Medium/High carb diet & good control

[GlazedDoughnuts]

Hi All,

Just wanted to share my experience on maintaining diabetes with a 'normal' diet, by normal I mean one that isn't low carb/devoid of carbs. I pretty much eat like a 'non diabetic'.

I am a Type 1 diabetic, I am on 30 units of Levemir a day, approx 32 units of Novorapid a day.

Here's my break down of dietary macros:

230 grams of carbs, from oats, bread, simple sugars & etc.
230 x 4 = 930kcal from carbs.

150 grams of protein a day
250 x 4kcal = 600kcal a day from protein.

40g fat a day from fish oils, nuts and meat.
40 x 9 = 360kcal from fat.
So that's 1890kcal a day.

What's your blood sugars like?
Upon waking: 5-7 mmol
Pre meal: 5-7 mmol
After meals: 6-7 mmol
Before bed: 5-7 mmol

Do you drink alcohol?
Occasionally yes, I simply miss a shot of Insulin and eat carbs here and there, by doing so, I can still stay in range.

Is x amount of Insulin making you put on excess fat?
No, in fact I've been losing weight as I'm eating at a calorific deficit.

Do you do anything else other than eat carbs & take Insulin to maintain good control?
Yes, in order to maintain good control I weight train five times a week, do Martial Arts training twice a week, and do a lot of walking, you could call the Martial Arts training cardio.

How do you feel day to day?
Great, diabetes is a very small part my life; it's taken a back seat - where it belongs, I rarely have hypos/hypers. Do not experience any other diabetic issues either. Last hba1c was 6.9% (before I became incredibly active), my eyes show no damage, no ED & etc.

How often do you test?
Only when I feel 'odd' but to my surprise I find my sugars are within range 5-7mmol, and usually an odd feeling is due to something else. I can now pretty much go without testing and maintain great control.

Are you over weight?
Nope, within normal BMI.

What's the point of this thread?
To say there is another way, low carb may work for some, but for those who enjoy eating carbs and want to be able to eat any where/without restrictions there is a way forward! Regardless of diabetes or not, perhaps we should all take a moment and exercise (if we're not physically limited of course).

I'm sure there are quiet a few others who maintain good control without having some crazy restricted diet, please do step forward and share your experiences.

In conclusion I eat like I have always done, maintain awesome control and bear no restrictions due to diabetes. Diabetes is what you make of it, you can either put it on a pedestal and let it take control of you, or you can actively manage it and live a pretty normal life AND still maintain good control.

 

[donnellysdogs]

Yep, I also eat what I like pretty much... Never worry how many carbs ( or cals) I have.
No complications.
27+ years type 1.
Hba1c 6.5 or 7.2 taken within a week of each other ( one artery/1 finger).
Drink alchohol.
On pump, physically very active, bmi of 22.
Just think my food intake balances out my physical activity.
Not quite so balanced as your bgs, because oh highs when pump, sets, airbubbles effect my life, but pretty much normal ranges 93-97% of time.
I don't let my diabetes rule me either.

 

[SamJB]

Good for you, wish I could've achieved that on carbs. Unfortunately I was having a lot of random highs. Since switching to low carb I don't get them.

I always say if you can get by on carbs, then why restrict yourself? Likewise if a high carb diet isn't working for you, then why continue?

 

[Daibell]

Hi. All of the posters are T1 and I'm also a 'T2' now on insulin. We are lucky to the extent that we can increase insulin to the extent necessary to match the carbs we would sensibly like to eat. Before I went onto insulin 2 months ago I had to starve myself of carbs for many years to even achieve a recent HBa1C of 8.3%. Never overlook the T2s, particularly the 20% who aren't insulin resistant, who don't have any choice. There is a complete range of diabetes types out there and low'ish carbing is normally a safe default way forward to keep sugars low; note I said low'ish not zero'ish carbs.

 

[noblehead]

It does like your all the right things GlazedDoughnuts and have a positive outlook living with diabetes

I'm sure there are quiet a few others who maintain good control without having some crazy restricted diet, please do step forward and share your experiences.

Unfortunately some people with diabetes do have to restrict the carbs in their diet and this is particularly so in those who have type 2 diabetes, it's easy to forget that as type 1's we can choose to eat a well balanced diet and inject insulin to cover our food intake.

I don't low-carb but did try it for a short period of time and did stick at around 90 - 130g a day for several months, at present I eat probably between 150 - 180g a day, from my own experience I find eating carbs with my meals more manageable when it comes to bg control as they are digested quickly and don't impact on bg several hours after...such as a diet which is high in protein and fat, I also had concerns about the long-term effect of a diet high in protein and fats and that did influence why I never stuck to a lower (ish) carb diet, if ever I were to low-carb again I would seriously have to change my insulin regime as the insulin's I'm using on MDI would mean I'd have to inject over and above the 4 injections I now take each day.

I say each to their own and it's up to the individual to find a diet that best suits them, there's always going to be a few who feel that they need to push a particular view or feel it necesary to detail what they've eaten during the course of the day, I say good luck to them and if it helps them cope with living with diabetes then so be it!!!

 

[GlazedDoughnuts]

I get the whole T2 argument, but at the end of the day there's a reason NHS suggests a diet for all diabetics, if with drugs you still cannot control your blood sugars you may legitimately need Insulin...

But going against the NHS advice, lowering your blood sugars by not eating carbs may give you good results, but what's to say you're producing enough Insulin? You're masking an issue, and by doing so could be hindering your health.

When I was first diagnosed, I came on here, bought into the low carb concept, ate near enough Keto style, awesome, lower blood sugars, **** performance in gym, ketones (but it's ok, i'm low carbing right???) and feeling **** in general.

I sat down and had a think, hmm could I be just fooling myself/my health team by doing this? Went back to eating carbs, holy batman, constant ketones, high blood sugars, couple of weeks go by, still producing ketones, still losing weight, I was put on Insulin.

Low carb is great, but I think we should allow our health teams to confirm first, whether we're truly Insulin resistant or whether we do not produce enough Insulin!

Edit:

Hi. All of the posters are T1 and I'm also a 'T2' now on insulin. We are lucky to the extent that we can increase insulin to the extent necessary to match the carbs we would sensibly like to eat. Before I went onto insulin 2 months ago I had to starve myself of carbs for many years to even achieve a recent HBa1C of 8.3%. Never overlook the T2s, particularly the 20% who aren't insulin resistant, who don't have any choice. There is a complete range of diabetes types out there and low'ish carbing is normally a safe default way forward to keep sugars low; note I said low'ish not zero'ish carbs.

This is interesting, now if you hadn't low carbed, followed the typical NHS advice, would it be fair to say you would have probably been put on Insulin quicker? Surely they would of seen your body is unable to cope with carbs regardless of drugs to help increase sensitivity/natural output of Insulin. And this is why I don't think it's wise to sell the low carb idea, especially yo new diabetics so quickly, it could just mask a bigger issue. :think:

 

[Daibell]

Hi Glazeddougnuts. You're assuming that all GPs are expert or care enough to spot those who need insulin and move them to it as soon as needed. I am one of those T2s who have never been overweight etc. When I told my newly trained diabetes GP a couple of years back that I was having to starve myself of carbs to keep my blood sugar anywhere near reasonable she told me I should be having 'normal 'diet and when I said I wanted to go onto insulin she said 'it was a last resort' and we ended up adding Sitagliptin to my tablets which helped a bit for a while. This year having had 2 years experience of the real world of diabetes she offered me insulin and I've been happily on it for a couple of months now. GPs rarely do a c-peptide test to determine insulin levels. I had mine done privately a few months back and it showed I had virtually no insulin; pity the GP didn't test for it. The problem is once you get labelled a T2 you are sent down a route and low-carbing is unavoidable to start with if you are not insulin resistant and important initially anyway if you are insulin resistant to get weight down. No, low-carbing isn't non-sense as long as you don't go lower than you really need to and you have the support of knowledgeable GPs. My current DN, however, is fantastic.

 

[GlazedDoughnuts]

Insulin may well be seen as a last resort, some GPs may ignore some obvious triats, but there guidelines in place (NICE) which can even be found online, given this, if your blood sugars are consistently over the NICE limit, your GP should be putting you on different drugs/getting closer to Insulin.

If that's not the case, you can complain, write to your PCT, change GP etc.

I wouldn't sit there and just low carb to avoid the issue, and hope no one else feels the need to either!

 

[jddukes]

Hi Glazed,

I am very pleased to hear your success story - those are great numbers and good news to hear. Have you had your tri's and LDL:HDL ratio levels checked recently, and do you have reference values to compare with if you have recently obtained these? Those would be quite interesting as well to bear in mind.

The problem is, there are a huge number of people who do not have such great control as you do on medium-high carbs. This is in fact, published material. Sam posted a study which was looking into how educating people on low-carb diets improved their adherence to them (type 1's) and as a consequence improved their HbA1c AND more importantly their AUC/standard deviation of their levels. This is very important as one of the most detrimental things to a type 1 is fluctuation of levels, highs and lows. This is a reason why an average on a meter is not a good indicator of how well your diabetes is under control, for such people.

The other problem is that guidelines are out of date. There is a significant amount of growing evidence that low carb diets reduces CVD blood markers and as said above, improve overall glycaemic control. This can mean a better quality of life for many, and more importantly a longer complication-free life.

I think the issue is actually that you are following the guidelines and there is a reaction from those of us whom the guidelines have failed. This may come across on the forum as many low-carb advocates saying that low-carb is the best thing and superior to other methods, but in fact I do not feel that is the case. I myself am on very low carbs and highly recommend it to anyone struggling on high carbs - but I would never blanketly state that they are superior.

The reaction comes from the fact that GPs, dieticians, guidelines - they all promote high-carb diets and for many, this simply does not work. Combine this with growing evidence that low-carb diets can be safe and very effective for many (not all) and quite frankly what most of us want is that evidence to translate to the GPs, dieticians and guidelines. We are not saying everyone should be low-carb nor that it should be standard of care. We are saying it should be presented as an equally viable dietary option and that is should most definitely be considered and pursued in the case of those struggling with proper glycaemic control under a standard high carb diet. That is for the sake of their health.

Many of us are going against what we are told and are improving all of our markers of diabetes and CVD with no negative side effects. Does this mean that our approach should be advised to everyone as the best approach? No not at all. However it should mean that experts need to accept its validity and have a responsibility, as those trying to further the advance of medicine, to give these approaches an equal standing as an alternative diet.

Diabetes is very unique to the individual and everyone will be different. So while you have a great success story, many others will try your approach and fail. I believe it is immoral to deny those people asking for advice the alternative of trying low-carb. Equally many will try low-carb and struggle with it and find it too inhibitory/fail with it or do not even need it as they can manage on high carbs fine, like yourself.

The issue is more equal acceptance of differing approaches that can both be effective - not that one is better than another in all cases.

Well done though, it is great your diabetes can be such a small part of your life!

J