I would love to hear from those who pretty much eat a “normal” diet, carbs and all, and are able to have good A1c’s using insulin.
If you read through the responses of the “How Many Carbs Do You Eat per Meal, per Day?” discussion, there are a lot of people that eat fairly normal diets in there. We’re all different physically and otherwise. For me, eating a lot of carbs works out but mostly because I stay away from processed foods and it’s in my nature to be super-organized, so my documentation really helps me to figure out exactly how to bolus for what I want, when I want it. Also, the pump does make a big difference in being able to control things. I’m a huge fan of the extended bolus feature.
I eat the things I like… and I can more or less count the things I don’t like on one hand so I like a lot of foods. 
I think the main thing that has been key for me is portion control. I have a scale, and I use it all the time, but I’m not neurotic about it. Because I use it at home, I’m very good at eyeballing things when I’m not at home. I generally lean towards “good” carbs, fruits and veggies (heavier on the veggies), and lean protein, but I still eat chocolate, ice cream, bacon cheeseburgers, fries, etc. I just don’t eat a lot in one sitting regardless of what I’m eating. Like Julie, I use the extended or combo bolus more often than not because I think it more closely mimics what my pancreas used to do way back when. My last A1c was 6.5, and while I guess some people would find that unacceptable for themselves, I’m happy with it because it means I’m in good control without imposing dietary restrictions on myself that from my perspective are unnecessary and would definitely make me miserable.
I also use a nutritional scale at home, so I’m usually pretty good at eyeballing when I’m not at home too. I highly recommend a scale.
Julie. and Lee Ann…I think that discussion is what has me wondering. It sounds as though a lot of people are able to eat a whole bunch of carbs. I was wondering what the resulting A1c’s are. Others seem to find low carbing to be the only thing that works. I think I am doing OK carb counting but the scale sounds like a great tool. I know that a balance of acceptable #'s and a diet one can live with is the key. Possibly it is very different for everyone.
Thanks for your responses.
I thought of some more specifics. I guess I should mention that I think the real key is to eat unprocessed foods. If I am eating something processed (and that doesn’t just mean a hot dog…it is anything that has had a lot done to it before it’s cooked, so that it’s already partially broken down or that is from a restaurant that may not be completely natural, which is almost all of them.) then I figure my usual bolus based on my carb ratio and then add an entire %25. This almost always manages to take care of “hidden” ingredients if you’re eating out as well. I usually extend at least some of my bolus if eating out, to account for all the hidden fat in restaurant food…and there is a lot of it. I think eating a lot of natural fiber from beans, veggies, avocados, and whole wheat bread (which lucky for me I really like) is also very helpful and that stuff is loaded with carbs. My main point…it’s not how many carbs you eat, it’s what type of carbs you eat and knowing exactly how many carbs there are. Good Luck
Julie, I was pretty much trying to eat that way before my diagnoses 4 years ago. I find that any carbs raise my #'s significantly and bolusing aggressively will cause lows. The lows have become less frequent, I suspect, as my second phase ability has diminished. You are so correct about restaurant food. A seemingly benign salad will cause my BS to sky rocket… I think I have a lot to learn about fats and proteins (more recent reading here.) I don’t mind MDI or even MMI (multiple meal injections…dividing the dose, (I made that up!)) but it is labor intensive and the logistics can be challanging when not at home. A pump is most likely in my near future if I am truly serious about this.
Thanks again for the insights and inspiration.
I was on vacation recently and ate a very different diet. It wasn’t wildly high carb but I did have maybe one piece of bread with a meal and an occasional small serving of potatoes. I did well for the most part, with the highest readings being around 160 but the amount of testing and injecting i had to do make it just not worth it as an everyday way of life. I am willing to do that for the odd meal out or special occasion but am so relieved to be home on my normal routine which involves about 15-20g of non-processed carbs for each meal and just 5 units of levemir in the morning. I am early stage LADA so this gives me a range of about 95-125 at all times. If I want a bit more for dininer, I do a couple of units of Novolog. Even with my basal plus my own residual insulin, and MMI (I like that term!) -4 U Regular plus 4 U Novolog - for covering a high carb meal, I can’t get that narrow range and either go high or low or both.
I know Libby! Are we just very sensitive (as my first endo said,) to carbs and insulin? It can’t be that all those people eating carbs with abandon have horrible highs and lows.
So what’s for dinner?
I think it’s partly to do with early stage for me. My own insulin production is unpredictable. What is really interesting is that since I started a basal I have found I have much better control and better post meal readings. I had thought I didn’t need a basal since my fasting was rarely over 95 and I was afraid it would cause me to go low. I used to shoot up to 180 with anything over 12g. Now I can eat a small apple, for example, with no bolus insulin and I will go up to 130. My whole range has shifted upwards, instead of 80-110 I am between 95 and 125 most of the time but I think I can live with that. I might try experimenting with a bit more basal to see if I can shift the range downwards. I am satisfied to have almost normal BG on this very low carb diet, rather than struggle to contain the highs and lows and maybe get a good average but not stay in the 30 point range which makes my body feel good. The other incentive I have is that I know my diet is the most healthy way of eating, especially for me as a cancer survivor with a compromised immune system. If I eventually become insulin dependent I would probably consider a pump, not so I could eat more carbs but so I could continue good control.
So, what’s for dinner? Stir fried organic veggies from the CSA (Community Sustainable Agriculture) farm, pork chops and salad with home grown sprouts and fresh peach home made ice cream for dessert. Doesn’t sound like too much of a sacrifice, does it?
I would probably kill someone for fresh peach ice cream!!!
hi elaine,
i just started on the omnipod pump in may, after doing mdi for about 16 months (i am t1). my “carb guesses” still sometimes suck, but there’s definitely a learning curve going on. my biggest surprise is that i kept my a1c at 5.8 even though i definitely eat more carbs now than i used to. i definitely agree that eating whole grains, fruits and veggies as your carb choices are easier on your body. i can tell a huge difference between white rice and brown rice in my blood sugar. i didn’t want to go on a pump because i didn’t want to count carbs, but it is really nice to have a little bit of wiggle room and the ability to correct that wiggle that turned into a wag.
Ice cream is really not hard to make, Elaine, if you are doing a higher fat diet. It does have a lot of calories and fat so for people trying to lose weight it isn’t the best option but it is very low carb in half cup servings. I use a cup of cream or half and half and two egg yolks. Heat the cream until almost boiling, cool a little and stir in the yolks one at a time. Add 1/4-1/2 cup sugar equivalent: I use liquid splenda but Da Vinci syrups work well. Add a tablespoon of vanilla and a cup of blended fruit- if you’re using peaches you boil them briefly to take off the skin. I have an ice cream maker but I imagine it would work if you just put it in the freezer. It’s a bit harder but tastes the same. I sometimes add half a cup of cream cheese for an even creamier taste. You don’t actually need the egg but I find it improves the taste and is worth the extra work. Plus I am trying to maintain or even gain a little weight so every bit counts.
If you want a quick treat, use a cup of cream, whipped with vanilla and sweetener. Add a cup of frozen fruit- raspberries and strawberries work well- but I think you can find frozen peaches at the grocery store. Stir it up in the food processor or a good blender and voila! instant frozen dessert.
I eat more than 350 carbs per day. My lipid profile is right on the money. My A1c is 6.2 from 7.3 and 10.7 at diagnose. No pump, no basel and no other medicine . Fasting is between 80 -120. Yet i’m not gaining weight. Switched from Novolog to Regular month ago and so far matching all the grain carbs and protein perfectly with all the fiber in the meal.
Hi A! Do you also watch fat? I had a low carb, high fat meal last night (Cheese,) and my BS steadily went up for over 4 hours despite 5 more units of insulin than called for by the carb count. This just keeps getting harder and harder.
Love room to wag! Actually, I am comfortable, even enjoy carb counting…Unfortunately, I just can’t get this down. There are so many variables! Congrats on your great A1c…I am most likely headed for that pump, myself.
Libby…we keep waiting for your cookbook!
Hope you enjoyed your dinner last night.