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To low carb or not to low carb

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phil90

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I keep thinking about whether or not to do this. I was diagnosed type 1 last July. It's been a roller coaster with regards to glucose levels. My control overall maybe looks good but day to day constant dips and spikes. I generally don't go over 10mmol like I did in the first few months after alot of time spent adjusting doses, bolus timing and food. I still average around 200 to 250g of carbs a day. Have a hba1c of 5.3 according to my libre but I know it's more to do with the lows I have everyday. I don't always get the best results after a meal, sometimes the same meal causes a spike of 5mmol and others times 1mmol. I could be hypoing before a meal , during or after. Its up and down constantly. Snacking to get things back up between meals etc Here is a few questions I have regarding going low carb :

How safe is it ? I read about how the NHS guidelines are wrong but everyone at my clinic repeats that I shouldn't go on a low carb diet

Is it possible to gain weight on a low carb diet ? I'm still underweight since my diagnosis, I exercise regularly and fear ditching soo many carbs will only make matters worse

How does it change things for exercise?

Is it still possible to have the odd high carb meal or whilst on holiday indulge a bit ? And if so how difficult is this to handle? As in if you are going low carb soo long then all of sudden introduce a large amount of carbs. I feel like I'd be dragging my partner down with me if I change . Would be difficult to afford two sets of shopping and have to say to her I can't have takeaways anymore.

Any help or experience on this would be fantastic , thank you !
 
Others will have a different opinion, especially I suspect those who have led a Type 1 life, so I differ to them.

As you have posted in an open area of the forum, I'll put a couple of penny's into this as a non Type 1, who has followed low carb / keto.

I would say try low carb / keto under the direction of the Type 1 Grit membership; I would think it would be potentially dangerous to do this in the same manner as a Type 2 not on insulin / sulfonylureas without expert guidance. I know this is the choice I would make if my diagnosis had been for 1 instead of 2, as I would always go for the less is more option. This isn't to say the alternative choice of "coverage" by carb counting is not a valid one, but for me I like what Dr Bernstein has done for Type 1's, which is essentially the protein based diet I do (hence my rationale).

Andrew Koutinik, Dr Troy Stapleton and the inspiration David Dikeman may offer some insight.


But as always safety first, this can't be done on a wing and a prayer.
 
As a T2 not on insulin I don't have any experience with which to advise.

However, I would have thought that lower carbs would result in lower margins of error with bolus doses, and therefore could help reduce the number of hypos you have.
 

I'll check suggestions out thanks. Not a big fan of Dr Bernstein though. I got his book and found it extremely limiting and made me want to do the opposite to be honest. Will see what the others say. Thanks
 
Some people find low carb with Type 1 very helpful.
I believe (apologies if I have this wrong) @NicoleC1971 follows a low carb diet with a very active lifestyle.

However, I attempted it and found it much much harder for me than a "normal/lower" carb level diet.
When I eat low/no carb my blood sugar levels still rise so I need to consider insulin to protein ratios. This is more complex than insulin to carb ratios because the ratio is different for every type of protein - ratio ratio is different for nuts, eggs, cheese, salmon, prawns, ... I don't eat meat but understand that will add another level of ratios to remember and juggle.

I have chosen to be more aware of the carbs I eat and like the variety of not eating sandwiches for every lunch and find yoghurt much more enjoyable for breakfast than cereal but I still enjoy rice with my curry, couscous with my tagine, potatoes with my fish, noodles with my stir fry, ... just less than my non-diabetic partner.
 
I follow a low carb/keto diet based on Bernstein. The flip side of the coin is to have normal blood sugars which is freeing. I'm living a normal life without the stress of following that rollercoaster.
 
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I'm Type 1 and for me keeping below 140 carbs per day, with no more than 30 at a single feed keeps me off the rollercoaster. I never eat grains, potato, rice, take-out, premade commercial stuff, and have low carb veggies most of all. There is too much conflicting opinion about diet triggered by big-money interests. I eat what makes me feel good and keeps me in range.
 
If you decide to try lower carbs, it doesn't have to be difficult. My husband is not diabetic and enjoys lots of carbs. I eat the same meals but without the carbs. He buys lots of carby items for himself when we do the food shopping, and I know I won't be eating them, so no need to do two shops. As for takeaways, all you have to do is either not eat them at all or else eat them but miss out the carbs. But as a Type1, as others have said, you will need to keep a close eye on your levels.
 
I'm lowish carb (less than 100g a day) because I have issues with weight gain and insulin resistance and low carb stops me from gaining any more or needing super large quantities of insulin.

But I inject insulin if I really want to eat a high carb meal, I just accept that I might get the dose wrong.

I had two T1 pregnancies on NHS recommended low gi but relatively high carb amounts, and my children and bgs were fine, albeit with some spectacular loss of hypo awareness (pre cgms/flash sensors)

phil90 said:
I generally don't go over 10mmol
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That is awesome IMO. If I have a day like that I cheer.

.
 
I tried no or very low carb and god it made me so I’ll but I have a quite active life. So now I do carbs but it’s brown rice, wholewheat pasta, sweet potato or just have a meal each day with very low/no carb. My bloods are usually under 9 two hours after a meal
 
My first post on this site and no one has really answered any of my questions. Just seem to be pointing out that low carb is the answer. Not helpful. When I finally get my levels in a better place I'll be sure to give everything I can to help others
 
Gosh it looks to me like you’ve had lots of helpful answers, however it’s true that your specific questions haven’t all been addressed: that’s probably because people don’t know the answer to them.

I’m a type 2 and not on insulin, so can’t help with the vast majority of your questions. However, in terms of making a low carb diet work with a partner: my husband isn’t low carb (or diabetic) and we make it work fine in various ways (I certainly don’t do two lots of food shopping for example).

If we have a takeaway, he obviously has whatever he wants. I have something that’s lower carb and don’t have rice. So, for a curry, I might choose a chicken tikka starter, and a spinach and prawn curry for my main. If we have kebab I will have grilled chicken kebab and salad, not eat the bread. Chinese is a little harder but I’m usually OK with something like beef with ginger and spring onion, or king prawn with vegetables, or crispy duck using lettuce for wraps (and going very easy on hoisin sauce).

Home cooking we just have the same but if he eats rice I don’t. Or I’ll have cauliflower rice.

I’m rather overweight so can’t help with the weight gain side. But you can eat plenty of fat which won’t affect your glucose levels but might help keep your weight steady.
 
phil90 said:
How safe is it ? I read about how the NHS guidelines are wrong but everyone at my clinic repeats that I shouldn't go on a low carb diet
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OK, in 52 years I've had a lot of different dietary recommendations, so I tend to follow my meter now. My current dietician (in New Zealand) is happy with low carb but prefers me to have at least 30g a meal. One reason why some doctors don't like it is because they are afraid that if you have a keto diet and are in dietary ketosis then if your blood sugar goes up because of eg illness then you won't be able to tell if you are going into DKA, However, I personally find that my moderately low carb diet doesn't put me into ketosis so this isn't an issue for me.

Personally, I thought that the whole point of a basal/bolus regime is that you change your insulin to adapt to your chosen diet, whether that's 10g a day or 500g. So try low carb if you want, or continue to experiment with more carbs. Different people prefer different diets and I don't think there is a one size fits all best diet for everyone.
 
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