Type 1s - just a question

If you're interested, you could read Think Like A Pancreas.

Although control of carbs is helpful - that is, not eating an excessive amount, especially in one go, the management of Type 1 is very different compared to Type 2. Type 1s usually have no or very little insulin due to the destruction of their beta cells by their immune system. So even if a Type 1 only ate fat (just to,use a silly example) they'd still need insulin and would die without it.

LCHF is not a magic bullet for Type 1 and can, moreover, cause complications due to delayed blood sugar rises and physiological insulin resistance.

Type 1 is a very different beast

Resurgam said:

It might very well be so not my business to comment here - but I am very puzzled by how type I is managed.
It seems that the concept is to eat 'normal' amounts of carbs and try to imitate a 'normal' response to it by injections of insulin at what is hoped are the right times.
It doesn't seem logical - I am raising one eyebrow here.
Is there some reason not to eat a mainly protein and fat diet - like the esquimo people did - those processes are not impaired by diabetes.
I ate low carb for decades before being diagnosed, and lived very easily and well. I am back on it now, with plummeting BG levels.
Why not have a breakfast with minimal carbs?

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The idea is to take insulin for the carbohydrates in your meal and inject just before you eat your meal. Nothing wrong in eating a lot of carbs or small amounts. Some people's BG can react quite differently to anothers with certain carbs, such as rice, pasta, breads etc. I personally eat what carbs i like but ensure that i have the correct amount of insulin to take care of it.

I've just enjoyed 2 lovely mince pies for 72 grams of carbs and covered that with 13.3 units of insulin.

Regards

Martin
Edited for my usual spelling mistakes.

Resurgam said:

It might very well be so not my business to comment here - but I am very puzzled by how type I is managed.
It seems that the concept is to eat 'normal' amounts of carbs and try to imitate a 'normal' response to it by injections of insulin at what is hoped are the right times.
It doesn't seem logical - I am raising one eyebrow here.
Is there some reason not to eat a mainly protein and fat diet - like the esquimo people did - those processes are not impaired by diabetes.
I ate low carb for decades before being diagnosed, and lived very easily and well. I am back on it now, with plummeting BG levels.
Why not have a breakfast with minimal carbs?

Click to expand...

You're very right with what you've said.

Low carb/high fat (LCHF) certainly helps to manage your BG levels as a T1D. However, MDI basal/bolus regimes are designed to help the diabetic eat as "normal" a diet as possible. Normal, with respect to a non diabetic diet, means eating all food types (and that includes many with carbs).

MDI basal/bolus is primarily a means for tighter BG control with added flexibility. If the medical proffessionals were to dictate that all T1D's stick to a strict "low carb" diet, I'd imagine that it would be quite overwhelming for the patient, who is already having to deal with what is a fairly life changing disease.

As much as I understand the merits of LCHF diets in easing the management of BGL's in T1D's, I love carbohydrates and couldn't live without them. And my saving grace is my MDI basal/bolus regime

Resurgam said:

Why not have a breakfast with minimal carbs?

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The choice is there for most who are on a basal/bolus insulin regime or a pump, but if you can eat healthy carbs like oats for breakfast with some protein and fat and still maintain good bg levels why would you exclude them?

An example, if I were to eat a breakfast of eggs & bacon or a cheese omelette I need to take 4 units of insulin, on injections I would need to split the dose due to the fat content or use a dual-wave bolus on my pump, however for a breakfast of oats, seeds, blueberries and natural yogurt I need to bolus 5 units in one go, so that's only 1 unit more for a breakfast with carbs added but one less injection if I were still on MDI (multiple daily injections).

Hope the above is helpful and makes sense

It seems most logical to save all of my money, never enjoy it, and retire much earlier. However, that's not a very practical way of living life is it? Similar principles hold true in addressing your question.

What is most logical and what is most practical aren't always the same thing. Logically, I could probably have better control with an insulin pump. However, I don't want another device attached to me 24/7 like my Dexcom.

Logically, I should eat a low carb diet, and when it is practical I do. However, I work too hard in life and in managing my diabetes to not enjoy the occasional Christmas party, the night out with my fiance, or the odd slice of pizza watching football.

It's a fair question, and I'm glad you asked it. Honestly, I believe the statement "Type 1 diabetics can eat whatever they want as long as they take insulin" is a load of ****. We may be able to enjoy food just like anyone else, but moderation (when it comes to carbs) matters a whole heck of a lot more to us than non-diabetics.

noblehead said:

The choice is there for most who are on a basal/bolus insulin regime or a pump, but if you can eat healthy carbs like oats for breakfast with some protein and fat and still maintain good bg levels why would you exclude them?

An example, if I were to eat a breakfast of eggs & bacon or a cheese omelette I need to take 4 units of insulin, on injections I would need to split the dose due to the fat content or use a dual-wave bolus on my pump, however for a breakfast of oats, seeds, blueberries and natural yogurt I need to bolus 5 units in one go, so that's only 1 unit more for a breakfast with carbs added but one less injection if I were still on MDI (multiple daily injections).

Hope the above is helpful and makes sense

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Not to be picky @noblehead, but just to make @Resurgam clear - a lot of us T1D's still need to bolus for protein, and an LCHF diet can actually increase the amount of bolus insulin we require when knocking back on the carbs.

So @Resurgam, although in an ideal world - eating "zero carb" would imply no bolus insulin, or "low carb" requiring less bolus insulin, is actually not the case for a lot of us.

Resurgam said:

I do now understand the 'honeymoon period' - if the modern diet is being eaten, then it makes the eventual need for insulin absolutely inevitable.

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I'm afraid none of that is true. The requirement for insulin with type 1 diabetes is inevitable in it's own right, regardless of diet.

@Resurgam You've touched on an important point - dietary differences and reactions.

I don't put on weight and have a BMI of 19. Insulin resistance is more common in Type 2s. In addition, Type 2 is also usually diagnosed at an older age so the person may be out of the reproductive years (or may not, of course) This would also affect carb intake due to pregnancy and breadtfeeding if the person was female.

As I said above, Type 1 and Type 2 are both equally serious (and very annoying!) but they are different