Low Carbing

A questions here...

Your highs when you haven't done exercise for a couple of days! Are you adjusting your insulin dose to compensate for lack of exercise!

I've never tried low carb pasta, but I do find that making my own pasta it doesn't impact on my blood glucose in the same manner has shop brought pasta...

I would agree with the 'Trend' of T1's doing Bernstein, it something I've seen over the years, it comes into fashion then disappears again, similar to any VLC diet mainly due to only a few are able to maintain their motivation over a long period of time...

When you looking into VLC diets, it's wise to pay very particular attention to your insulin dose, and your insulin profiles, Bernstein actually uses 3 types of insulin, a background, a soluble quick acting i.e humulin S and a quick acting insulin such as humalog.. The latter being mainly used for corrections..

As the older soluble insulin, has a slower profile to reach it's peak, so can be easier to match it's slower profile to the adsorption of high fat/protein meal..

Another thing you've got to consider and be wry off, is when you running your BG in a tight range near the lower end of the 4's this can diminish you hypo awareness... As the more time you levels duck under the 4mmol/l and run just under this mark, it desensitise the body's hypo warning symptoms, which then means when you do pick up hypo's you have a very brief window to get yourself out of the hypo, before a medical emergency is created...

Another consideration, is do you have a driving licence! Because running your levels at the bottom end of 4mmol/l, which could mean you are ducking under 4mmol/l for period of times, this will revoke your driving licence... If you have a driving accident, and it's found that you've started your journey at the low end of 4mmol/l and your BG has dropped below this then you could land yourself up in court, driving without due care and attention and/or driving under the influence...

But whether you have to go to a vlc diet, may be not.. May be that you just need to look at the portion sizes you eat, and cut these back slightly to improve good control... T1's I know who have been long term diabetic, and I'm talking about 40plus years, all eat a normal but moderate carb diet, and haven't suffered long term complications...

I eat a normal diet, but it's not that high in carbs as such but I do have a small appetite so in my case this helps...

Hi Sam,

I'm Type 1 and I do a low carb diet at about 30 grams a day. I've had the best control in my life on this method.

I'd say that hypo's are less likely to occur as you stop the blood glucose swings.

You are also taking less insulin so the action is more precise - Bernstein talks about this in his 'law of small numbers'.

There's a lot of info in the Low Carb section - you really need to have a read of that and it should answer your questions.

You will need to monitor your insulin levels of course and get used to not having toast and cereal for breakfast (or any other time) but I guarantee your HbA1c will improve and therefore you risk of complications will decrease.

I drive and have no problems doing so on this regime, I also have good hypo awareness. I've not had a severe hypo (i.e. where I've needed to be assisted by someone else) at any time during this approach. I also find my energy levels are much higher and am less prone to crashing out; that is because if you are in ketosis you have a constant supply of energy. Low carbers who do marathons don't hit the wall as there is no wall to hit if you're burning fat.

Best

Dillinger

Sam,

I've never low-carbed in the respect that Bernstein does as the diet is very restrictive and not one I could adhere too, however I was eating between 90-120g a day for a while and felt fine although my current level is 150g and I do not have any issues with energy levels or tiredness.

Read the low-carb section for tips and advice, as Jo and Dillinger say you will have to monitor your bg levels more closely for a while and it's likely that your insulin requirements may reduce, any questions fire-away as there's a couple of type 1's on the forum who follow the Bernstein approach as well as Dillinger.

Good luck!

Thanks for posting this question Sam.
I found what Dillinger said very interesting and will look up the Bernstein diet now. I count carbs and have been cutting down from 90 grams per day to around 60. I am on very little insulin but go hypo very quickly, and felt that less insulin and carbs would be better for me. Good luck with what you decide.
Gerri x

SamJB said:

I know this topic has been raised before and indeed there is an entire section on this forum dedicated to it, but to save me trawling through the forum I'll just ask my question here!

I've noticed that low carbing for T1s is becoming a bit of a trend, so I just want to know what people's experience of it is. Do you find that you lack energy? Is it safe to eat so little carbs (in terms of general health)?

I'm considering going on it (a routine similar to the Berstein one) as I do experience a lot of spurious highs if I've not done any exercise for a few days and I've figured if I'm not eating many carbs I won't get so many highs.

What does low carb bread and pasta taste like? I've found this website that seems quite good..

http://www.lowcarbmegastore.com/

Thanks!

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I like the lowcarbmegastore.co.uk or sugarfreemegastore.co.uk, same place I have had good things from them.

If you look on the thread - low-carb for type 1 diabetics by Dr John Briffa - posted today - he has written a whole article about it.

I've just read Briffa article of T1 and low carbing...

He's actually giving misleading information... As the results he gives for the study is incorrect, sorry but those who succeeded to adhered to the diet, only drop by 1% so down to 6.6%! He also fails to mention that even though LC diets are popular in Sweden, that 52% of those taking part in the study failed to adhered to the diet! So not quite the easy diet to stick to..

He's also making other assumption that could for an unaware T1 diabetic, that less carbs means less insulin, Which isn't always true, as a high fat/protein meal can often require more insulin than a carb based meal!

So, if a T1 is considering a VLC diet, then their best advise is avoid a misleading Briffa, and take a look at Bernstein who even though I don't agree with him myself, but at least he does a better job with giving information based on using insulin with a VLC diet..

SamJB said:

Dillinger, could you give ne an idea of meals you eat to keep your carbs so low? Cheers.

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Hi Sam,

I basically follow Atkins induction. You have to disregard all the previous dietary advice you've had about avoiding fats though!

The low-carb pasta doesn't work for me - still raises blood sugars

There are lots of ideas in the recipe section in the low carb bit.

Best

Dillinger

Exactly what has someones punctuation and grammar got to do with the content of a members post?

Perhaps, if Briffra would show some respect to his readers by ensuring that his he's firstly proof read what he's written to ensure that not it's hasn't got typo errors, but information he's provides is actually correct! Which he hasn't at all...

He's misleading readers to believe that the precipitants of the study improved control by a greater degree than they actually did, he also suggests that all precipitants that failed to adhered to the dietary regime made no improvements, but if you check the study, you will find that concerning improvements, they had split those that didn't adhered to the dietary regime, as dependant on the level of failure to adhere to the dietary regime meant that some still made improvements with controls all be it not as great as the ones who stuck with it, and one of these non-adhering (smallest group) didn't actually make any improvements!

That is nothing but giving misleading information!

Hi Sam!

I have LADA and I have low-carbed since my misdiagnosis with type 2 nearly 3 years ago. I'm not as strict as some of the other guys and certainly don't manage the regimented diet Bernstein recommends (although i am absolutely sure he is right). I have up to 50g of carb a day (usually between 30 and 40). This level has kept my HbA1c between 5.7 and 6.1 for the whole time. I find avoiding starch and, especially sugary, carbs essential for avoiding the high spike/sudden crash roller-coaster. It also means I can keep my insulin needs low which makes it more accurate. I don't get the severe hypos that others talk about - when my BG goes below 4, it generally hangs around the high 3s for a long time without going lower and is very easy to correct.

I think learning to cook good low-carb food and treats is really important to your ability to stick to it. Have a look in the low-carb diet section - there are some great recipes on there. Don't be tempted to try to lower your fat intake, though, or you will be hungry and lose weight - you still need to get the right amount of calories!

As for whether it harms you, I don't think it does. My HbA1c has been good, my cholestorol and blood pressure are excellent and my weight is stable, so I'm happy with it. I honestly believe that one day it will become the recommended way to control Type 1/1.5, but for now, you need to mae up your own mind.

Good luck.

Smidge

Hi Sam

I am not T1 but have an interest in the that recent 2012 T1 Low Carb Study http://www.dmsjournal.com/content/pdf/1758-5996-4-23.pdf as it was done by the same team who recommended similar stuff for T2's like me.

It shows a 1% improvement in HbA1c which although sounds small then as the NHS and actuaries would tell you that it would give a 40% reduction in your risk of cardiovascular disease and an "episode" in the next 10 years so hardly insignificant. Given that both the ADA and UK health services advocate low GI diets because they can reduce HbA1c by 0.5% then a 1% reduction has to be viewed in that context.

It has been criticised on this forum as having a low adherence rate of 48%. In reality that is a better adherence rate than the NHS gets for T1's on its present dietary recommendations by around 15%. If you consider that only 33% or a third of T1's achieve an hBA1c inside the NHS 7.5% target then having a group of T1's where a half of them rather than a third not only meet the 7.5% target but blow it out of the water seems to be a massive improvement.

I discovered the 2012 study seems to repeat a similar one done by the same researchers back in 2005 which came to similar conclusions. Both studies end up showing similar reductions in hBA1c and show lipid levels remaining largely static. The earlier study can be seen here. http://www.dsolve.com/component/option,com_docman/task,doc_download/gid,24/ That one reported around a 40% drop in insulin requirements and big improvements in hypo rates.

Just read them both and draw your own conclusions.

Reminder. Personal attacks against forum members are not allowed and this includes any remarks about a members spelling or grammar. I have cleaned up some posts in this thread.

Debate about whether something is correct or not is fine insults and personal attacks or not please keep this on track if the discussion is to continue.

SamJB said:

All diabetics should be made aware of this

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Yes those Swedes do seem to know their stuff :lol: As T2 I try to follow their health service recommendations for diabetics in preference to the NHS "starchy carb" dietary guidelines. A lot of their guidelines have been set by people with a similar slant to those who wrote the research. My personal heroine is a lady doctor called Annika Dahlqvist. She started recommending low carb regimes to diabetics back in 2006. She was taken through the Swedish courts for recommending a dangerous diet but won her case and now a lot of what is recommended by the Swedish government is based on her and similar peoples work. You can find her dietary recommendations in English here

http://blogg.passagen.se/dahlqvistannika/?anchor=my_lowcarb_dietary_programe_in

The Swedish government is actively promoting "low carb" to its general population as a means of combatting the ever increasing rise in obesity, diabetes and associated health issues. It's now though a quarter of Swedes try and follow a "low carb" regime. Shame we don't have such a forward looking health system in the UK.

In that context it's also worth checking out is this site as it's the English version of the major Swedish site used to promote low carb.

http://www.dietdoctor.com/lchf

Everyone should make their own choice over this kind of stuff. What I would suggest is to keep asking questions as many T1's, T1.5's and insulin using T2's on the forum have followed variations of similar low carb regimes with great success over the years and should be able to offer you some really good advice. You are right everyone deserves a decent hba1c!