- Messages
- 448
- Type of diabetes
- Type 1
- Treatment type
- Insulin
Not so long ago it has been a year that I "celebrated" my first anniversary with diabetes. I think this is a good moment to look back and summarize my experience so far.
When I turned 40, I went for a regular checkup to my GP. The results were OK except for 2 things: cholesterol (highish) but more importantly, my fasting BG was over 7. A bit of a surprise to the GP as well as to me. On the other hand, I have to say, I had been feeling weird (tired, irritable, without energy, etc.) for the past two or even more years.
Anyway, the next step was to take the OGTT test. This is a test where they make you drink a glass of glucose and then measure your BG after 1 and 2 hours. What a shock that the first time I could not take the test as my fasting BG was over the max. permitted value for this test - I think 8 or so. I came in once again and just made it for the fasting limit this time. The OGTT revealed my BG after 2 hours was 12. If you are over 11 (at least where I live), you are diagnosed as diabetic.
I went back to my GP to hear the verdict of being a diabetic. She handed me a prescription for Metformin (500 mg/day), gave me a few leaflets with dietary advice and murmured something in the sense that I seem a bit young for a type 2 diabetic. Then she told me I should see a specialized diabetic consultant. I asked where I should go, she made a few phone calls and mentioned one specific consultant that was supposed to be good but had a long waiting list. I decided to wait a bit longer hoping to get good advice. I got an appointment in three months time from diagnosis.
I googled diabetes-related info and recent research and stumbled upon some supposedly revolutionary discovery that claimed diabetes can be reversed with a vegan diet. Since I was vegetarian for a period of time in my twenties, I thought I could revisit the diet and this time go even vegan. I also stumbled upon a few articles mentioning BG meters and totally ignored them as I was under the impression my diabetes was of a very moderate kind and did not require anything as drastic as finger pricking.
The vegan diet combined with Metformin did wonders. I feld extremely energized and thought I found a solution. I had never measured my BG during that period but anecdotal evidence would suggest it was relatively well controlled (once I got my BG measured at the doctor's after breakfast and it was 7.2). I think this was my true honeymoon period.
Three months passed, I was on the vegan diet with Metformin, lost 10 kg because of not stuffing myself with chocolate after dinner and felt great. The diet was certainly not low-carb but my total carb intake decreased during this period (compared to pre-diagnosis). Also, because of the weight loss, I must have become more insulin sensitive.
When I eventually turned up at the diabetic consultant, he asked me a few questions, asked several times about my recent weight loss and I explained it was due to the low-calorie vegan diet. He said more tests needed to be taken and then he would be able to tell more - in particular what type of diabetes I have. I had a number of tests done, including C-peptide, GAD and HbA1c.
During my next visit, he informed me of the results. He said the GAD is 80 times over the norm and that indicates - unfortunately - that I am Type 1 diabetic. I was in complete shock. He said type 1 diabetes is not an easy condition but that it can be managed and normal life is possible. He also said my diabetes was caught at its onset - rather unusual he said - and that my HbA1c (38) was actually still in the norm. I thought he would perhaps increase my Metformin dosage but quite the contrary. He told me I can now dump my Metformin tablets and must start injecting insulin right away.
At first, all went extremely smoothly but after about two weeks the shock came back and I also had my first incidents of hypoglycemia. I will not go into details here as it would be a very long story but I started having some serious issues. I suffered a couple of panic attacks triggered by hypoglycemia. I think it went like this: I injected 20 minutes before my meal. My BG would typically be just above 5 when injecting. Since I still had quite a bit of my own insulin, the combined effect of my own insulin and the injected insulin pushed me into hypoglycemia at the start of my meal. I started feeling really lousy but when I would check, I would already be above 5. I did not have a CGM then but I think this could have been the situation. Of course not 100% sure... The problems significantly diminished (though not completely disappeared) after I started injecting immediately before my meal and after switching from Lantus to Levemir as well as decreasing my basal dose slightly.
As for my diet, I have gone through some very turbulent developments. As already mentioned, I started with a low-calorie, high carb vegan diet. As soon as I was diagnosed type 1 diabetic, I did some more extensive research, found this forum, read posts about low-carbing by @LucySW, @tim2000s, @Ian DP and many others. I decided I should go very, very low carb. So, I did. However, I ran into some major issues. I got scared and decided to start following the advice of my diabetic consultant, to eat "normal." I still find it hilarious to call a diet that requires meticulous carb-counting, exact bolus timing, imminent risk of hypo- or hyperglycemia "normal." For some time, I was doing relatively OK on the the "normal" diet but then found that my BG was getting rather highish - easily reaching values close to 10 after eating. Was this normal? I was not sure and asked for advice on this forum.
After a couple of months on the normal diet, I decided that I have had enough. I got completely fed up with the constant uncertainty of whether I bolused too much or too little. I decided I will give LCHF another try. I returned from vacation a little early before my family and went hard-core LCHF with a daily intake of 30g of carbs. This time it worked and I went into ketosis. I ate lots of saturated fat as recommended by many following this diet. I was wondering what it would do with my cholesterol and it really did spike. Already a couple of months into the diet, my LDL cholesterol jumped to 4.6 (from the previous borderline 3.0). I felt this was a huge setback. A diet that I enjoyed and more or less worked for me increased my CV risk. Luckily, @Indy51 recommended I follow the advice of Franziska Spitzler who seemed to have the exact same issues like me with LCHF. Cutting back on the saturated fat worked wonders. My LDL cholesterol dropped back to the previous level within just 2 months. Thinking about this, I have to admit I do not understand why high intake of saturated fat has such prominence in LCHF. High intake of saturated intake decreases insulin sensitivity and increases LDL cholesterol for some (may be a minority but still).
So, here I was, on the ketogenic diet, strictly following the advice of Volek and Phinney and waiting until my body fully adapts to ketosis - I read it should take 2-3 months. After about 5 months in ketosis (pretty much uninterrupted, another advice by Volek and Phinney) I sadly realized that my body still cannot function without glucose for certain sports activities (especially anaerobic). I realized that many people (also on this forum) are on and off in ketosis. I figured I may not need to be so dogmatic about being in ketosis 24/7.
After about 5 months in ketosis, I decided to make another change to my diet: keep low-carbing (about 50g of carbs per day) but without going ketogenic. What a relief: I did not have to worry anymore about being kicked out of ketosis by eating food with some tiny extra amount of carbs. Low carbing without going ketogenic is my current diet. This may be true just for me, in my specific situation (with still quite some insulin of my own as confirmed by my most recent C-peptide test about a month ago): Low-carbing without going ketogenic gives me more stable BG levels and also makes me feel better. When ketogenic and after excercise, I would often have to completely stop taking insulin as I was going too low. So, I was on an off on insulin which I did not find great. My goal was never to go "insulinless" as this could not work for me in the long term anyway. I think LADAs should always try to take a tiny bit of insulin (if only 1 unit of NovoRapid before meals).
To sum up, I found low carbing without going ketogenic the best of all the diets I have tried so far. However, I have to admit I still do not feel as good as in my pre-diabetic life and currently struggling with my basal. The goal for me, like probably for most on this forum, is to feel "normal" and I found this is very hard if I eat "normal."
Finally, a big thanks to everyone on this forum. When I was diagnosed with T1, my diabetic consultant told me that a lot of learning is in front of me and that the healthcare staff would teach me a great deal in the months to come. That actually never took place. Almost everything I learned about diabetes was on this forum.
And one more thing: getting a CGM made a whole world of difference to my diabetes management and also to my self-confidence.
When I turned 40, I went for a regular checkup to my GP. The results were OK except for 2 things: cholesterol (highish) but more importantly, my fasting BG was over 7. A bit of a surprise to the GP as well as to me. On the other hand, I have to say, I had been feeling weird (tired, irritable, without energy, etc.) for the past two or even more years.
Anyway, the next step was to take the OGTT test. This is a test where they make you drink a glass of glucose and then measure your BG after 1 and 2 hours. What a shock that the first time I could not take the test as my fasting BG was over the max. permitted value for this test - I think 8 or so. I came in once again and just made it for the fasting limit this time. The OGTT revealed my BG after 2 hours was 12. If you are over 11 (at least where I live), you are diagnosed as diabetic.
I went back to my GP to hear the verdict of being a diabetic. She handed me a prescription for Metformin (500 mg/day), gave me a few leaflets with dietary advice and murmured something in the sense that I seem a bit young for a type 2 diabetic. Then she told me I should see a specialized diabetic consultant. I asked where I should go, she made a few phone calls and mentioned one specific consultant that was supposed to be good but had a long waiting list. I decided to wait a bit longer hoping to get good advice. I got an appointment in three months time from diagnosis.
I googled diabetes-related info and recent research and stumbled upon some supposedly revolutionary discovery that claimed diabetes can be reversed with a vegan diet. Since I was vegetarian for a period of time in my twenties, I thought I could revisit the diet and this time go even vegan. I also stumbled upon a few articles mentioning BG meters and totally ignored them as I was under the impression my diabetes was of a very moderate kind and did not require anything as drastic as finger pricking.
The vegan diet combined with Metformin did wonders. I feld extremely energized and thought I found a solution. I had never measured my BG during that period but anecdotal evidence would suggest it was relatively well controlled (once I got my BG measured at the doctor's after breakfast and it was 7.2). I think this was my true honeymoon period.
Three months passed, I was on the vegan diet with Metformin, lost 10 kg because of not stuffing myself with chocolate after dinner and felt great. The diet was certainly not low-carb but my total carb intake decreased during this period (compared to pre-diagnosis). Also, because of the weight loss, I must have become more insulin sensitive.
When I eventually turned up at the diabetic consultant, he asked me a few questions, asked several times about my recent weight loss and I explained it was due to the low-calorie vegan diet. He said more tests needed to be taken and then he would be able to tell more - in particular what type of diabetes I have. I had a number of tests done, including C-peptide, GAD and HbA1c.
During my next visit, he informed me of the results. He said the GAD is 80 times over the norm and that indicates - unfortunately - that I am Type 1 diabetic. I was in complete shock. He said type 1 diabetes is not an easy condition but that it can be managed and normal life is possible. He also said my diabetes was caught at its onset - rather unusual he said - and that my HbA1c (38) was actually still in the norm. I thought he would perhaps increase my Metformin dosage but quite the contrary. He told me I can now dump my Metformin tablets and must start injecting insulin right away.
At first, all went extremely smoothly but after about two weeks the shock came back and I also had my first incidents of hypoglycemia. I will not go into details here as it would be a very long story but I started having some serious issues. I suffered a couple of panic attacks triggered by hypoglycemia. I think it went like this: I injected 20 minutes before my meal. My BG would typically be just above 5 when injecting. Since I still had quite a bit of my own insulin, the combined effect of my own insulin and the injected insulin pushed me into hypoglycemia at the start of my meal. I started feeling really lousy but when I would check, I would already be above 5. I did not have a CGM then but I think this could have been the situation. Of course not 100% sure... The problems significantly diminished (though not completely disappeared) after I started injecting immediately before my meal and after switching from Lantus to Levemir as well as decreasing my basal dose slightly.
As for my diet, I have gone through some very turbulent developments. As already mentioned, I started with a low-calorie, high carb vegan diet. As soon as I was diagnosed type 1 diabetic, I did some more extensive research, found this forum, read posts about low-carbing by @LucySW, @tim2000s, @Ian DP and many others. I decided I should go very, very low carb. So, I did. However, I ran into some major issues. I got scared and decided to start following the advice of my diabetic consultant, to eat "normal." I still find it hilarious to call a diet that requires meticulous carb-counting, exact bolus timing, imminent risk of hypo- or hyperglycemia "normal." For some time, I was doing relatively OK on the the "normal" diet but then found that my BG was getting rather highish - easily reaching values close to 10 after eating. Was this normal? I was not sure and asked for advice on this forum.
After a couple of months on the normal diet, I decided that I have had enough. I got completely fed up with the constant uncertainty of whether I bolused too much or too little. I decided I will give LCHF another try. I returned from vacation a little early before my family and went hard-core LCHF with a daily intake of 30g of carbs. This time it worked and I went into ketosis. I ate lots of saturated fat as recommended by many following this diet. I was wondering what it would do with my cholesterol and it really did spike. Already a couple of months into the diet, my LDL cholesterol jumped to 4.6 (from the previous borderline 3.0). I felt this was a huge setback. A diet that I enjoyed and more or less worked for me increased my CV risk. Luckily, @Indy51 recommended I follow the advice of Franziska Spitzler who seemed to have the exact same issues like me with LCHF. Cutting back on the saturated fat worked wonders. My LDL cholesterol dropped back to the previous level within just 2 months. Thinking about this, I have to admit I do not understand why high intake of saturated fat has such prominence in LCHF. High intake of saturated intake decreases insulin sensitivity and increases LDL cholesterol for some (may be a minority but still).
So, here I was, on the ketogenic diet, strictly following the advice of Volek and Phinney and waiting until my body fully adapts to ketosis - I read it should take 2-3 months. After about 5 months in ketosis (pretty much uninterrupted, another advice by Volek and Phinney) I sadly realized that my body still cannot function without glucose for certain sports activities (especially anaerobic). I realized that many people (also on this forum) are on and off in ketosis. I figured I may not need to be so dogmatic about being in ketosis 24/7.
After about 5 months in ketosis, I decided to make another change to my diet: keep low-carbing (about 50g of carbs per day) but without going ketogenic. What a relief: I did not have to worry anymore about being kicked out of ketosis by eating food with some tiny extra amount of carbs. Low carbing without going ketogenic is my current diet. This may be true just for me, in my specific situation (with still quite some insulin of my own as confirmed by my most recent C-peptide test about a month ago): Low-carbing without going ketogenic gives me more stable BG levels and also makes me feel better. When ketogenic and after excercise, I would often have to completely stop taking insulin as I was going too low. So, I was on an off on insulin which I did not find great. My goal was never to go "insulinless" as this could not work for me in the long term anyway. I think LADAs should always try to take a tiny bit of insulin (if only 1 unit of NovoRapid before meals).
To sum up, I found low carbing without going ketogenic the best of all the diets I have tried so far. However, I have to admit I still do not feel as good as in my pre-diabetic life and currently struggling with my basal. The goal for me, like probably for most on this forum, is to feel "normal" and I found this is very hard if I eat "normal."
Finally, a big thanks to everyone on this forum. When I was diagnosed with T1, my diabetic consultant told me that a lot of learning is in front of me and that the healthcare staff would teach me a great deal in the months to come. That actually never took place. Almost everything I learned about diabetes was on this forum.
And one more thing: getting a CGM made a whole world of difference to my diabetes management and also to my self-confidence.
