Type 1 Exploring Low Carb... Advice?!?

1) understand that a low carb diet doesn't eliminate the blood sugar roller coaster. In the absence of carbs, your body wants to find glucose from somewhere. It will do this by turning protein eaten into glucose via gluconogenesis. This is a process that takes time. So you might have a low carb meal and be perfectly in target 2hr post prandial, but by 4hrs you could be on the climb. Gluconogenisis can be somewhat erratic and therefore difficult to bolus for.

2) have you experimented with pre bolusing to try to manage the roller coaster while eating carbs. Just as different times of day can require different I:C ratios, they can require different pre bolus timings. Different carb meals can also require different pre bolus timings.

Hi @**shell** I was pretty much like you, fed up with the highs/lows of my meter and needed to do something to help address my anxiety which also seemed to suffer from the roller coaster ride each day. I try to eat low carb but don't deny the odd treat like last night had a mini magnum or if I want chips I have them when I eat out. Day to day diet is pretty much the same every day, I have protein bread for breakfast or greek yoghurt, soup for lunch, snack on nuts/cheese/olives, supper is main meal minus the rice, pasta, potatoes. I have to admit that some days I see a flat line on my libre yet on others it still looks like a trip to everest coupled with some deep sea diving, so still have to deal with hormones, exercise and stress which all impact on my control, however by eating lo carb I have helped to avoid many of the highs/lows. I know from DAFNE the guys on my course all had better control and ate substantial carbs, but as a woman and dealing with hormones/stress etc I found I was the odd one out, I do think we have more variables than men to manage.

Morning,


I'm T2 myself so I am not sure how it would work for you but my approach was to keep a food diary. I didn't change my diet in the first week, I just recorded what I ate, and how many carbs were in the various meals/foods. I could then look back and figure out what I could change slowly - swapping Weetabix for scrambled eggs for breakfast, swapping sandwiches for a salad for lunch. I also set myself target. 130g is considered Low carb for the non-special people (non diabetic ) so I figured I would go below that. My target is 75g per day - 15 per meal and 15 for teas/coffees/snacks. I was also realistic in my expectations. It’s a target and sometimes I miss it, some days I achieve lower but it is a target not a fixed point. Yesterday I hit 66.4g but on a couple of days last week I was over 80. In fact I have just checked my average for this month and it is running at over 80 but I know why – I have been away and there have been a few celebrations. Over 80g is above my target BUT it is till low carb and more importantly I know why.

I also monitored the impact of various foods on my BG. Porridge does spike me (on average 1.5mmols) but it does drop off very quickly, within 2 hours. Weetabix on the other hand just keeps giving.

I low carb (50g target) and find its a million times better on my Dexcom than not.

I don't count fruit juice for hypos in my target (because that's not fair) and I also find if I 'cheat' by having chips/pizza/whatever I recover much faster to a flat line too.

Low carb takes work, but once I understood how things worked, I avoid the rollercoaster blood sugars most of the time. My libre helps! I'm in range 95% of the time and the rest of the time, well I cope with the odd 8 or 9 (liver dump). It's a huge change but worth it. My HbA1c is a true reflection of my daily average. I recommend reading Dr Bernstein.

catapillar said:

1) understand that a low carb diet doesn't eliminate the blood sugar roller coaster. In the absence of carbs, your body wants to find glucose from somewhere. It will do this by turning protein eaten into glucose via gluconogenesis. This is a process that takes time. So you might have a low carb meal and be perfectly in target 2hr post prandial, but by 4hrs you could be on the climb. Gluconogenisis can be somewhat erratic and therefore difficult to bolus for.

2) have you experimented with pre bolusing to try to manage the roller coaster while eating carbs. Just as different times of day can require different I:C ratios, they can require different pre bolus timings. Different carb meals can also require different pre bolus timings.

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Please could you explain bolus for me.
Many thanks.

I’m T1 and have found that low carb has drastically improved my sugars, I try to keep to less than 30g a day if I can but really try to stick to less than 50g. It is a massive change to make, but worth a try if you’re not happy with your current regime. My insulin needs have halved in a couple of months, and a feel much better. There’s quite a few of us T1 doing quite well on low carb.

Motherhen2014 said:

Please could you explain bolus for me.
Many thanks.

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its the short acting insulin given to accompany carbs by those injecting

I am on the very fringes of diabetes - I visit the forum to remind myself that I am so very very lucky to be where I am.
I have been eating low carb for decades - despite doctors and nurses going ballistic over it, and I know that I simply cannot eat the modern diet - first of all I feel unmotivated, then so very weary and I put on weight very very quickly.
The diet I use now is the same as when I needed to recover from what for me were excessive amounts of carbs on 'normal' diets. They really have to be wrong about what we should eat - we are all the mark one Human - Homo sapiens sapiens - not Homo sapiens supermarket variant.
I do sometimes wonder if we are creating for ourselves an environment where we can no longer flourish.

Another factor is that current "close loop" systems can automatically tell a pump how much inslin is needed based on a CGM when someone is eating low carb.....

Resurgam said:

Homo sapiens supermarket

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You make my day.

**shell** said:

I don't think I want to go as extreme as the Keto but lowering my carbs might be worth a try.

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Relatively new T1D book with LCHF experience is Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me
Full of advice how to manage T1D with help of LCHF diet. Only 3 $ for kindle version.

**shell** said:

Thanks for the response!
I hadn't given any thought to the effects of protein in the absence of carbs, I don't know much on the matter to be honest so that means more research!
On the point of pre-bolus times, I don't feel like I am regimented enough to know exactly what foods make me respond in what way and I have considered Fiasp but didn't feel like there was enough pros.
x

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Hi there! I am trying out low carb too and am very anti being a 'professional diabetic' so have had to ease myself in with some get out clauses for when chocolate/toast seemed too good to deny myself. I see low carb as taking out a variable for those like me who don't want to weight out food but have found that I do need to bolus about half as much for protein ). All the other variables such as pmt and exercise still apply of course.
You could start by swapping out carbs in just 1 meal and seeing if you get a smoother ride. My top tip would be make sure you get plenty of fat as doing low carb and low fat is pretty impossible!
Somebody else recommended The Ketogenic Diet for Type 1..which is appaently more readable than Richard Bernstein (I just wasn't ready for 30g only a day at the time I read that) plus Adam Brown's e book Bright Spots and Landmines. Another type 1 doctor (like Bernstein) Ian Lake can be found on YouTube; his take on low carb for type 1s is that less insulin is generally a good thing (and therefore less carbohydrate) to prevent insulin resistance and the problems associated with it.
Let us know how you get on. Oh and as mentioned, do expect push back from the hcps who tend not to support this way of doing things...

Hi Shell,


I'm a type 1 on low carb. I 've done this for over ten years after reading Bernsteins's book. I don't follow him strictly anymore but follow a Paleo/Primal style diet.
The stuff on here about gluconeogenesis , while possible, is highly unlikely as you are far more likely to burn carbs:glycolisis ( you still eat carrb on low carb, just not a lot) and fat: ketosis than you would protein. Although gluconegenesis in itself isn't a problem unless you are starving yourself. These three systems are natural processes in the body and are why humans have evolved to at a wide range of food.

If you've read Bernstein's book then you'll be aware how much unexpected food sources raise your blood sugar significantly. This is one of the problems in trying to keep your blood sugars level while eating the foods want. For instance eating a reduced amount of rice will more than likely still raise your blood sugar faster than the insulin you have taken.This will make it difficult to avoid the "roller-coaster".

If you decide to go down the low carb route then your biggest problem might be cravings esp if you slip off the wagon. But equally if you do stick with it you'll lose the taste for carb rich food and much of it will be too sweet for you.


To start, try swapping out all your main dense carbs for alternatives eg Cauliflower rice instead of rice etc... and see how you get on.

If you are exercising, you may want to slow down your cardio to the 80/20 approach as intense cardio can be very draining on low carb.

I have had very few problems on it and more importantly my triglycerides are low which is ideal for internal heath