How many grams of carb do you eat per day and why?

Food
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Currently, I eat between 55 and 70 grams of carbohydrate over a 24 hour period, and I do my best to get all carbs from vegetables though I do eat some rice or quinoa on occasion. Thirty two years ago, I ate 150 grams of carb in the same period, but I find myself feeling better–and taking less insulin (T1) on less.

The naturopath I’ve been seeing is recommending I go to even less carbs aka Paleo… I’m not sure how that would even work for T1.

Would love to hear from others about how you manage carb intake and why.
Thanks,
Ahnalira

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My current daily carb target is 30 grams/day. I’ve evolved to that limit over a series of steps starting three years ago. My initial motivation was to shake things up following a diabetes complication diagnosis at the time. I’d read about the low carb movement in the diabetes community but, like many others, was reluctant to make the commitment to cutting out foods that I liked. Foods like bagels, pasta, and potatoes, I just couldn’t imagine cutting them out for life.

My initial daily carb limit was 100 grams. Shortly after starting that and finding it easier than I imagined, I cut my limit to 75 grams per day. It subsequently fell to 50 grams and now 30.

I’ve told this story many times. I started with better blood glucose (BG) control as the target and soon discovered that I starting losing weight with little effort. I lost 25 pounds or about 13% of my body weight. I need 50% less insulin while my BG control amazed me. My BG average fell but more importantly the variability in my blood sugar improved, a lot.

I’m a firm believer in Dr. Bernstein’s law of small number which says, fewer carbs equals less insulin which equals smaller mistakes. A low carb diet has improved my safety. I haven’t had a severe hypo in the 3+ years since I started. I used to experience a few each year.

After a few years at 50 grams per day, I found that I put about 10 pounds of the lost weight back on. So I cut my daily carb consumption to 30 grams and I lost 8 of those 10 pounds again. I think that there’s something significant to the 30 grams per day limit. When I was at 50 grams/day, my averages hovered in the 105-110 mg/dl. When I cut back to 30 grams/day, I started seeing averages under 100 mg/dl.

Of course, every body is different, and your experience may not follow mine. But there are enough people with stories like mine to make me believe that I am not unique.

I see carb limits as one of the best things I have done for myself in my 31 years of battling diabetes. It’s effective, healthy, and gives me energy. It’s totally changed my outlook about managing my diabetes. It’s made me more optimistic and positive.

I encourage you to try a lower daily limit, like 30 grams/day. Stick with it for a few weeks and judge for yourself. There are so many good foods that are not carby that I don’t feel deprived.

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Paleo works quite well for T1’s. I have been on a paleo diet for about 2 years. I try to limit my carb intake to 30-45 grams/day. I primarily focus on berries, non-starchy veggies, protein (does not matter the fat content), cheese and nuts. My insulin requirements are lower than they have ever been in my 31 year D journey and I am not sluggish or tired after eating. My post meal spikes are rarely over 180 mg/dl. My most recent A1c was 6.1. There are times that I miss “white” food. But, I’ve become quite creative with low carb recipes to satisfy those urges. Mashed cauliflower is a great substitute for mashed potatoes. :smile:

Sarah :four_leaf_clover:

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I’m having a battle with the CDE as I speak. I get to go back to the dietitican to be told I need 150 carbs a day. Well I recently went to a pump, and they want 50% basal and 50% bolus. Well it aint going to happen I explain I eat very low carb to keep my insulin requirements low. I think I’m going to ask the dietitician if it is a requirement to eat the SAD diet. I see my doctor in July so that visit is a little bit away. I’ve tried to eat higher carbs the last few days and my BS is higher.

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This is all good info! Thanks, everyone :kissing_heart:

I think I can take it down to 45 grams per day and see it how it goes from there.

Right now, I am all refined carb free–including all forms of sucrose–gluten free, 98% grain free, and almost all organic except when I eat at a restaurant. Part of my reluctance is emotional and social…I’m looking for the balance between health and happiness, if you know what I mean :wink:

It’s great to hear about how well it can work if I do decide to go this route.
Thanks again,
Ahnalira

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Maybe your CDE will consider some alternative views on the basal/bolus split:

https://www.facebook.com/StephenPonderMD/posts/1591563254424369:0

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About 40 a day mostly from fruit because I don’t want my blood sugar to fluctuate a lot

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I eat around 140 grams of carbs a day backing out all fiber and not counting green vegetables. A couple of times a week I probably eat around 170 grams. I’m pretty lucky - I don’t have wildly fluctuating blood sugars and maintain a good A1c.

Maurie

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@Terry4 can I ask what your current height/ weight / BMI is? Describing your carb restrictions and the associated weight loss doesn’t align with my own personal struggles… but I am interested because you and I have similar builds, insulin sensitivities, and in many cases (I think) diet…

Sorry for the absolutely illiterate level of typos in everything I have posted lately. I gave up on my PC and have gotten online only with my iPhone 6+. I’ve used iPhones for years but I seem to have trouble adapting to typing with fingers on the larger size…

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Sam - I am 5’8" and weigh 163 pounds. My BMI is 24.78 according to the Stanford Health Care calculator.

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It drives me crazy when doctors confuse means and ends. The 50/50 basal/bolus rule of thumb is way to approximate an appropriate insulin regimen for a typical diabetic on a typical diet, but it isn’t some kind of goal in its own right. The notion that one should eat a particular diet to enable a 50/50 split is an asinine example of putting the cart before the horse. There may be other reasons to eat a higher carb diet–that’s a contentious issue–but don’t take anyone seriously who tells you to eat one because it enables an arbitrary 50/50 basal/bolus split.

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Couldn’t agree with you more @niccolo. My basal/bolus percentage is about 90/10 right now. And I honestly do not care what my endo thinks about it. I have a low TDD, decent A1c, and overall I feel great. Low carb is my plan of choice.

Sarah :four_leaf_clover:

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Niccolo - I am also puzzled by certain clinicians latching onto the idea of a 50/50 basal bolus split. It’s never a target for me. I’ve checked it from time to time, whenever this topic arises, and I found I range from 40/60 to 60/40. Right now I’m at 50/50.

I take the basal insulin I need and it changes. I just changed several time periods this morning. I take the bolus insulin I need to cover the food I eat. I see the 50/50 split as a meaningless goal.

Diabetes is a dynamic disease, a moving target. Fixed regimens like this one can interfere with appropriate adjustments when needed.

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I have decided to keep on my less than 50 carbs a day. I did a few days at the 150 carb rate, and my blood sugars got over 200 a few times. So with the CGM and the flat lines low carb does for me, I don’t think the doctor can argue with me, and if he does, it’s time for a new team.

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Happy day, Maurie,
Backing out all fiber is a new term for me…could you explain how to do it?
Thanks for your help,
Ahnalira

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I think he means subtracting dietary fiber grams from the total carbohydrate count in order to calculate an insulin dose. For foods like raspberries, it is significant. Here’s a cut and paste for Calorie King on 100 grams of raspberries:

In this case I would dose for 5.4 “net carbs” (11.9 - 6.5) instead of 11.9 total carbs. Some people dose on total carbs.

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The Japanese study showed that, at least for those on the pump, even that isn’t correct. The study participants were eating meals with 50% to 60% carbohydrate and none of them ended up with 50/50 split. Rather, it was around 30 basal/70 bolus for most, which is exactly where my split has been since I started the pump last month.

EDIT to add that what this means is that for some people whose doctors force them toward a 50/50 split, they’re probably actually eating to the basal, which of course, can often lead to weight gain.

And one more EDIT to further add, as demonstrated by the numbers people are sharing, low carb can skew the numbers the opposite way and that’s okay too. I hate diabetes “rules of thumb” because none of them seem to apply to many of us.

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my basal/bolus ratio all depends on my current eating habits. Now that I low carb, my ratio is pretty darn close to 50%. Prior to low carbing, my boluses were a huge portion of my TDD.

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Thanks, Terry4!
Got it.
Ahnalira

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Hi Ahnalira,

Food labels not only list carbs but include fiber as a subcategory. For example a medium apple as 25g of carbohydrate which includes 4.4 grams of fiber. I dose for 20.6 grams.

The Joslin teaches this method; others including Dr. Bernstein suggest subtracting 50% of carbs and still others suggest subtracting fiber if there is more than 5g per serving. How you count carbs doesn’t affect the correct dose rather it will affect your insulin/carbohydrate ratio.

Maurie

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