.

It's also difficult to convince him to do any changes due to diabetes, as he hates having to do anything differently from "normal people" as he calls us.

I would get very cross with my partner if they tried to convince me on how to manage my diabetes, no matter how well meant.
Sharing thoughts and articles they think might be usefull, all fine with me, but actively telling me how they think I should manage my diabetes, big fat nope.

There's a lot between the eatwell plate and low carb. If he sees he consistently spikes after high carb meals no matter how and when he doses, he might be interested in trying with a little less carbs for that particular meal,

 

[Fairygodmother]

I personally find the kind of carb eaten affects blood sugars as much as the amount does, and correctly calculating the amount of carb in a food source is super-important in keeping blood sugars within a given range.
For instance, cheese on toast may well take longer to release carb than tomatoes on an identical amount of toast as the fats in the cheese delay the body’s uptake of carb.
In my opinion calculating amounts of carb in a food source is also sometimes made more difficult by inaccurate packaging advice. I’ve learned which products to avoid if I want an easy meal.
It can be safer, though more time consuming, to use the raw ingredients and cook it yourself.

 

[jaywak]

How much carb does your husband eat now and what do you intend him to go down to ? I was told about 50 years ago that the norm was about 200 g a day , I don't know what they class as the norm nowadays but I go for about 150 g and find that quite easy and suits my normal lifestyle , I read on here that some people go for less than 50 g is that normal I don't know ,I don't think it would effect bs for a type 1 as we usually inject to suit the carbs we eat .

 

[aylalake]

Type 2s on a keto eating lifestyle try to stay around 20g a day. Obviously that doesn’t apply to Type 1s.
A low carb eating plan is generally below 100g.

 

[Fenn]

Hi I have been eating 20g or lower each day since September 15th, I woke at 1am to pee which was unusual for me, tested bg at 24, so decided I needed to try and fix my erratic numbers, I haven’t eaten many carbs for years and years but decided lowish carb wasn’t enough, I would go from hypo to in the 20s and yo-yo up and down, my libre chart looked like the alps, I tried everything from timing to dosing to correcting, they all worked! But they all worked too well or not well enough so the rollercoaster continued.

I also discovered intermittent fasting, When I say discovered, I knew about it for ages but considered it bananas, I have found it life changing! Very low carb and IF now mean my numbers are flat, I still get a bump in the morning from my dawn phenom but I correct it with very little insulin, my Insulin has gone from needing around 60 units a day (levemir/novorapid) to 10, I don’t spike, some meals I don’t even bother injecting for as my basal seems to cover it, I think because my 1 or 2 units for My meal is low I don’t or can’t over or under shoot very far, the timing is less important, my libre line just wobbles.

I am very strict with both keto and IF, I never cheat, even over Christmas, I have no idea why but I find it very very easy to stick to, of course not so easy at first but now it’s a doddle, I am 53, before September I felt 63, now I feel 43, it’s incredible.

Best of luck to him and well done you for trying to help

 

[becca59]

I low carb, less than 80 a day but not Keto. Mainly because it suits me and I manage it well. I have a main meal round about 2pm only have a snack if levels are low in the evening, without additional insulin. Then breakfast about 7am. However that is my choice. I would not take kindly to advice from my partner on how to eat, (he wouldn’t do so) particularly if they didn’t think they could do it with me. How galling to watch your partner tuck into things you originally enjoyed but they suggest you no longer eat. It all has to come from the individual themselves. Self determination is the winner.

 

[JAT1]

Low carb is what keeps me in range, even after eating, spikes are below 10. The best part is that there are no sudden falls into hypo numbers.

 

[Zinadane]

The Dr Bernstein diet.
I would love to be able to do it, but just too weak willed
Low carb for T1 simplifies everything!

 

[jaywak]

The Dr Bernstein diet.
I would love to be able to do it, but just too weak willed
Low carb for T1 simplifies everything!

That sums me up as well , just been to the pub pint of lager and a bag of crisps 30 carbs already .

 

[Trishhh]

Hi Becca,

So, if I understood correctly, you don't usually anything in the evening? If so, don't you feel hungry?

I wouldn't eat anything that he wouldn't. If we went low carb, it would be for both of us. (I might eat a little more carbs as advised by a dietician due to being underweight, even though that's my "normal").

Anyway, I wouldn't be telling him to do it, only suggesting, and only if you guys have tried and found it useful, as I see that the fluctuations frustrate him. Also, the suggestion would come from me because I'm the one who cooks and he wouldn't ask me to cook anything different from what we usually eat, so I'd have to offer to try something different.

 

[Trishhh]

[QUOTE=.Hi Fenn,

Thanks for your reply. May I ask how do you do your intermittent fasting?

 

[Trishhh]

Hi Antje,

Thanks for your reply.

I understand how difficult it is to control BG due to all the variables. With my husband, sharing articles is not enough, as he wouldn't even look at it, that's why I'm here, as sharing with him experience from people with the same condition might back up anything that I say about diabetes. I'm the one who found out and told him about the libre, as he wouldn't search for anything new, even though everything he learned about diabetes was in the nineties when he was old enough to start managing his insulin intake on his own.

I asked about low carb because I'm the one who cooks so I'm the one to suggest trying different things, as he wouldn't ask me to do anything different for him and he doesn't know how to cook.

 

[In Response]

I tried low carb diet and found it much harder to manage my diabetes.
In the absence of carbs, my body converts protein to glucose at a very variable rate (different proteins contains raise my BG by different amounts and at different times).
There is also evidence that low carb increases insulin resistance.
I have the advantage of a pump and CGM so able to provide small amount of insulin and vary my basal.

Following my “normal” diet , my HbA1C is 40 and my TIR is around 80%.
Diabetes does not control my life - I exercise regularly, I eat what I want and have a stressful job with lots of travel.

I am not suggesting this works for everyone but want to highlight that it is possible to manage diabetes without a low carb diet.

 

[Antje77]

Hi Antje,

Thanks for your reply.

I understand how difficult it is to control BG due to all the variables. With my husband, sharing articles is not enough, as he wouldn't even look at it, that's why I'm here, as sharing with him experience from people with the same condition might back up anything that I say about diabetes. I'm the one who found out and told him about the libre, as he wouldn't search for anything new, even though everything he learned about diabetes was in the nineties when he was old enough to start managing his insulin intake on his own.

I asked about low carb because I'm the one who cooks so I'm the one to suggest trying different things, as he wouldn't ask me to do anything different for him and he doesn't know how to cook.

How is he currently deciding on how much to dose for his meals? Does he carb count and use an insulin to carbs ratio, or is he on fixed doses?
If he's on fixed doses, suddenly going low carb from a 'regularl' carb diet will send him hypo.
What insulins is he on?
Has he done any basal testing lately to see if his basal dose still suits him?

Sorry for all the questions, but I think they're really relevant in this situation!

 

[Trishhh]

How is he currently deciding on how much to dose for his meals? Does he carb count and use an insulin to carbs ratio, or is he on fixed doses?
If he's on fixed doses, suddenly going low carb from 'regularly' carb diets will send him hypo.
What insulins is he on?
Has he done any basal testing lately to see if his basal dose still suits him?

Sorry for all the questions, but I think they're really relevant i this situation!

He takes aspart (novo rapid) and degludec (tresiba). I don't know anything about basal test. As far as I know, his team only checks his Hba1c, which seems like nothing, as they say it's good when in truth he spends a lot of time with hypo and hyper...
His ratio is 1ui:10g. He supposedly counts carbs, but he does so by looking at it, even though we have a scale. And the worst is that he rarely checks his BG and gets angry if I ask, even though I have realised he's hypo and have had to convince him to eat something so many times I've lost count...

 

[Trishhh]

[QUOTE="Diabetes does not control my life - I exercise regularly, I eat what I want and have a stressful job with lots of travel.[/QUOTE]


How I wish my husband would think like you! Unfortunately, he tends to say quite the opposite and I've given up on trying to convince him otherwise. Instead of thinking that exercising, eating healthy and keeping track of his blood sugar is HIM controlling the diabetes, he sees it as the diabetes controlling him. I suppose counselling would be helpful, but obviously, he won't look for it either.

Anyway, that's interesting, and sad, that low carb could make BG control more difficult instead of easier.

Does the bomb really help? I've asked him about it, but he says he doesn't see the point, as he would have to programme it anyway. I don't know how it works though.

I'm happy for you that you can manage the diabetes and lead a happy life

 

[Antje77]

His ratio is 1ui:10g. He supposedly counts carbs, but he does so by looking at it, even though we have a scale. And the worst is that he rarely checks his BG and gets angry if I ask, even though I have realised he's hypo and have had to convince him to eat something so many times I've lost count...

Is he using fingerprick testing or CGM like Libre or Dexcom?

If he rarely tests, going low carb is a risk, it will need serious adjustions to his insulin. If he's not up for that, and up for testing a lot to work out what to do, it will likely give him even more unstable numbers.

Really, it does look like you're trying to do the impossible, I'm sorry.
As per your other thread, please take care of yourself first, you can't force someone to start paying more attention to their diabetes, you can only offer..

 

[Trishhh]

Is he using fingerprick testing or CGM like Libre or Dexcom?

If he rarely tests, going low carb is a risk, it will need serious adjustions to his insulin. If he's not up for that, and up for testing a lot to work out what to do, it will likely give him even more unstable numbers.

Really, it does look like you're trying to do the impossible, I'm sorry.
As per your other thread, please take care of yourself first, you can't force someone to start paying more attention to their diabetes, you can only offer..

He uses libre. I thought after starting using it he would check his BG more frequently, but that's not the case.

You're right, even though it's hard to watch someone you love damaging their own health, I should stop trying to make him look after himself. After 15 years of trying, I should have realised he won't change the way he feels about being diabetic and how he manages it.

 

[EllieM]

I've been T1 for 53 years since the age of 8. The first 15 years were pre glucometer and I admit to no testing once I was a young adult and looking after my own bgs. Getting a glucometer (and moving from fixed doses to a basal/bolus regime) made a life changing difference, as did the advent of getting a sensor. I've been through periods of burn out where I didn't test much and my control was mediocre/poor. It's much better now though I don't have the body I'd have if I hadn't had all those years of T1. But it's still good enough to allow me to lead a happy and active life, at least at the moment.

My personal view is that you can't do anything about years/decades of past poor control, but it's never too late to improve your future prospects. I've known a lot of long term T1s who've had treatment for retinopathy, all still seeing. I have friends with things like rheumatoid arthritis and long covid, though diabetes is a pain it has the advantage that the patient has some control over the treatment rather than being dependent on a doctor for medication adjustments.

I suspect your partner needs help for depression and it would be great if he could ask his diabetic team or GP for that help. Eying food to carb count can work well if you've been doing it for a long time.

Please don't despair. My advice would be to try to concentrate on your own mental health but remain open to the possibility that your partner can seek mental health help for himself. It's only too late when you are dead.