LCHF - does it actually help T1D's?!

Welcome! I think a low carb diet may be a consideration later on, but it sounds like you have some more pressing issues that need to be addressed first.

My first questions are to ask if you carb count and how often you test? What exactly are you struggling with at this point?

If your levels have skyrocketed from an a1c of 11% that's not only going to lead to complications, that's potentially life threatening IMMEDIATELY. I don't want to scare you but I am very glad you joined here. I think it will be well worth your time.

You have the essence of it in that big carbs=big BG swings=bigger corrective doses. Carbs are quite addictive and I have found that cutting carbs has meant I am not hungry between meals and have completely eliminated snacking which if combined with mealtime swings can leave your BGs all over the place. In the short term I would try and cutback on the heavy carbs (bread/rice/pasta) while you steady things down.

Hi @lenaiiyy, you might find this useful. http://crick-tech-munch.blogspot.com/2016/01/deconstructing-myths-surrounding-low.html

As @TorqPenderloin has already mentioned, running with Hba1C levels that high really isn't good for you, but you already know that, which is why you are looking at alternative approaches.

As a T1 of 27 years who has eaten most ways, my take on it is that the key benefit of low carb is that it reduces the swings you see in blood glucose. This makes you feel much better. As @steve_p6 mentions, by reducing the amount of carbs and increasing both fats and protein, you find that you are also much more satiated. You don't need to snack to any great extent and you feel much less hungry. In that sense, if you struggle with your weight at all, it also helps you to reduce your food intake and lose weight.

Finally, by reducing the amount of carbs, you reduce the amount of insulin you need. And smaller amounts of insulin lead to reduced bg swings and lower likelihood of severe hypos.

Coming back to your original post, you state that you are struggling with maintaining levels at the moment. This is usually a sign that your ratios are out of kilter, and more normally, that there are issues with your basal set up.

Have you undertaken basal testing to confirm whether this is correct? This is a how to, and what to do next link: https://mysugr.com/basal-rate-testing/ Often, people find that this is wrong, which makes everything else go wrong as a result.

Once you are certain that this is good, you can look at your Insulin:Carb ratios to confirm whether they need updating.If you've not been carb counting, then this will help a lot: http://www.bdec-e-learning.com/

Also, if you haven't done any kind of "Living with Diabetes" education, it is well worth nagging your diabetes care team like crazy to go on something like DAFNE, which takes you through all of this stuff.

Hope that helps, and welcome to the forum!

lenaiiyy said:

thank you for your links and advice - great to have that confirmation, especially as you said you have eaten most ways! Basal testing - I've never even heard of it! Would it make a difference that I manually inject?
I have asked to do DAFNE, but my work schedule doesn't really allow me the time - do you know of any other programs I could possibly try that are online or something?

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Hi Lena, reading your post, it suggests that your biggest problems stem from the way you are currently managing the condition. You really need to get yourself into Carb Counting. It's the only way that you can really know how to inject the right amounts of insulin. The link to http://www.bdec-e-learning.com/ is your friend here. It will take you through carb counting, and I can't understate enough how important this is. You still need to be able to do this to maintain good levels on an LCHF diet as a T1. The reality is that on the MDI model, there is no alternative to learning to carb count.

Secondly, basal testing is something that you do regardless of whether you use a pump or multiple daily injections (MDI). Most of us have had to do it at one time or another in order to regain optimal management.

The only way to really understand what is going on with Diabetes is what I like to call the 3Rs. Record, Review and React. I wrote about it on my blog, but it's what I do to understand what's happening and how the patterns roll out. It's a bit of a discipline, but it's extremely helpful.

It also relates to your issues with trying to maintain decent levels with exercise. I used to do Tae Kwon Do, and that in many ways is like boxing. It's a highly intense sport. What's happening at the moment is that you are essentially injecting random amounts of insulin and not really knowing how much should lower you blood glucose or match off against any carbs that you've eaten. Once you understand this, and follow the three Rs, you can start to observe how much exercise reduces your blood glucose levels by when you do take insulin and then start to adjust your dose accordingly. You probably don't need to just stop taking the lunchtime dose, but until you know how much affects what amount of carbs, and how much exercise increases the effect of the insulin, you can't really manage it. You might want to go and take a look at the www.runsweet.org website, which is all about exercise with diabetes to gain a bit more understanding of this.

As my signature says, No condition demands more of the individual than Type 1 Diabetes, but at the same time it is a condition that you can make work with you and live alongside. Treat it as a friend, and while it might not be benevolent, it's much less likely to screw you over.

Hi Lena, lots of good advice and links from @tim2000s. What opened my eyes to the need to sort out my carbs was getting a Freestyle Libre which was a massive help. There is a lot to learn, plus you have to learn how your body responds (we really are all quite different) to be able to control things. Follow the 3Rs, fight one battle at a time and the skills will develop and your control will improve. Any setbacks or surprised are simply opportunities to think about why it happened and what to try differently next time.

The key thing is balancing your insulin against what you are eating; carb counting is not optional. You cannot manage blood sugars without it.

Once you have that down then the next step is to reduce your carbs until your blood sugars become manageable.

Read up on carb counting and dose adjustment; it's pretty simple really (start with 1 unit of short acting for every 10 carbohydrates and adjust from there).

Make sure you are getting the best medical support you can. Try and find the best regarded diabetic clinic (hopefully a teaching hospital) near you and get referred there by your GP. Ask your GP where they would go if their child was a diabetic if you are having trouble locating one yourself.

Not doing DAFNE because you are too busy at work is kind of crazy really; your work needs to support you and make reasonable accommodations for you and your illness. If it really is impossible take a week as holiday and do it then.

Your HbA1c is a real problem; it's hurting you so, please keep trying and keep reading up on this and act on it.

Buy the book 'The Diabetes Solution' by Dr Richard Bernstein.

You are on the way to sorting this out; good luck.

Best

Dillinger

I too think a lot of your control problems stem from not counting carbs. That's absolutely crucial. If you don't count carbs, it's like 'driving blind'. Your insulin needs to 'cover' your carbs. You can only do this by counting carbs and knowing your insulin to carbs ratios.

But start with basal testing first, as that's the foundation on which you'll build.