Thanks for the info, I really appreciate it! Yeah I’m pretty good at not overdoing sugar and carbs. My average carb intake is less than 100/day, and I try to keep added sugar most days below 16 grams - usually I eat much less. I’m definitely not a big eater, or a big sugar eater, but still, it’s not something I avoid as if it’s the devil. And a treat once in a while is totally acceptable, in my book.
From what you know, is the insulin insensitivity issue you’re talking about similar - or maybe the same - as what happens when people develop Type 2 diabetes?
Also, it’s probably apropos to mention that it’s not just about carb amount, but carb type. Are the carbs one eats generally whole foods? Or are they processed/hyper-processed? In terms of health and how your body processes what one puts into it, 30 carbs of a whole apple is not the same as 30 carbs of a Little Debbie cake or Snickers bar. 1 tblsp of pure, real maple syrup is not the same as 1 tblsp of high-fructose corn syrup-based “maple syrup”. Etc. And I would imagine, if the insulin insensitivity one develops as a T1D-er is similar to or basically the same as T2D, a diet high in processed foods and lacking in real, whole foods is a large part of the issue, not just carb/sugar amount.
I agree. The speed with which the carbs are absorbed also has its effect. This involves the glycemic index of the food with the snack cake likely absorbed more quickly than the whole apple.
I also agree that highly processed foods are less healthy than whole foods. They often contain industrially produced seed oils (aka vegetable oils) that no one should consume.
The fact remains, however, that the more carbs one eats of any quality, the more insulin is required (if insulin sensitivity is held equal) to metabolize it whether produced by a pancreas or injected by a diabetic. Hyperinsulinemia can occur in T1D and T2D.
I think the “eat anything you want, just cover it with insulin” aesthetic is an unhealthy philosophy to guide diabetes treatment. It grants permission to eat a nutritionally empty, though highly palatable, diet.
Terry, the more carbs eaten the more insulin needed is not altogether true. Eating 30 carbs a day I used as little as 17 units and as much as 22 or 23 units over an 11 yr period of time Eating 275 low fat healthy carbs daily I have used as little as 19 to as much as 23 units daily. I added an hr of exercise, but by decreasing the amount of fat in my diet my insulin resistance has changed drastically.
Marilyn, I’m aware that in your case, when insulin sensitivity is high, you are able to eat a high number of carbohydrates, use a nominal amount of insulin and still keep blood glucose in a good range.
That’s why my comment stated, “if insulin sensitivity is held equal.” Insulin sensitivity and resistance are two ways of saying the same thing. Does that make sense?
The only way I can eat a good number of heathy carbs, is by limiting my fat to only 10 to 15% of my daily calories.
For years I gave enough insulin to cover whatever I wanted to eat, although I never had to give more than 40 total units of insulin. I don’t know if eating that way was healthy for me. I would much rather eat low fat, so that I can eat very well but take much less insulin.
I love never having to worry about my weight creeping up. Also eating low fat is great for heart and kidney health.
That’s great you found a strategy that works! Personally, I focus on eating mostly whole foods, that’s really it. I don’t worry about fat, but on the other hand the only fat I do eat is nuts, seeds, sometimes avocados or coconut milk (like for a curry), sometimes vegan butter or mayo, and cooking oil when needed. I’m vegan, so that automatically cuts out a lot of junk, since so much junk has animal products in it (but of course not all vegan food is automatically healthy, either). Factoring in how many nuts I eat, my fat intake is pretty high, but I don’t worry about it - the fats I eat are almost all of the healthy sort, and I don’t have issues with weight, fortunately.
My hunch is that a lot of weight issues, when they’re related to diet, have to do with eating too much processed food, and eating portion sizes that are too big. So yeah, I just eat a wide variety of plant-based, natural whole foods, and limit processed foods and added sugar, and don’t over-eat, and that solves any issues then and there (for me), without having to focus on particular foods or nutrients to avoid. Eat whole foods, limit processed foods, and eat modest portion sizes, is my moral!
So when I say “I eat what I want without insulin dictating to me what I should/shouldn’t eat,” it’s all in the context of already wanting to eat healthy. But so fror example, I do eat bread (again, homemade or relatively unprocessed, in modest portions), and I have no problem eating bread or think it’s some kind of devil food, but it was a major challenge for me to learn how to dose insulin correctly for it. I was pretty demoralized for a while. But I kept trying, rather than having insulin dictate to me that I couldn’t eat it, and eventually I found a good strategy (which I’m so happy for).
Also, to put what I said in the context of the rest of the disucssion - in my book, “splurging” - say, on some vegan ice cream, or a piece of cake, or a stack of pancakes - once in a while - by which I don’t mean “every other day”, more like, “once a month” or so - is totally acceptable from a health perspective. A person’s health, w/ respect to what they eat, is the totality of one’s diet over a lifetime, not whether they had a brownie a few times a year. I’m just saying, if I want a brownie a few times a year, I’m going to dose my insulin and deal with it, and not have insulin dictate to me that I shouldn’t, just because I’m unfamiliar with dosing for that or because I’m scared to, etc.!
I have been a Type 1 for 62 yrs now. I have had heart stents for 11 yrs. I eat a low fat green diet now because I am trying my hardest to make it at least to age 80. So far, my very low fat woe is helping reverse the amount of plaque in my arteries and is an excellent woe for kidney health.
If I didn’t have heart stents, and if I could keep my glucose levels stable and my A1c low, I would eat like you are eating. It sounds healthy to me.
Thanks for sharing your thoughts. My hats off to you for managing this disease for so long. I’m glad you’ve found something in your control that can help with keeping your body as healthy as possible - I’m optimistic for you!
At a ratio of 1:2 + 1:1 CoD, I often will be bolusing < 12U at a meal, small doses in the 3-7U range, I just let my pump push through, but anything over 10, I split dose 30min - 2.5hr depending on protein or fat content. Most ive taken in one bolus was 42.70U, (forgot to dose the meal the 30mins prior and it was starting to spike fast), and most in a 2 hour bolus + extend was 63U. Back when I was on MDI, single bolus was 75U and split-dose (1,5hr split) was 115U.
So if you wanted to correct your glucose level from 7.0 mmol/L (144) down to 6.0 mmol/L (126), you would inject 1 unit of insulin. Am I understanding you? I don’t think in mmol/L so that may be the trigger for my question.
