Type 1 and a Low Carb-High Fat Diet

@lh378, nuts and seeds are great sources of healthy fat!!! Here’s a very user-friendly summary of health benefits of different nuts, complete with recipes http://www.bbcgoodfood.com/howto/guide/health-benefits-nuts

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Yes, Jen, that is correct. I have heard about “chair dancing” a few times. It is an excellent exercise for people in wheelchairs. An interesting topic you can find on your browser.

Richard, I have a DVD that shows seated Tai Chi, very easy to do in front of the tv. Tai chi is a great exercise for the elderly (like me). If you are interested I can give you details of this DVD.

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I am not surprised, Pastelpainter. I am still walking very well, but in a few years, who knows, lol

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[quote=“Richard157, post:50, topic:46521, full:true”]
I am not surprised, Pastelpainter. I am still walking very well, but in a few years, who knows, lol
[/quote]I wish you could come to Tai Chi sword dance class with me, Richard! You and your upgraded knees would probably make us all look like a bunch of goofy fools :smile: I notice when folks take a snack before or after, it’s a few nuts. LOL - seems appropriate enough!

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How would you do this diet if the person was vegan?

Can it scale?

33 units? Is that what I have to look forward to? I’ve had T1/LADA for almost 10 years and my cab ratio has barely changed. I take 1 unit of insulin for every 8g of carb.

Low Carb High Fat (LCHF) is difficult, but not impossible on a vegan diet. The challenges are sources of protein and fat. I think you are already familiar with the protein challenge, a LCHF diet essentially has the same protein as other diets, as long as you get 50-70 g/day you would be fine. It is the fat that is the challenge. And it isn’t just quantity of fats but the kinds of fats.

I find good sources of vegan fats include avocado, nuts, seeds, olive oil and coconut oil. I personally buy olive oil in the double gallon pack and coconut oil in the big tub at Costco. Liberal use of these oils in your food preparation can go a long way towards meeting your fat needs. A challenge is also getting essential fats. Our bodies require the omega-3 fatty acids DHA and EPA which are unfortunately not found in plant foods. We can convert the omega 3 ALA into DHA and EPA but the conversion is low and it has been found that those with diabetes have even poorer conversion. That being said, it would be good to get as much ALA as you can. Good sources include chia, flaxseed and walnuts. Canola and soybean oils contain ALA but some people get concerned that too much omega-6 fatty acids can be inflammatory and vegetable oils are high in omega-6s. There are numerous sources of flaxseed oil, so that is something to consider, it can be added to food but it is not a cooking oil. I also use avocado oil which is a cooking oil and is mostly saturated and monounsaturated.

Hope that is helpful.

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[quote=“Khurt_Williams, post:54, topic:46521, full:true”]
33 units? Is that what I have to look forward to? I’ve had T1/LADA for almost 10 years and my cab ratio has barely changed. I take 1 unit of insulin for every 8g of carb.
[/quote]I don’t use 33 units, that would be a lot of food for me to digest! Terry said using LCHF reduced his insulin from 80 units to 33. TDD is not a competition, but in this thread I learned that “the less insulin the better” is the goal. I thought the goal was to keep the bg in a normal range. And, yes, a vegan can do LCHF. Whatever that is.

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I thought this too until I read Dr. Bernstein’s book,“Diabetes Solution”. He advocates a very low carb eating plan to keep BG in line, he has been a TYPE 1 since the 1940’s. I am just finishing the book and looking at changing my eating habits to see if I can achieve better control over my BG.

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I drastically cut carbs about 2 months ago and the improvement in bg’s is amazing. Now I know what all the fuss is about, after being stupid about my eating for, oh, say the last 35+ years or so… :slight_smile:

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While I know we are not all the same, your experience echos what many before you discovered. Fewer carbs = less insulin = smaller mistakes. And I will add, less variability and much more time in range.

Be aware that he prefers to add back calories (from the reduced carbs) with protein instead of fat. I encourage you to try Dr. B’s methods, at lest the fewer carbs part, without too much delay. I thought about it for a year or two before I pulled the trigger due to a diabetes complication diagnosis. The time for better BGs and more time in range is always now.

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Lower carbs and reduced carbs all make sense. In practice, I’ve found it quite difficult. I am at about 60 g of carbs a day. It seems to make me mentally and physically happy; any less I don’t seem to feel right, any more I definitely feel sluggish. My BG (according to the Dexcom) hovers between 90 and 140 most of the time( with the occasional spikes ;-( ). I’d like to aim for bringing it down to 80 to 130 as a start. Any suggestions? increase bolus insulin slightly? (1-2 units of Novolog usually covers my meals) I don’t wish to reduce carbs. I can try to trade or change the carbs. I am a bit concerned about going “low” and wish to avoid it. For example: Tonight, I deliberately under counted by carbs by about 5 g for the bolus and less than 2 hours after the meal when I went for a walk the Dex had the angled down arrow at 79 and I had a moment of panic because 1. I didn’t bring my meter or any sugar 2. never had a post meal of 79. I turned around went home, checked the Dex again…horizontal arrow at 79. I decided to eat a piece of cheese and less than 1/4 cup haagen daz ice cream. BG 128. I think seeing the Dex angle down arrow around 80 after I’ve taken insulin makes me nervous.

I think the actual goals are increased Time in Range, better A1Cs and fewer diabetic complications. If achieving those items results in less insulin, then that is all the better.

Why?

Because a large TDD on a long-term basis might lead to developing insulin resistance, and that can become a bad spiral to get into (really bad, IMO!).

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I’ve found I have to restrain my initial reaction to my downtrending Dex numbers. It’s especially concerning when, like in your case, it occurs with significant insulin on board following a meal. Like you observed, the Dex can switch from a down-trending arrow to a sideways arrow relatively quickly while it keeps the same BG number. If you had your fingerstick meter with you then you could have verified the actual BG and treated accordingly.

Without additional fingerstick data, I’ve often over-reacted to the Dex’s downtrend warning and over-treated and get an unneeded bounce to the upside. I usually walk without my meter and try to treat trending lows with small carb doses spaced out over time. I like Tic-Tac mints since they only contain about 1 carb for two pieces. I also try to walk after a meal when the Dex trend is moving up. I like to watch the Dex level out and start to trend slowly down and back in my preferred range.

We’ve all been caught out without back-up sugar. I place a high level of importance on always having a source of glucose with me, even if my BG is high and I’m trying to knock down with a walk. Better to have it and not need it than the other way around.

If you’re meeting your BG goals (90-140 or 80-130) a high percentage of time, you’re doing a great job. I don’t think that there’s any specific number of carb grams that’s ideal for everybody when your’e talking about 60 grams per day or so. You know what’s working for you. My only suggestion is to continue to watch your BGs, both fingerstick and Dex, and learn what your body is telling you. You are in a good range; keep it up.

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Terry4, thanks so much for the encouragement.

" I also try to walk after a meal when the Dex trend is moving up." This makes alot of sense. My Dex reading was 112 horizontal and I was expecting it to rise either horizontally or angle arrow like it often does after a meal. Boy was I surprised! and I panicked.
My recent a1c was 6.9. Is it likely that I’m spending more time in the higher range closer to 130 rather than closer to 90? My “nighttime”~ midnight to 6am is usually 100. Perhaps too much time is spent in the higher BG range rather than the lower BG range? My fasting is most often around 100 +/- 10; sometimes mid 80’s. Late dinners, or a high post dinner BG leads to higher fasting numbers. I’m hesitant to increase my basal Lantus for fear of going low during sleep. Would going on the pump help address some/many of these fine tuning issues? late dinners, unexpected high dinner BG numbers?

An insulin pump allows fine tuning basal needs, especially if you need an aggressive early morning basal profile to offset significant dawn phenomena. Here’s my current basal profile:

I probably could reduce the number of basal rates I’ve programmed to eliminate some of those smaller steps, but you get the idea. I have a larger need for basal insulin in the first half of the day with a lower need in the afternoon and then a step up in the evening following my dinner. It’s difficult to get a long acting insulin like Lantus to do this. Having said that, I know many people make their MDI program work well.

Overall, a pump will allow more freedom to adjust.

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@ Terry4 - Which pump do you use? I’m very seriously considering the omnipod. I am concerned that I’ll be a mess of tangled tubes with the others.

@lh378 - I use an Animas Ping pump. Here’s a link to a recent comment that summarizes my experience and feelings about choosing a pump.