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Need help with low carb diet

Discussion in 'Type 1 Diabetes' started by prakash68, Dec 23, 2017.

  1. prakash68

    prakash68 Type 1 · Member

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    Hi All,

    My sister have been type1 D for 10 years. She switched to low carb diet recently so that she can maintain the blood glucose in range, and limit risk of hypos by not dealing with high doses and getting it wrong.

    She had Kashi Pesto ChickPea quinoa bowl once(https://www.kashi.com/our-foods/entrees/kashi-entree-pesto-chickpea-quinoa-bowl) and ended up with high insulin resistance and sustained high for almost 2 days. We were not clear if this is because of the 14g fat (most of them are unsaturated) in it. But after this experience, she is bit scared of having fat too.

    This fear of fat causing insulin resistance and low carb is leading to low carb, low fat, high fiber and medium protein diet. We are not sure if this a healthy meal plan as she is losing weight.

    I have few questions that I am hoping someone will be able to help me understand

    1. What is the healthy way to do low carb diet, is avoiding fat sustainable in low carb diet?

    2. How much of fat will trigger sustained insulin resistance ?, since there is fear of hypo, when ever there is sustained high, it usually takes long time to correct since she is bit apprehensive about dosing high or increasing the basal.

    3. Off late, it takes a long time and lot of gluco tabs to recover from the low, could it be possible because liver’s glycogen store is very less because of the low carb diet? If yes, how do ppl following low carb diet work around depletion of glycogen store in liver due to limited carb intake?
    Thanks
    Prakash
     
  2. Scott-C

    Scott-C Type 1 · Well-Known Member

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    Hi, @prakash68 , I don't think this has anything to do with insulin resistance nor with fat. I can't get the kashi webpage to load, so can't check the carb content. However, chickpeas are very low on the glycemic index: they break down into glucose slowly, and so will sometimes continue drip-feeding glucose into the bloodstream after the meal bolus shot has worn off, leading to a high which will stay high without a correction dose.

    Or the simpler answer might just be that she didn't bolus enough for the meal in the first place!

    If she's losing weight, it's because she's not eating enough.

    I've never really thought about insulin resistance or fat content when choosing foods. I don't think T1s need to. If one ends up too high, it's generally a result of too low a bolus shot, not insulin resistance. Fat will generally slow down absorption of carbs but that is nothing to do with insulin resistance. All it means is that if I have a pizza, I might need to keep an eye on levels a few hours later and do a correction dose if I'm trending high.
     
  3. Daibell

    Daibell LADA · Master

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    Hi. How do you know the problem was insulin resistance? I'm sure many of us have a high carb day occasionally and it may cause very short-term extra fat storage but that's nothing to worry about. When following a low-carb diet it is important to have enough fats and proteins. If you're going low when low-carbing then you need to adjust your insulins to take account of that. I wouldn't worry about the liver or insulin resistance but just have enough fat and protein to keep you feeling full and adjust the insulins a bit where needed and use the meter to avoid hypos.
     
  4. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    that is probably more than my entire day's intake of carbs in one small bowl - and with 48gm of wholegrain in the mix.
    going low carb is best done - from my own experience and hearing how others have managed, by avoiding high carb foods even in small amounts.
    By eating low carb foods the impact seems to be lessened even if there are 50 gm of carbs eaten during the day - it simply seems easier to cope with.
    Although I have no injecting of insulin to cope with, a high carb food will increase my BG levels for hours, into next day, but it is not the fats which are the problem, it is all about the carbs.
     
  5. EllieM

    EllieM Type 1 · Moderator
    Staff Member

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    Are you concerned that she may be developing an eating disorder? This is surprisingly easy to do when following a restrictive diet, and becoming obsessive about diet can be a symptom (doesn't help that diabetics need to think carefully about their diet!) I understand a fear of hypos but I would also be concerned about going low carb and low fat.
     
  6. prakash68

    prakash68 Type 1 · Member

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    Hi Scott,

    I have attached the nutrition info of the kashi bowl. The reason I said insulin resistance is because it required much higher amount of correction doses to bring bg down to range. Even after that, the foods that she normally has, took much higher insulin to bring back in range. This continued for almost 2 days until she ran in treadmill for 30 mins. After the exercise, the insulin response returned to usual. We are finding it difficult to form an understanding around the cause based on this experience. One conclusion was, 14g fat resulted in some change in behavior in body that is causing it to not respond to insulin like it normally does.

    Thanks
    Prakash
     

    Attached Files:

  7. prakash68

    prakash68 Type 1 · Member

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    ,

    Hi Ellie,

    Yes, I am concerned that we are unknowingly building habits without understanding the consequences fully or with partial knowledge. I have been reading, Dr.Bernstein's Diabetic Solution book and other resources on low carb diets. All of these balance the calorie intake by replacing carbs with fat and protein. In our case, we are not doing it. This is because of aversion towards having fat and understanding that it could cause insulin resistance/or decrease insulin sensitivity for long period of time if it exceeds > 7g per meal. I am not sure if this understanding is right.

    Thanks
    Prakash
     
    #7 prakash68, Dec 24, 2017 at 3:58 PM
    Last edited: Dec 24, 2017
  8. prakash68

    prakash68 Type 1 · Member

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    Hi Daibell,

    When you say 'very short-term extra fat storage', how long is short term?, In our case, after having Kashi bowl(14g fat - 1.5 saturated), the body was not responding to usual insulin doses for foods she regularly has for almost 2 days until she exercised for 30 mins. After the exercise, the usual insulin response returned and bolus dosage worked as expected for the regular foods she has.

    Thanks
    Prakash
     
  9. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    but the meal was not low carb - grains and lentils do exactly the same sort of thing to my blood glucose, I very much doubt that it was the small amount of fat - it was far more likely to be the high concentration of carbs from foods which are notorious for elevating blood glucose.
    Demonizing fat and making it responsible for all the ills of Humanity has resulted in people in general getting fatter, sicker and more unhappy with their lives.
     
  10. cz_dave

    cz_dave Type 1 · Well-Known Member

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    I think that your sister was high because of the carbs in the meal, not the fat.
     
    • Agree Agree x 1
  11. DaveTC

    DaveTC Type 1 · Active Member

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    Have you considered she might have been ill?

    I like to eat big meals from time to time. But even after stuff 2 12" deep pans it's rare to see my bloods still rising more than 12 hours after eating them compared to normal. Bare in mind one pizza probably has around 150g fat and a similar amount of carbs, I should probably be struggling over a month later based off the 14g of fat she ate.
     
    • Agree Agree x 1
  12. prakash68

    prakash68 Type 1 · Member

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    Hi Dave,

    She was not ill at that time. If this behavior is not expected, We will raise this concern in our next doctor visit to make sure that she does not have any other complications related to metabolizing fat.

    Thanks
    Prakash
     
  13. prakash68

    prakash68 Type 1 · Member

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    Hi Resurgam,

    Based on what you are saying, low carb-high fat food should not pose any problems. Incase of Kashi, it is the, relatively high fat along with high carb that caused the issue. We will try out low carb, high fat(unsaturated) to see if causes any problems.

    Thanks
    Prakash
     
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