Need a diet

[Natbat87]

I got diagnosed with type 1 8 weeks ago.. I'm a little over weight & want to shed them extra pound.. what diet does everyone recommend

 

[GrantGam]

I got diagnosed with type 1 8 weeks ago.. I'm a little over weight & want to shed them extra pound.. what diet does everyone recommend

It's a personal choice @Natbat87. I find reducing my carbohydrate intake and intermittent fasting helps me drop weight fairly well.

Since you are newly diagnosed, it is very common to see an increase in weight once insulin therapy has been started. It's not an increase in weight as such - it's more a case of you putting back on the weight that your body lost. A lot of newly diagnosed get concerned at this "weight gain", although the majority of those who get concerned don't realise just how much weight was actually lost leading up to diagnosis

 

[Ann1982]

Have a read of the low carb forum see if it would suit you. It seems to have helped lots of others here

 

[Mbaker]

Hi @Natbas87 like what @GrantGam has said it is your choice. If you like fish and meat, I would recommend LCHF, with around 65% low carb vegetables, nuts and berries. I do like the concept of low carb vegetarian but come from a West Indian background with unbelievable smells and tastes for fish and meat protein. LCHF is for me an easy compromise with general proven health benefits (notwithstanding some of the issues with the way poor quality meat and fish is delivered).

 

[GrantGam]

Hi @Natbas87 like what @GrantGam has said it is your choice. If you like fish and meat, I would recommend LCHF, with around 65% low carb vegetables, nuts and berries. I do like the concept of low carb vegetarian but come from a West Indian background with unbelievable smells and tastes for fish and meat protein. LCHF is for me an easy compromise with general proven health benefits (notwithstanding some of the issues with the way poor quality meat and fish is delivered).

I would personally avoid the high fat aspect, especially some of the quantities I've seen mentioned on other sections of the forum...

For T1's, extraordinarily high levels of fat can result in temporary insulin resistance - which leads to elevated BG's many hours after consuming the meal. What this means for us, is ultimately that BG becomes harder to manage. Bolus doses often need to be split and/or increased to account for the effects that the fat can have. It's often referred to as the "pizza effect" - and is a total curve ball when it comes to successful BG management in T1D. It's something that experienced diabetics even struggle with and for that reason, not a dietary choice I'd recommend for a recently diagnosed T1.

A reduction in carbs to a low/moderate level can certainly aid weight loss and make your bolus dosing margin for error significantly smaller; that I can appreciate. But the addition of large quantities of fat will more than likely make things more difficult to manage @Natbat87. I certainly have found that eating too much fat with a meal just turns things upside down entirely.

 

[NicoleC1971]

Hi. I think if you are getting used to a new diagnosis then I might avoid the stress of changing your diet too much and as has been previously mentioned you may simply be getting back to normal weight if you'd lost weight due to undiagnosed type 1 diabetes. Insulin causes weight gain if your body hasn't had much in a while. Stress can stop you losing weight anyway! After that I would look for progress not perfection in improving your diet/stress/sleep habits that might be hampering weight loss - I bet you already know what to do but maybe have trouble doing it consistently? If you don't know where to start then this forum is more low carb oriented and as a diabetic PT I am a fan of that personally! That said there are people who do well on low fat/higher carb but what most effective diets (those that produce sustained loss of fat) have in common is an avoidance of sugar and processed foods.
'Don't do anything you can't stick to for life' is a good guideline since it gets you out of the diet mentality of hopping from on and off whatever diet wagon you are on. Think about what works for you and implement it consistently and try and track results in terms of how good you feel (hunger, energy levels, reaction to certain foods) and circumference measurements (or how certain clothes fit) since the scale can be a terrible indicator of fat loss.

 

[NicoleC1971]

I would personally avoid the high fat aspect, especially some of the quantities I've seen mentioned on other sections of the forum...

For T1's, extraordinarily high levels of fat can result in temporary insulin resistance - which leads to elevated BG's many hours after consuming the meal. What this means for us, is ultimately that BG becomes harder to manage. Bolus doses often need to be split and/or increased to account for the effects that the fat can have. It's often referred to as the "pizza effect" - and is a total curve ball when it comes to successful BG management in T1D. It's something that experienced diabetics even struggle with and for that reason, not a dietary choice I'd recommend for a recently diagnosed T1.

A reduction in carbs to a low/moderate level can certainly aid weight loss and make your bolus dosing margin for error significantly smaller; that I can appreciate. But the addition of large quantities of fat will more than likely make things more difficult to manage @Natbat87. I certainly have found that eating too much fat with a meal just turns things upside down entirely.

Hi. Just wondered where the idea about high fat being bad for blood sugars comes from? I know if we eat carbs and high fat eg. pizza then the meal gets more slowly absorbed but fat in itself will not make sugars rise. Carbs and to some extent, protein do raise blood sugars. Pump users can control for pizza night by using an extended bolus button to drip in the dose more slowly!

 

[GrantGam]

Hi. Just wondered where the idea about high fat being bad for blood sugars comes from? I know if we eat carbs and high fat eg. pizza then the meal gets more slowly absorbed but fat in itself will not make sugars rise. Carbs and to some extent, protein do raise blood sugars. Pump users can control for pizza night by using an extended bolus button to drip in the dose more slowly!

The fat causes a temporary rise in triglycerides which in turn causes insulin resistance. So for me, the insulin injected to cover the carbohydrates does not cover the entirety - so the end result is BG higher than I anticipated.

So you're right, the fat in itself does not raise your glucose - but the fat can directly affect your insulin sensitivity - meaning that the 8u of insulin you injected to cover your typical 80g carbs for example, doesn't cover all of the carbohydrates.

Pump users have access to many excellent bolus delivery profiles - but unfortunately I'm still on MDI so I need to make do with splitting my bolus doses (and increasing them) for fat heavy carb based meals.

Some pump users actually need to do a combi bolus and then run on an increased basal rate for some hours after eating fatty foods. I read about that in Think Like A Pancreas, it's a very good book if you've not got a copy

 

[noblehead]

Hi. Just wondered where the idea about high fat being bad for blood sugars comes from? I know if we eat carbs and high fat eg. pizza then the meal gets more slowly absorbed but fat in itself will not make sugars rise. Carbs and to some extent, protein do raise blood sugars. Pump users can control for pizza night by using an extended bolus button to drip in the dose more slowly!

@NicoleC1971 this Mendosa article explains the process involved:

http://www.mendosa.com/The-Fat-of-the-Matter-How-Dietary-Fat-Effects-Blood-Glucose.htm

 

[hannahrose]

I got diagnosed with type 1 8 weeks ago.. I'm a little over weight & want to shed them extra pound.. what diet does everyone recommend

there are so many good books out there....our support group put out a cookbook years ago....depending on how pizza is made, it is one of the worst foods a diabetic can eat at night! Especially if canned or jarred sauce is used....there is so much corn syrup in it....then there is the dough... I just open up a can of Italian tomatoes and put them on the pizza..in the summer, we use fresh tomatoes... even in this part of NYS, they have no idea how to make pizza...we come from the outskirts of New Haven, CT...where some of the best pizza is made...but my mother taught me how to make pizza...she was from Italy (Caserta)... every year our support group has a harvest dinner....we bring a dish to pass BUT...we have to figure out the carbs and list them on our recipes! It was hard at first but I enjoyed figuring it out... I think 1 of the most important things with diabetes, is eating on time! Not pigging out either...small, frequent meals....and remember..just because it says low sugar, doesn't mean there is NO sugar...there is sugar in everything except water... count carbs too...not the sugar content. Don't know if u ever heard of Chobani yogurt...I don't care for them..it's made 2 towns away from us...the owner will not make a sugar free yogurt yet...so I boycott them... Hopefully he will move out. Our diabetic nurse has 2 kids who work there, and she has spoken to him...maybe she will change his mind? Walk, if u can!

 

[TheBigNewt]

The fat causes a temporary rise in triglycerides which in turn causes insulin resistance. So for me, the insulin injected to cover the carbohydrates does not cover the entirety - so the end result is BG higher than I anticipated.

Actually the trigs don't spike much wrt fat intake in most people. There are some people with lipoprotein lipase deficiency whose trigs can spike up to 3,000. They need to take a fibric acid derivative or high dose niacin. Also some Type 2 diabetics can run slightly elevated trigs, like 300 or so. We don't treat those with drugs, just the diabetes. But most people's trigs stay normal after they eat.

 

[GrantGam]

Actually the trigs don't spike much wrt fat intake in most people. There are some people with lipoprotein lipase deficiency whose trigs can spike up to 3,000. They need to take a fibric acid derivative or high dose niacin. Also some Type 2 diabetics can run slightly elevated trigs, like 300 or so. We don't treat those with drugs, just the diabetes. But most people's trigs stay normal after they eat.

@TheBigNewt, I am speaking from first hand experience as a T1. I cannot be 100% sure if my triglycerides rise - but given the fact my insulin resistance is short lived following a hefty fat intake, the theory fits.

Raised trigs from fat may not be the case for everyone, but it almost definitely is for me - so please don't try to prove me wrong as my point is very much valid and actually contributes to this thread, unlike yours.

I will take the viewpoint of Gary Scheiner as credible - as seen in the link that @noblehead has so kindly provided. It just so happens that he is also the author of the book I referred to...

By the way, here is evidence that post-prandial trig levels are typically elevated:

"After eating a meal the blood is rich in triglycerides. It usually takes a few hours for triglyceride levels to return to normal."

https://heartuk.org.uk/health-and-high-cholesterol/triglycerides

Also, as you have read, trigs are a form of dietary fat found in meats, dairy produce and cooking oils. Further evidence that there is a tangible link between increased fat, raised post-prandial triglycerides levels and in turn, temporary insulin resistance.

 

[Mbaker]

The fat causes a temporary rise in triglycerides which in turn causes insulin resistance. So for me, the insulin injected to cover the carbohydrates does not cover the entirety - so the end result is BG higher than I anticipated.

So you're right, the fat in itself does not raise your glucose - but the fat can directly affect your insulin sensitivity - meaning that the 8u of insulin you injected to cover your typical 80g carbs for example, doesn't cover all of the carbohydrates.

Pump users have access to many excellent bolus delivery profiles - but unfortunately I'm still on MDI so I need to make do with splitting my bolus doses (and increasing them) for fat heavy carb based meals.

Some pump users actually need to do a combi bolus and then run on an increased basal rate for some hours after eating fatty foods. I read about that in Think Like A Pancreas, it's a very good book if you've not got a copy

Hi @GrantGam, I agree with you about too much high fat, I would struggle to get my head around a fat bomb for example, mainly due to as a spoty teenager associating fat / oil with spots. If you look at my signature, I refer to good fats, so I include avocado, cook with either butter or coconut oil.

By reducing carbs, the ratio of fat naturally increases, so below are typical versions of my interpretation on LCHF:

The majority of the fat I intake comes from copious amounts of nuts everyday.

I understand it is carbs which drive up trigs not fat, this correlates with my trigs of 0.51 and a 2 to 1 cholesterol ratio, so in my case I have a different view to yours. I accept that some on LCHF have experienced higher cholesterol.

 

[GrantGam]

Hi @GrantGam, I agree with you about too much high fat, I would struggle to get my head around a fat bomb for example, mainly due to as a spoty teenager associating fat / oil with spots. If you look at my signature, I refer to good fats, so I include avocado, cook with either butter or coconut oil.

By reducing carbs, the ratio of fat naturally increases, so below are typical versions of my interpretation on LCHF:

View attachment 22658

The majority of the fat I intake comes from copious amounts of nuts everyday.

I understand it is carbs which drive up trigs not fat, this correlates with my trigs of 0.51 and a 2 to 1 cholesterol ratio, so in my case I have a different view to yours. I accept that some on LCHF have experienced higher cholesterol.

Hello @Mbaker, thanks for sharing your experiences

As a T2, I think there is good reason why your LCHF experience varies to mine and that of many other T1's. In this instance though, my focus isn't really on cholesterol levels or trigs, it's entirely about making BG management as easy as possible for the recently diagnosed OP. When I mentioned trigs, it was simply to discuss the mechanics behind temporary insulin resistance in T1's following a high carb/high fat meal.

If I were to be in the situation of the OP, ramping up my fat intake would just make matters more complicated for the reasons I've already outlined. Carb counting and bolus dose calculations are difficult enough as it is, and the addition of high fat to the diet can make things even more awkward to manage.

It's also important to note, for the benefit of @Natbat87, that significant dietary changes can require pretty extensive alterations to your insulin doses. If you drop your carb intake too low, strange things like gluconeogenesis can happen. This is when your body converts protein into glucose for energy when there is not sufficient carbohydrates present. Ultimately that means that bolus insulin may be required to cover any protein ingested, it's rather complicated I find.

If I were you @Natbat87, I'd reduce your carbs a little to a moderate level and get in plenty of medium intensity exercise. But that's just my view... We are all fundamentally different and really don't know how our bodies will react to various lifestyle changes. At least if you start in the middle somewhere then you can lean either way to get an ideal balance that works for you.

If it's of any use, when I want to drop weight I skip breakfast and don't eat after my dinner (18/6 intermittent fasting) and will spread 130g-150g of carbs across lunch and dinner. I also do cycling and swimming as my exercise at a consistent pace for fairly long periods. Intense exercise spikes my BG and makes it harder to manage. That's what works for me anyway.

Do let us know how you get on

 

[Mbaker]

Hello @Mbaker, thanks for sharing your experiences

As a T2, I think there is good reason why your LCHF experience varies to mine and that of many other T1's. In this instance though, my focus isn't really on cholesterol levels or trigs, it's entirely about making BG management as easy as possible for the recently diagnosed OP. When I mentioned trigs, it was simply to discuss the mechanics behind temporary insulin resistance in T1's following a high carb/high fat meal.

If I were to be in the situation of the OP, ramping up my fat intake would just make matters more complicated for the reasons I've already outlined. Carb counting and bolus dose calculations are difficult enough as it is, and the addition of high fat to the diet can make things even more awkward to manage.

It's also important to note, for the benefit of @Natbat87, that significant dietary changes can require pretty extensive alterations to your insulin doses. If you drop your carb intake too low, strange things like gluconeogenesis can happen. This is when your body converts protein into glucose for energy when there is not sufficient carbohydrates present. Ultimately that means that bolus insulin may be required to cover any protein ingested, it's rather complicated I find.

If I were you @Natbat87, I'd reduce your carbs a little to a moderate level and get in plenty of medium intensity exercise. But that's just my view... We are all fundamentally different and really don't know how our bodies will react to various lifestyle changes. At least if you start in the middle somewhere then you can lean either way to get an ideal balance that works for you.

If it's of any use, when I want to drop weight I skip breakfast and don't eat after my dinner (18/6 intermittent fasting) and will spread 130g-150g of carbs across lunch and dinner. I also do cycling and swimming as my exercise at a consistent pace for fairly long periods. Intense exercise spikes my BG and makes it harder to manage. That's what works for me anyway.

Do let us know how you get on

Hi @GrantGam, I appreciate that you are Type 1 and experience a different regime to me, however I have read and watched many accounts of Type 1's who are practicing LCHF, too many to ignore. Using search terms around diabetes mainly on YouTube such as T1 LCHF. This returns stacks of T1's who utilise LCHF even at keto levels. Whilst low carb one might ask how much, 50, 80, etc, and the same for fat, I would say that a Type 1 who wanted to try this route could gradually creep towards figures which promote satiety. Dr Bernstein is probably one of the most respected Type 1's who has treated many similar on LCHF, and diet Doctor is another respected diabetes resource which promotes this:
https://www.dietdoctor.com/type-1-diabetes-and-lchf-a-great-combination.

I agree that protein should be moderate, which it is on a balanced LCHF, unlike Akins 1 to prevent excessive glucose production from protein. I also agree about exercise and their are many discussions for Type 1's on this forum, with excellent advice. I further agree with intermittent fasting I also do on at least 5 days out 7 an 18 / 6 and sometimes one meal a day.

@Natbat87 has said weight loss is a desire. In this case carbs add to weight and insulin to cover this, further increases the potential for weight gain; of course the opposite of fewer carbs means less insulin requirement so a possible win for the body on both counts. I believe the link between higher carb and a requirement to desire more is established.

I am clearly an advocate of LCHF, so to declare my interest, my wife runs a Physio / Health clinic, has a Physio and Sports Science degree and was bought into high carb because of the teaching on these courses. She has now adopted LCHF both for herself (2 stone loss) and as value add for her patients. She has so far reduced the weight of approaching 10 non diabetic patients, helped them drop stones in weight, even for 2 who are wheel chair bound (and of course she has put my catastrophic diabetes numbers into remission figures).

It is a choice for the OP based on the evidence online. Of course it cannot be stressed enough that should the OP choose this lifestyle it is more than vital to especially at the start, obsessively monitor numbers - again @Natbat87 take the most care if you embark on LCHF, especially if combined with exercise as your insulin dose would definitely require altering and your BMR would change with the exercise further reducing insulin requirement.