How do you control your Type 1? Diet + insulin?

Hey Everyone!

Just throwing this out there to see if anyone has any suggestions for how to control blood sugars without letting diabetes take over their lives. I am a very busy and active person and have had diabetes for 15 years. I don’t have any complications yet (that I know of) but I am feeling like my sugars have not been in optimal range for awhile, so I’d like to pay more attention.

I started eating pretty low carb recently and it seems to be helping. I get tired of constantly increasing my insulin levels, which makes me resent having to take my shots. I take Lantus and Novolog pen insulin right now, and have never been able to convince myself to go on the pump because I don’t like the idea of an external device. I live in the city and have a very full social life and professional life. I read Dr. Bernstein’s diet book which is great but seems perhaps a little too extreme for me. (I absolutely love fruit and don’t know if I could give it up! I am already giving up so much!)

Anyway - tips on getting A1c’s consistently in the 5’s or 6’s would be great - without major hypo reactions, as those scare me a lot. My last A1c was 8.0 - which is not cool with me at all! Only the second time it’s been that high…

Thanks! Hope you all are happy and healthy!

Hi Sarah. Get ready for 101 different answers. I’ve been type 1 for over 25 years now and am just now really getting good control of my diabetes. How? Pump + CGMS. Since I am hypo unaware, I was looking for something that would warn and help me to know ahead of time when I was going low. The CGMS does that perfectly for me. It also let’s me know when I am getting higher than I care for so that I can correct much sooner than in the past. Many times I don’t know I’m high until I’m in the 300+ levels. Other times, I know when I am approaching 200. It is so different every time for me, as is my diabetes. It’s always a bit different each week.

Lower carb intake, exercise, tight monitoring of my bg’s, proper nutrition overall, and some luck all add up for me in better A1C’s. Then I can have days when the bottom will fall out of everything. Stress will cause my bg’s to rise, as will any illness I may encounter. I rarely get sick, so those days are rare for me. I try to avoid those stressful types of situations. In this world, that is not easy.
I feel that I’ve proven to myself that it can be done, but I will always have to be in charge of my diabetes to make it work. For me, my type 1 will kick my butt in a heartbeat if I don’t take the lead.

I wish you much success in this challenging part of your health.

I don’t eat super low carb, but I refuse to raise my insulin above a certain level so I need to eat to the insulin rather than the reverse. I review my I:C ratios every three weeks which is a page on my notebook. If I’m not on target say more than five times for a meal I’ll lower the ratio by a carb. I also wiggle my basal dose a bit if my fasting and before meal numbers are too high. I find it really hard to eat out and be in target. I’m still struggling to find restaurants and dishes that will work for me. I’m very organized at home but seem to forget I’m a diabetic when I see a menu! I’m partially retired and I know that makes it easier. If I was still working fulltime I think I would either bring my lunch or find a reliable place and dishes to order on a regular basis. I was recently away for a weekend and so bought things for my hotel room and made an effort to pay attention and it worked out okay so I know it’s possible! I think if I was still working fulltime I would seriously look into a pump.

I agree Dr. Bernstein’s diet is a bit extreme. 6, 12, and 12 for crying out loud! I don’t think we would be able to control my niece’s D without a pump. We are using Dex 7 Plus also which helps, but can be inaccurate (sensor problems? Receiver problems? Dex is going through some technical difficulties currently). I know if she want back to MDI we would have to split the shot to gain better control as her daytime needs are much less than evenings/early a.m. To gain better control, I can only recommend prebolusing 15 minutes before some meals and changing the glycemic index of the food you eat, along with modifying carbs (but not to a ridiculous extent). We give grapes or bananas for moderate lows if at home as, for her, those fruits work quickly. For a more severe low, glucose tabs. A cgms such as Dexcom can be used with injections, can warn you of lows a lot of the time, can be hidden under clothing. If you feel more comfortable gaining controls of your lows, you should then be able to work on lowering the A1c. Particularly, since you are active, I would get the Dex.

Best thing you can do is workout
and i dont believe in Low carb diets
i did that and i almost died really…
just keep it simple
somtimes we forget all we are is taking insulin from outside
have your carbs
what i reccomend to every diabetic is the sweet potatoe
yeah i know sweet:P
well this here is a gift from god
its sweet
but its burned off very easily and sustains the sugar level
wish you all the luck:)
<3

To add to what is said below, try journaling too. I know it’s a pain, but I have found that certain foods cause my kids BS to react differently than what is listed on the lable. Maybe you can spot trends on how yours reacts after eating a certain type of food. One that brings you down or one that brings you up.

Do you split your Lantus between morning and night or is it all taken at one time of the day?

I split my Lantus. Shortly after going on it, I found that it doesn’t last the full 24 hours for me - I have been able to reduce it quite a bit with low carb though - I’m down to 15 day dose, 5 at night, and may continue dropping the night dosage.

Thanks everyone so far for your replies! I am looking forward to trying out some tips - Jan the Dex 7 looks pretty amazing…I am on the website now.

Set do-able goals and look at moving closer to 6% A1C as a series of small steps. To go from 8 to 6 quickly and safely is fairly unlikely, especially with no pump and CGM.

Instead, concentrate on one thing at a time. Here’s my list, in order, of how I’ve slowly but surely (and without serious hypos) tightened my control. It’s a journey, not a destination!

-Pump
-Avoid overtreating lows (I use glucose tabs, not food and test 15 minutes after treating. Repeat if necessary)
-Trying to get at least 30 minutes exercise each day (easier to deal with on pump; can go on temp basal rate to avoid lows; blood glucose-lowering effects last for hours after)
-Diabetes online community! Hooray for all the great people and advice I’ve discovered here.
-More after-meal testing (to see if my insulin:carb ratios are correct and to let me treat/correct out-of-range numbers so I don’t spend hours off target).
-More frequent basal-rate testing. Age and stress mean that I have to make adjustments more frequently (as in several times a year) than I first suspected I would need. And, I have 10 different basal rates throughout the day. Funny how very minor changes, as little as .1 units, can make a difference.
-I don’t eat low carb (defined as under 135 grams total per day), but I do make a strong effort to eat high-quality carbs: low-fat yogurt, veggies, whole grains, lots of fiber, some fruit.
-Dual-wave bolusing (some insulin immediately, rest of dose doled out by pump over 30 minutes-2 hours, depending on what I’m eating) with every meal. The dual-wave bolus (other pump brands have similar features) is great for allowing “regular” consumption of carbs (about 50% of caloric intake) without peaks over 140 mg/dl as long as meals are well-balanced (with some fat and fiber to “slow down” the digestion of the carbs).

Good luck! Let us know how it goes.

That’s a splendid idea Danny…Make it happen. :slight_smile:

For me it’s insulin, diet, and exercise. Glucose control is generally easier if I don’t overdo certain foods (and avoid almost all processed foods), and when I’m more active.

Fruit is generally really easy for me in terms of BG control… it’s easy for me to dose insulin for simple sugars. High fat/protein meals are my problem :slight_smile:

Hi Sarah: You have gotten some great advice here from TuDiabetes members. I really agree with several that a pump is very useful for lowering your A1c. I was just at a diabetes conference (Taking Control of Your Diabetes (TCOYD)), at a session on pumping, and the endo asked how many of us prior to pumping didn’t want a machine attached to us 24/7 and most hands went up. Then the endo asked how many of us care about that now and not a single hand went up. The endo said it’s the biggest barrier to pumping. I really find wearing a pump to be easier and more convenient, although there of course is lots of work associated with it. I have had less success with the CGM–my personal opinion is that it’s first generation technology and much improvement is in order, especially accuracy. Good luck to you! Melitta

My A1C1’s are consistently in the low 6’s, which my doc figures is pretty optimal for type 1. Pushing for lower A1C1’s would push my into the hypos.

I was consistently in the mid 7’s while using multiple shots. Switching to a pump and being able to use variable basal rates and dual wave boluses, along with discovering trends through CGMS brought my A1C1’s down. I did try Dr. Bernstein’s theory a long while back, pre-pumping days, but seriously did not enjoy a low-carb eating, and it also made exercise a miserable experience for me.

You’ll have a hard time finding ‘junk’ carbs in my kitchen - just about everything is whole and unprocessed. I eat a lot of carbs - fruits, veggies, whole grains, legumes etc. and if I keep the junk out of my diet and get regular exercise, find I need very little insulin and have very even numbers which in the long run, help with great A1C1’s.

That said, different strokes for different folks. You have to find what works for you.

I’ll help you round up group members, 'cause you’ve been such a champion for Diagnosed Age 4!

Sweet potato?!! I sure hope nobody listens to your silly advice!

I never understood the need for creating groups. Why are there groups? Why can’t everything be discussed in the open and everyone allowed to comment instead?

Before I join any new group, I would like to see my feature request considered serously : http://tudiabetes.com/forum/topics/feature-request-make-groups . The only problem I have with groups is that they seem to swallow up a lot of good discussion which I miss just because I’m not part of that group… see my post for more information about my pet peeve.

Hi John Smith, Mohamed Kay’s recommendation is similar to the one I got from my nutritionist–and that’s not bs (bs meaning, bull shit): In a nutshell, sweet potatoes are a good food for diabetics because sweet potatoes are a good source of fiber. The fiber helps lower bs (bs meaning, blood sugar) by slowing the rate at which food is converted into glucose and absorbed into the bloodstream. Plus, because sweet potatoes are such complex carbs, they can help control weight–in other words, they’re very filling. Best regards, Lucy

OK John , sweet potatoes …maybe should not be called " sweet potatoes " , however this is their " legal name " and they have a very low glycemic index, one of the reasons , why they do well in NOT increasing blood sugars rapidly . Buy them , try them and test them : they are for real …if you google, you are able to find recipes as well .

Sweet potatoes are a staple in my household. They are great for keeping stable blood sugars and for keeping lbs off the tuckus.

Thanks for all your replies correcting me. I always learn more on these forums.