Hi all
I want to try cutting down on carbs. I am eating about 200 carbs per day at the moment. I stay in my target range for about 60% of the time (5-10 mml/l), and my BGs fluctuate a lot during the day.
I got inspired by people here to try and lower my carb intake. But where do I start?
I can carb count and take as much isulin as I need for the certain amount of carbs, but what about my basal insulin? Wouldnāt I need more of it if I eat more fat and protein? How do I change the dose? (I use novo rapid and levemir)
I found there was a big difference between changing to a ālower carbā diet and changing to a true ālow-carb diet.ā The transition to ālower carbs,ā for me, meant to cut down on my carbs to around 100g per day. That transition was quite simple: just eat fewer carbs and adjust my bolus insulin accordingly. There was no impact on my basal requirements, so I really only needed to count what I planned to eat and manage it. The results were good, but I still saw a lot of fluctuations and went on BG rolloercossters on a regular basis.
A bit more than a year ago, I decided to go on a ālow-carbā diet ā to really cut down on my carb intake to less than 50g - and generally less than 30g - a day. That change, for me, was a lot more significant in its impact. Yes, I dramatically cut down on all my bolus dosing, but the change impacted both my carb sensitivity and my insulin sensitivity ā I ended up cutting my basal insulin in HALF. My I:C ratio and correction factor have been more difficult to adjust, as I seem to be sitting in a fractional ratio, and my pump only does whole units ā so I have so do a bit more math and a lot of guesswork to get it right ā but with small numbers of carbs, thatās not all that difficult.
Note - Iām not truly on a LC diet - I eat a fair amount of carbs on weekends. (I know lots of LC enthusiasts will tell me Iām doing wrong with that, but it makes me a bit more comfortable for now, so thatās what Iāve been doingā¦) Even with that, the changes Iāve seen in terms of control and dosing have been fairly profound. I hope that translates into ābetterā over the long term.
What you will need to do is likely to be very unique to you. The best advice Iād give is to be careful and TEST TEST TEST ā watch what happens and adjust accordingly. I wear a CGM, which helped me immensely in dealing with the changes that were happening.
Thas, let me ask a slightly unrelated question. I am cutting back down from around 100g total per day to less than 50g total per day. Do you worry about fiber intake at all? Iāve really struggled to try to figure out how to get enough fiber (I aim for 30g-40g per day) while eating very low carb. When Iām in the 100g total per day range, I can easily hit my fiber goal, butā¦
Very well said. I donāt think there is a lot to be added to what you have to say. About the only thing I would add is in regards to timing of insulin doses. I take mine immediately before the meal (I am on MDI). I eat less than 100 carbs per day and most of that is in a couple of snacks and a few things here and there to keep me sane (berries, apple slices etc). If I took my insulin 30 minutes before I eat I would probably go low because of the type of food I usually eat with a meal. My blood sugar does not rise that quickly.
As an added note; I also eat quite a few nuts of different types. This, along with vegetables has been a sufficient source of fiber for me. I have been eating this way for seven years now and see no reason to stop.
My understanding is that if you go on a truly ketogenic diet you will have to bolus for the fat and protein. Your body needs carbs to run things, so it will get them regardless of which pathway is used (eating carbs or creating carbs). I would guess that if you eat low carb (above ketogenic but below an arbitrary point, say 100 g of carbs a day) you wonāt need to bolus for protein and fat.
My son eats between 60-100g per day and we donāt need to bolus for protein. At some point, when lowering your carbs your body will start to use the ācreationā pathway and you may find you need to bolus for it. As was mentioned above YDMV and observation and testing will provide the answers.
Iāve done both very low carb (<30g) and lower carb (<100g) diets.
The very low carb diet of course requires much less insulin, and for me personally, less stress around taking too little/much insulin. Iāve always had a hard time finding enough variety of foods to maintain for long periods of time. If I could solve that problem I would stay very low carb long-term.
For me itās how many carbs you want to remove from your diet. Sugary things like dessert and the like are no-brainers and the first things to go. Next are breads, pastas, and riceā¦ anything that spikes blood sugar and doesnāt taste like much by itself. From there it depends on how much more you want to removeā¦ starchy veggies, legumes, low-fiber fruit, etc. Bernsteinās book was a great first resource for me. Keto stuff on the web is good too.
Not a dietitian, so take a grain of salt with this post :)ā¦ Iād read up, and then maybe gradually reduce carbs so you can learn your insulin needs. Good luck!
Just one piece of experience that might turn out to be useful: if you decide to go very low carb, adjust your electrolyte intake accordingly. One of the things that happens when you cut down to, say, 30g of net carbs per day or less is that your body starts to release glycogen from your liver and muscles. If you keep it up for a few days, your glycogen will get depleted. Glycogen is a way your body stores glucose by joining it to water molecules (and electrolytes).
The short version is simple: most people when they go very low carb experience something people call the ālow carb or keto flu.ā It can feel like one has the flu. Itās the primary reason people donāt stick with low-carb diets: they literally think theyāre going to die, and it reinforces the notion that one has to consume carbohydrate to live. Itās not easy or pleasant to get adapted, but human beings do not have to eat carbohydrate to live. You can literally be perfectly healthy eating zero digestible carbohydrate (although dietary fiber would be good). As someone above mentioned, your body can turn both protein and fatty acids into glucose through the gluconeogenesis pathway. So there should be no fear about ānot eating enough carbs to live.ā
On the other hand, the unpleasantness of flushing the water out of oneās body and experiencing flu like symptoms canāt be overstated. The solution is, for most people, quite simple: consume a lot of sodium, magnesium, and potassium, preferably in the form of various salts. When going very low carb, I start adding sea salt (which is high in magnesium and potassium in addition to sodium) to my drinking water, I salt my food to the point my wife wonāt eat it, and I take magnesium and potassium supplements in the morning with my arsenal of other supplements. The result? No keto flu. And that makes it much easier to stick with a low-carb diet.
Additionally, if you exercise a lot, you may find your electrolyte needs are three-four times what they were before, and you also might find that you need to drink two to three times the amount of water every day. As long as you donāt suffer from acute hypertension, there really arenāt any drawbacks to increased electrolyte intake.
One more question: how does physical activity affect you when on low carb diet? I do moderate physical activity- have a young daughter and work part time in a nursery, so am constantly active, but not overly.
The only physical activity related difference for me on very low carb diet I experienced was cramping in my leg at night on occasion after I ran. Donāt think this was anything to do with diabetes but likely a combination of some degree of dehydration and perhaps lack of potassium. Agree with post above you definitely have to be more intentional about drinking water, and I also bought potassium and magnesium supplements. The keto folks have good information on this if you search.
I tried Keto out of curiosity. Am already low carb usually less than 50/day. Keto did not work for me at all. High BG in the morning and difficult to control all morning. Everyone is different. I feel my best on LC
6 months ago I was advised to try the low carb routeā¦ and as I saw someone else mention here, there is a big difference between low carb and really going true law carb - which for me is under 10gr of carbs for one meal, the advice I was given by my doctor was to start by changing just one meal out of the day to low carb, so we changed lunch time because I get the highest high glucose levels after lunch. My initial (first month or two) reaction to this change was that it for some reason sent me into after dinner time highs (which was completely out of the norm) but after about the 3rd month my sugar levels were great, no highs at all during the day and I was taking much less insulin (MDI). I lost 20kgs in 6 months (which was something that I hadnāt even aimed at, but happy for nonetheless). I found it very hard in the beginning trying to find truely low carb meals, but eventually came to find my favorite stores that sold crackers/breads under 3gr carbs and I would have that with ham/cheese, low carb (under 3gr) yoghurts. Best decision I could have made, feel so much better throughout the day and slowly changing various other meals/foods/snacks to low carb. Good luck!
Iām counting ānet carbsā - leaving fiber out of the count, most of the time. For example, I had a Chia pudding for breakfast this morning, but only counted the carbs in the blueberries I added, nothing for the fiber in the Chia. My BG was a pretty good 85-95 all mosrning. So, no problem getting the fiber I need!
No worries, and that is, I think, what many people do. Iāve found it almost impossible to balance low-carb intake with high-fiber intake, unless using straight fiber supplements. Iām considering trying to go ātrulyā low carb as an experiment, by doing the āketoā trick of capping daily intake at 25g of total carbs. It sounds a bit nutty (for someone who has had bad weightloss issues), but since cutting back on Metformin and some other lifestyle adjustments, my weight has stabilized. BG control on very low carb is just too good for me to pass up at the moment, so Iām going to try the VLC diet again. If it doesnāt work, Iāll happily go back to moderate carb.
What Iām most curious about is whether my lipid profile will stay healthy if I donāt have my āusualā 30-40g of fiber a day.
While Iāve never tried to focus on getting a good amount of fiber in my diet (I should!), I just looked up the carb and fiber content of the components of one of my favorite go-to meals, chia pudding. Chia seeds contain over 80% of their carb content as fiber. I usually add some type of berries. Raspberries for instance are over half fiber of their carb content. The same is true of walnuts, another ingredient I use. Do a search on āAdam Brown chia puddingā and youāll find the recipe that I primarily use. I use melted butter instead of the coconut oil Adam uses.
Another food that contains a high percentage of its carb grams as fiber is avocado.
Good for you for trying a low carb way of eating. For me it was a game changer for my blood glucose control. Remember that goinf ālow carbā is not an all or nothing proposition. Iāve had a lot of success in the under 100 and under 75 grams of carbs threshold. I donāt count fiber carbs when calculating my total carbs.
Iāve been eating this way since 2012 and have found it easy to sustain. I donāt really keep close track of my carbs per se, I just maintain a general sense that Iām keeping it in the neighborhood I want to keep it in. Iāve also found that when I allow myself a high carb treat (like 70-100 grams for some decadent dessert) that it degrades my overall control for the next 24 hours. Your experience, of course, may vary.
Try to consume extra sodium in the first few weeks. That will help you as your body transitions to a new nutritional profile.
Good luck and please report back on your experience. I remember thinking, shortly after starting this way of eating, āwhy has this fantastic tool not been promoted by every medical professional who treats people with diabetes?ā Itās a potent tactic.
You know, thatās a really good idea. I phased chia pudding out of my diet a few months ago, after incorporating it because of your posts here I have a faulty memory, and chia pudding would be a good way to get more fiber back in.
Incidentally, seed crackers (I think Marie had posted a recipe here not long ago) can also be really high fiber, and quite good as well. I made some with equal parts golden flax seeds, black chia seeds, sesame seeds (super high fiber), sunflower seeds, and shelled pumpkin seeds. Mix those with water, salt, and some spices (I did garlic and rosemary), roll 'em out between parchment paper, and bake in the oven. Result was 13g carbs for a large serving, 10g of which was fiber. Have to make another batchā¦
