Hello
@sjb2610 ,
About 10 years ago I had an influx of disabling co-morbidities - diabetes complications - as a consequence of unbalanced glucose levels for 30years living with T1D.
I decided enough was truly enough and went on a journey to change my downward trajectory.
I didn't end up doing low carb but went the extra mile to a ketogenic lifestyle although currently I am eating high carbs because I'm not eating fat intentionally.
I cycle between the two because homo sapiens is adapted to feast and famine rather than seep fried fast food!
Adopting a keto lifestyle was pretty simple, I found. I just stopped eating carbohydrates. However that may not be the best strategy especially if using quite a high basal dose /rate.
I would advocate testing basal insulin needs first - although that in itself is usually done fasting while asleep and from waking. As it happens my basal dose was too high because I'd been asked to increase it time and again with high glucose levels in the mornings. I found that without carbs I came down from 18i.u. to 12i.u. quite quickly. It was made easier because of using Libre when it came out and being able to see glucose levels fall over the day while fasted. Initially then I was not in ketosis as I remember but that soon changed as I was not eating carbohydrates.
Consequently the boluses were a lot smaller. This was really marked. I kept the same ratio of 1i.u. to 10g carbs as previously.
Bear in mind that if eating more fat and lower carbs than is necessary for energy expenditure - definitely the case with keto - then it is likely that the body will spare the glucose that is stored or made by the liver for functions that really need it so resistance to insulin may increase and I see this as a natural adaptation.
Once my basal was adjusted I made sure I had enough protein and fat for health and energy. Importantly I increased my intake of non-starchy vegetables and eventually incorporated a few lower carb veggies such as swede, turnip, even the odd parsnip, carrot, or beetroot and berries. Even if just the low carb veggies like salad items and cruciferous are likely to be helpful in maintaining the vitamins and minerals necessary for health and energy albeit these can theoretically be obtained from animal products alone
On balance each person will have their own goals but it is important in moving toward these that we put diabetes health first - avoiding low glucose levels as a priority for example, maintain the nutrients we need, and continue to enjoy life so that we minimise stress and maintain good mental health.
Other really helpful sources of information are people like
Ian Lake who is a GP living with T1D, and Richard Bernstein who is a little more famous.
I know this was more about keto but progressing to low carb will have similar matters to address although I find it a little more difficult to manage low carb than 'no' carb, myself
If you have any specific questions then I'd be happy to provide my thoughts to you.
ATB
Mat