I’ve never bothered to restrict carbs in 35 years of Type 1 diabetes. Today I ate 347 grams of carbs using 16 grams of humalog. I also take 7 units of levemir daily in divided doses of 3 in the morning and 4 at night. I typically get 45 minutes of fairly vigorous exercise each morning after breakfast (hiking or cross country skiing). My A1cs are usually in the 5.2-5.6 range. I have no retinopathy. I guess I’d like to know that I’m not a freak and whether anyone else shares my experience. I think there are ways to continue with a pre-D diet without too much risk. CGM is a necessity for me and some of those 16 units of humalog are for corrections. My doctor once told me that the average non-diabetic person uses approximately 40 units of insulin daily. Is a typical diet that bad if you can do it on less insulin than a so-called healthy person?
If you take 16 units of Humalog for 347 carbs then you only dose meal insulin at 1 unit to about 22 grams of carbs. Everyone’s metabolism is not the same so we all can choose our own compromises. Your A1c is excellent, but an A1c number is not a good representative of your glucose exposure. What is your typical exposure to hypos? How much time does your CGM spend below your target range? If it’s 5% or less, I’d say you’re doing a good job with balancing carbs with insulin.
What is your BG variability as measured by CGM standard deviation? I like to keep this number at 30 mg/dL or less. If you are able to spend a high percentage of your CGM time in range (>= 80%) with little time spent hypo and your variability is livable then I think your current diet suits you.
There’s nothing to fear about a low carb way of eating. Some of us choose to eat that way because it allows us to live a relatively quiet metabolic life without a lot of stress and drama.
You’re in the driver’s seat. It’s your call.
I don’t eat a low carb diet at all (app. 255g carbs daily) but I use about 38 units of Novolog a day total insulin. When you think about it, you’re not that far away from 38 yourself. It may be possible that you still produce a bit more insulin than most long-time Type 1s do.
Or you’re a hummingbird and you’ve learned how to hunt and peck.
@Bob10, I am really impressed by your low use of insulin. My son who is only about 115 lbs uses more than you, although he spends many hours a week in sports. You must have a great constitution and be really sporty!
Possibly you still secrete more insulin than most?
Our pediatric endo says my boy can eat much more carb than he does. So he must feel like you. The reason he eats moderate carbs (not yesterday - see my thread about T1D sugar surfing…) is that otherwise the correction rides are really hard for us.
If you are right on the money based on your CGM this must work well for you! I wish it would too with my son (wishful:-)
I’m there with you. The diet my coach has me on (he is a diabetes specialist), calls for between 500 and 900 carbs a day, depending on how many hours of exercise I am doing. On some days my insulin ratio is close to 20, so our numbers are not too far off.
Don’t worry about the averages of other people. Do what works for you. If you aren’t excessively gaining weight, and your BG is controlled well, I think you are fine.
I think we are all different. My preschooler son does best on moderate to average carb intake (somewhere between 80g and 120 g, excluding fiber, per day). Other people seem to thrive on low-carb. I think diabetes is really the perfect opportunity to truly do experiments and really see how different foods and diets affects you.
In your case, I think you have all the data you need: You don’t use a ton of insulin and you’re not gaining weight, your A1Cs are fabulous and to me, that seems plenty good. If you’re not having many hypos, then you’re really doing better than 95 percent or more T1Ds.
Personally, I see low-carbing as a powerful hack to an already broken metabolic system, not as the ideal that every human being should follow. And in our case, it doesn’t seem to work, so we don’t use it!
Enjoy all those delicious carbs!
I don’t think it’s up to any of us to say who eating the right or the wrong amount of carbohydrates. If you’re keeping your blood sugars in order and your A1C’s are reflecting that, that is what matters. If you feel good, don’t worry about it.
Thanks for all of your replies. Maybe I should try uploading my CGM results to analyze variability better. I should have been a bit more explicit regarding my fears. I’ve enjoyed being able to eat anything I want, but I wonder with recent revelations of sugar perhaps being more the villain in cardiovascular disease than fat (and my relatively higher intake of sugar than those of us on low carb diets) whether I may need to reconsider low carb options. My lipid levels and body weight have always been within normal limits. I wonder, however, if I was to go low carb if lipids would rise with greater fat intake. There’s also the issue (for me) that my environmental footprint is already huge as a person with diabetes and to go low carb would move me up the food chain further exacerbating that.
good advice. If your BG isn’t a roller-coaster and weight is fine, whatever you are doing is working for you.
I’d think the T1 population would be similar to the general population, Where about 30% can handle the current high carb diets, 70% can’t and are overweight/obese.
I wouldn’t worry consider the environmental footprint in deciding my diet, but maybe that’s just me. I read a book once (when I lived in a hippie communal house where people never used the heat, ate vegan, rode bikes, never flushed toilets to conserve water, etc.) and learned that it would have still taken 4 Earth-sized planets to support the world’s population if everybody on the planet lived like me. If you live in an industrialized country then the vast majority of your carbon or environmental footprint is baked in: The streetlights, the roads, the infrastructure your taxes pay for, the fields that grow food whether you eat it or not, the cows that must be fed whether you eat them or not.
I think the lipids/fat relationship is not straightforward. For some I think a high fat diet does exacerbate high cholesterol levels, but for others, i think a high carb diet is the problem. For most people, diet has relatively little to do with cholesterol levels. (My husband has familial hypercholesterolemia and found that eating oatmeal, increasing fiber and upping fish intake helped, but a vegetarian diet on its own had little impact.)
On the flip-side, I think you have to take the case against sugar with a grain of salt (pun intended.) The evidence that sugar is not a superfood is ample; the evidence that it’s a poison largely responsible for modern-day obesity is much more equivocal.
There is no right or wrong, except insofar as what produces good results is “right” and what doesn’t is “wrong”. No one size fits all. Some people derive great benefit from low carb eating, others not so much. What’s important is whatever gives you the stability you want, not what someone else theorizes or promotes.
One objective fact about eating low carb is that it generally requires less insulin. Less insulin translates to less hypo risk. It’s what Bernstein calls the Laws of Small Numbers.
If your BG is behaving the way you want it to, then what you’re doing is working. End of story.