Type 1s: Bernstein for T1

Respect!

At 62, and in a very different life phase, I think differently - because I believe there is no such thing as an 'essential carbohydrate'. But I fully accept I could be wrong. And if you are enjoying your moderate carbs and that regime is working for you, excellent!

We must all do what feels right, I'm not even t2. I just sometimes feel the need to contradict the argument that LCHF is miserable and mean, because, believe me, it doesn't have to be?

Robbins said:

I love LCHF, I'm 45, and food aside, it makes me feel so much better, like I felt in my 30's!
Come on, we all know why it's not recommended by the Medical Profession? It doesn't sell the same quantity of drugs.

Click to expand...

Well as type 1's we still need drugs @Robbins , without insulin we would be dead.

We all have to find a diet that works for us and one that we are happy and content with, if that's low-carb, LCHF or eating carbs in moderation then so be it, food has to be something you enjoy and look forward to otherwise it takes away one of life little pleasures.

I personally couldn't stick to the Bernstein diet as it's far too restrictive and his bg target range is too tight, I'd end up hypo unaware and would lose my entitlement to drive which would impact on my work and social life, but like anyone who has lived with type 1 for several decades Dr B has my admiration and respect.

Somewhat off-topic, so please forgive me, but I have a question for Azure.

azure said:

If I was Type 2 I would probably eat less carbs because, I would imagine I'd have a fair level of insulin resistance.

Click to expand...

I'm interested to learn why you feel if you were T2 you would have increased insulin resistance? Do you have insulin resistance in your current T1 state?

azure said:

Nope - just checked my latest version of the Dr B book and pumps aren't done justice, in my opinion.

Click to expand...

Isn't the pump just another way of administering the "same ol" insulin then.?
Maybe I got it wrong? But on a pump. One gets "drip fed" a basal rate, then boluses for what one eats...?? To put it simply.
@tim2000s , feel free to slap me. I'm curious. The pump has been mentioned to me a couple of times during consultations I've dismissed it. For now....

I have great IS and VLCHF suits me great. No fears of hypos and taking bs 20 times a day. I have been type one and two and the same diet Bernstein recommends works perfect. I much prefer higher fat foods than cabs but that is just my personal taste. Love the laws of small numbers. Can't go too far either way....

AndBreathe said:

Somewhat off-topic, so please forgive me, but I have a question for Azure.



I'm interested to learn why you feel if you were T2 you would have increased insulin resistance? Do you have insulin resistance in your current T1 state?

Click to expand...

I have to admit to personally knowing a couple of pumpers who apear to have "infusion sites" in the same place...? "Discretion" being a main reason I believe.
As an old school injector. I was always advised (for tha last 40 years) to rotate my sites for a reason...

Jaylee said:

Maybe I got it wrong? But on a pump. One gets "drip fed" a basal rate, then boluses for what one eats...?? To put it simply.
@tim2000s , feel free to slap me. I'm curious. The pump has been mentioned to me a couple of times during consultations I've dismissed it. For now....

Click to expand...

I guess the key point about the pump is that it all runs off the faster acting insulin, but what you get are different ways of bolusing, so there's a couple of types:

1. "copy the injection of Novorapid" or Standard Bolus
2. "copy the action of Actrapid/regular" or Extended/"Square Wave" bolus where the fast acting is administered over a longer period of time
3. "copy the action of the human body and have first and second phase insulin" or "dual wave"/combo/"multi-wave" bolus which administers a combination of the standard bolus and extended bolus.

By having these different types of bolus, you have the ability to mimic all of the types of insulin that Bernstein uses individually and more importantly can tailor each of the actions to you and the food individually. It's a bit trial and error at first, but it gives you a huge amount of range in how you administer insulin.

And of course something like 85% of pump users never use 2 & 3 as they don't understand what they do or how to make them work effectively.

Rather like the ability to increase and decrease basal rate. On an injection you take it once per day and it works the same all day. With the pump, you adjust it to match the profile of your liver pumping out glucose, but then, when you go to the gym, you can drop the rate for a few hours overnight, for example, as your muscles are sucking up glucose and your standard basal injection might cause nocturnal hypos. Likewise, if you are having a sedentary day, or a stressful three hours and your cortisol is causing higher blood glucose levels, you can temporarily up your background to counter your liver action.

So yes, it's just a drip feed and bolus, but it's infinitely more flexible in both basal and bolusing operations!

AndBreathe said:

Somewhat off-topic, so please forgive me, but I have a question for Azure.



I'm interested to learn why you feel if you were T2 you would have increased insulin resistance? Do you have insulin resistance in your current T1 state?

Click to expand...

I don't know if I would, but if I did I may reduce carbs in that hypothetical situation. I understand insulin resistance is more common in Type 2 than Type 1.

Pinkorchid said:

Yes I believe that it may lower the risk of complications but where does it say that it will certainly prevent them. The medical professions do not seem to be saying that. If they thought that LCHF was the answer to not getting complications then that would be a big breakthrough in diabetic treatment and the majority of diabetics world wide would hear about it. At the moment it is only a small minority who do LCHF

Click to expand...

It is very difficult for something to become 'official' in the medical community it will take many many years to change a set treatment - it took many years to even determine that smoking 'increases risk' of cancers, and I am still pretty sure they can't say it 'causes' cancer because some people don't get it. But does that make it a good idea to smoke? or a better idea not smoke - that's up to us.

The people on this forum saying LCHF will prevent complications are just rounding up lol Because its not a shield that protects us from everything. If you LCHF but fail to tune your basal properly and stay high for 20 years - you will likely have complications - not from your diet but from mismanaged basal rates therefore the LCHF did not prevent it, so its clear that it can only reduce risk of complication incurred by diet. Not other/every sources.

LCHF will reduce risk of complications incurred by diet - I am pretty sure that is documented. If we can reduce risk in enough areas for long enough then we will not have complications. It is up to each of us to decide if they would like to reduce their risk of complications in this area or not - does it matter by how much? Not to me - If my boss said 'Would you like a raise?" even without a dollar amount I will always say yes - so why should it matter in this case.

Diamattic said:

LCHF will reduce risk of complications incurred by diet - I am pretty sure that is documented.

Click to expand...

You have to be careful when you make claims. That's the issue. It's all about evidence.

The overwhelming evidence shows that reducing long term blood glucose levels reduces the risk of complications. No-one argues with that. There is limited evidence that a reduced glycemic variation also reduces risk of some complications.

It's the link between insulin and diet, plus other things that push glucose levels up and down (these aren't the only two but are probably the items we have most control over and that have the biggest impact).

So all we can really say about eating a low carb diet is that it is a tool that potentially makes it easier to manage blood glucose levels and the insulin regime. It's not something that in itself will reduce the risk of complications.

Came across this tonight, interesting and relevant.

http://type1keto.com/?page_id=156

I eat low carb but I don't eat very low carb (below 30g of carbs per day). I experimented with VLC for a few months and I noticed certain physiological changes such as my hair was getting thinner, my urine got acid, I felt a certain weakness doing sports activities (especially at the start). After increasing my carb intake, the symptoms disappeared.

My control was excellent on VLC but it still is very good on low carb, I just had to increase my basal a bit.

The funny thing on VLC was that at times I had to completely stop taking insulin for up to 3 days, typically after heavy sports activity.

To sum up, for me personally, VLC had certain downsides and a moderate low carb diet works better for me.

Pinkorchid said:

There are many here who think Bernstein is the Holy Grail of diabetes management with diet because he has stayed free of diabetic complications. The thing is though is that no one not even himself can say that he may never have had any complications anyway whatever he had done.

Click to expand...

Incorrect. He had very severe complications when he lowered his carb intake in his mid-30s. I remember kidney and eye damage, but there was mire. The point is he managed to reverse all that.

It's important to be well informed.