Is it possible to conti to eat carbs and keep standard deviation < 30

Food
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Juicebox Podcaster Scott Benner claims that his daughter Arden is on NO dietary restrictions whatsoever. Her A1C is in the 5s and I’m not sure what her standard deviation is but I’m assuming it’s low.

Is anyone else pulling this off? I’m sure it’s possible but is it really feasible for the average person to figure out? I have a great understanding and I’ve nailed some difficult meals but others still seem sort of impossible.

Even if I do dose effectively for a high carb meal there is still a spike and a drop. “Effectively” just means that I kept the spike and the drop within my range. Are the highs and the lows of a regular carb diet going to undoubtedly cause related health issues later in life vs a more steady blood sugar?

It’s my 3 year old daughter that has T1D not me. I think it would really help me decide if I put a Dexcom on myself to see what my healthy pancreas does when I eat? How much does “my” blood sugar spike and drop when I eat similar meals? What is “my” standard deviation? I might do this to help me determine how well I’m actually doing with my daughter and to help me make future decisions regarding carbs in her diet. Have any other parent’s done this? Can I just pop one on myself and use the receiver that came with it without creating an online account etc.?

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Hi Christine. Welcome to the group. I am so sorry to hear about your 3 yr old daughter being diagnosed with Type 1 diabetes.

I could not eat regular carbs without my standard deviation rising.
I eat close to 300 healthy carbs a day. And my standard deviation is very good. One day it was 13.
My alc has been in the non diabetic range for almost 2Oyrs. It is currently 4.9.

I have found that the Mastering Diabetes plan works the best for me. I eat lots of fruit, vegetables, grains, lentils, legumes and very little fat. I ate 30 carbs a day for 11 years and I have eaten The Mastering Diabetes plan for 8 or 9 years. I eat close to 10 times of healthy carbs on the Mastering Diabetes plan and take about the same amount of insulin on both plans 17-22 units daily. Not eating fat greatly reduces insulin resistance. Mine is now extremely low.

All bodies are different and while I eventually had to stop eating very low carb, because it was causing health problems for me I am
just healthier eating fruits, and vegetables etc
than I was eating meat, dairy, eggs and fat.
Obviously the very low carb way of eating works really well for some and others do very well with Mastering Diabetes. Many people on this site do very well without using either of these plans.

Your daughter has a lifetime of wellness ahead of her especially with CGMs I tested my urine for years and then monitored my glucose levels by sticking my fingers for blood. I was 8 when I was diagnosed and am now 73. There are many folks here who have had diabetes for 60 yrs or more. I never chose to use a pump so I give at least 6 or 7 injections daily. It really isn’t a big deal, but I would have hated getting lots of injections when I was a child.

You asked about the accuracy of CGM’s. Most of the time I find my G7 more accurate than the G6. I actually love my G7, but again we are all different.

You are one busy woman and it is sad that your 3 yr old has Type 1, but she couldn’t have been diagnosed at a better time. Please ask us anything, because between all of us we have a ton of knowledge about diabetes.

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A “normal” makes insulin within 5 minutes when you eat and exactly in the amount needed. A liver is told to dump glucose into the system when needed. A type 1 is missing the ability to make insulin and you lose the signaling to the liver to releasing glucagon to maintain BG levels properly. Our systems work differently than a “normal”. We have to learn what insulin we need from an outside source and when we need a BG boost we have to supply that too. A normal wearing a dexcom while interesting, won’t equate to what her as a type 1 and what her BG level does as we have to rely on an outside source that just is not as effective as a "normal"s making it is.

A child most of the time you do keep a little higher BG level than I would as an adult. I had a dog that had type 1 and I did keep her numbers higher than mine as they can’t always speak up. Which is where a CGM is the very best thing you could put on her. I had a LIbre on my dog so I could tell what her numbers were doing. Same food everyday, same exercise and her numbers could vary. That’s unfortunately T1D for you, things affect us like stress, activity level, not sleeping as well etc that can affect our numbers. A CGM lets you know what the BG level is trending and is invaluable to let you know what is going on. And you can calibrate a Dexcom if needed. But it also saves fingers, a lot less finger sticks are needed which will make her happier. I would get one on her ASAP.

One of the most important things, because our system can vary. Always, always keep a quick glucose fix handy. While we try to avoid lows, it can happen, maybe she ran more for the day or who knows but always keep one near her and within easy reach, just in case.

I eat whatever carbs I want to. I am a vegan. All my levels and numbers are in non diabetic ranges too. I wear a pump and a CGM, I love both!

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Hi, Christine. There’s a lot to unpack in your post, so let’s dig in.

My first and primary message is that it’s reasonable to expect a long and healthy life when living with type 1 diabetes. This does not require continuous wizard-level control of blood glucose, as evidenced by the healthy type 1 folks who grew up before the era of modern glucose measurement and modern insulins.

There is good evidence that it is reasonable to aim for an A1C of less than 7%, provided this can be accomplished without significant hypoglycemia. In a developing child, the temporary BG excursions after meals are much less important than avoiding hypoglycemia and getting a good A1C.

Next is the issue of carbs and A1C. I’m old, type 1, like to eat plenty of carbs because they’re tasty and burn clean, my A1C is in the low 5’s, and according to the 90-day AGP, time in range 96%, time low 1% and very low 0%. (Time in tight range is 79%.). How is this possible? It comes down to two things. One is that I have learned how to dose insulin. The other is that I have good technology plus a personality that lets me react early to correct my BG when it starts to wander away from my target range.

Next is the question about dosing correctly for carbs and still getting a spike and drop, and would it help to see what a non-diabetic experiences on a CGM after eating. Here’s the thing. In the non-diabetic body, when the BG starts to wander off the pancreas gives a microdose of insulin directly into the bloodstream. This insulin immediately removes some glucose from the blood, and it’s over and done with immediately. This microdosing is repeated over and over as needed. For a type 1 diabetic the situation is completely different, because we are taking subcutaneous insulin, which is slow to get started, and which continues to lower the BG over a duration of several hours. So for us, it’s not just a matter of taking the right amount of insulin, it’s a matter of trying to match the rate at which injected insulin leaks into the bloodstream with the rate at which our food is digested and converted into glucose in the bloodstream, which also happens over a period of hours. We can use tricks like pre-bolusing and overbolusing to try to speed up the insulin, and we can choose food combinations that slow down the digestion and the release of glucose into the bloodstream, but BG excursions are common. Some will choose an extreme low-carb diet to avoid that, but not me. As far as I can see from the literature, BG excursions that are corrected promptly do not have a significant health impact, and so I follow an approach that has been called “Sugar Surfing” by Dr. Stephen Ponder.

You can wear your own CGM but I don’t think there’s anything to be learned from that, because of the difference between the healthy body’s microdosing of IV insulin, and the subcutaneous bolusing for meals by people with impaired pancreases.

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I really like Sugar Surfing, Stephen Ponder explains his method well. When I recently read this book I realized that I have been sugar surfing for years.

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I just want to underline that point. It will be a learning process with a lot of changes along the way with a growing child. Stuff will go wrong, or be not ideal, or be kind of awful way more often than you’ll want, but try not to catastrophize. Bad days, bad blood sugars should be addressed, but they do not mean you’re ruining your child’s health. It’s the long term that matters.
Going low carb with a small child strikes me as rigid and ill advised. Is there a pediatric endocrinologist recommending this to your ex or is this coming from the internet? I’d go with a trusted professional for overall management and to the internet for some gentle tweaks and encouragement.

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Could someone summarize the Mastering Diabetes idea in a few lines for me, so I could decide if there’s even a chance that it’s relevant for me?

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Cutting out all but 10% of oil is very good for bringing down one’s insulin resistance. We don’t eat any meat, eggs or dairy only fruits, vegetables, grains, a few nuts and seeds, and lentils. Everything should be as unprocessed as possible.
The first meal they suggest eating the way do is breakfast. Often fruit, and oat gouts are listed. I try to also try to eat some kale to slow digestion down.

They sell a book on Amazon called Mastering Diabetes it is inexpensive but full of information. You can also pay to train with them and I found that very helpful. They also have lots of YouTube videos.

I can now eat rice and potato dishes without much change in my glocuse levels. Vegetables with every meal. I still don’t eat bread of any kind, but have found cookie recipes that I really like that are ok to eat.

Hope this helps

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Yup. Thanks a lot.

/s/
M.

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Hi Marilyn6. I checked out a few of the recipes on the Mastering Diabetes website–they look really good! I’m vegetarian except for occasional fish, so it wouldn’t be a huge change for me except for the carb increase.

I am a bit confused about how to bolus for the carbs, since they don’t list fiber grams with the recipes, and these dishes are very high in fiber. Again, I didn’t dig deeply into the program, so I might have missed something. How do you bolus for the carbs with these meals? Thanks!

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Hi Lisa,

I remember only counting the carbs and I paid no attention to fiber. When I was on a very low fat diet I think I used 1 unit of insulin for 1-2 carbs. Eventually, using the MD plan, I was using about 1 unit of insulin for29 carbs. The change over was somewhat long but I was working with Robbie and Cyrus, and a few other people who were just starting this way of eating, and they held our hands while we adjusted to their diet.
Once you cut your fat down to 10-15% of your diet, your insulin resistance changes dramatically.

I think you should order their book off Amazon. Specific directions on how to do this are in the book. I will help in anyway I can.

Marilyn

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It’s essentially a low-fat vegan plan. Good for your health but hard for some people (like me!) to stick to.

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Will do. Currently I subtract fiber grams from carb grams to determine how much insulin to bolus, and it works well for me. I almost always have to do an extended bolus for high fiber meals since the fiber slows down the food absorbtion. I can see where getting most of the carbs from whole foods would be so good for me. It will be an adjustment, though, since I currently average about 100 g of carb daily. Thanks for the advice!

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This is such an excellent reply–thanks for sharing!

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i am reading the book now. It’s making a lot of sense to me so far. And the chapter about dairy and MAP— oh my gosh. I grew up on a dairy farm and drank an abundance of raw milk and ate a lot of meat from our small farm. I was diagnosed with type 1 at age 13 after a series of very likely autoimmune issues at least 3-4 years before the diabetes diagnosis. I think this book is going to help me tremendously, so I’m very glad I saw your comment, Marilyn!

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I am very glad that you find the book helpful!