I’ve recently joined this network and am very quickly realising that most of you have a completely different way of dealing with diabetes to the one which I’ve been taught and use. I’ve been type 1 for 6 years and had my diabetic ‘training’ in London, England. There, I was taught the DAFNE approach (dose adjustment for normal eating.) Their tagline is ‘eat what you like, like what you eat’ which gives you an idea about how relaxed their approach is. With this method, there are no limits on carb intake, only insulin adjustment- which means eating a pizza or chocolate cake is just fine, so long as you calculate the right dose of insulin- usually involving a lot of trial and error, hypos and highs… as I’m sure all of you can imagine. This is however the approach I have always followed, and as a result of a lot of miscalculation, my blood sugars continue to be all over the place really. My last A1c was 8.5 which worries me a lot and I am keen to change my whole approach to diabetes as I feel the one I have simply doesn’t work,. I see from most of you that you put drastic restictions on your carb intake, and my question to all of you really is this. What do you eat? How do you manage such a low carb diet? For example, for breakfast- what I would consider a normal, reasonably healthy breakfast would be cereal toast or fruit and yoghurt… all of which have a reasonably high carb content… If you have any advice, I would really appreciate hearing from you…
The tag line is eat to your meter. You will probably find you can have yogurt and blueberries for breakfast, but cereal, toast and milk are all high carb, fruit varies person to person. Most people eat eggs for breakfast, or leftover dinner, or cooked meats. Large salads with protein for lunch and vegetables and salad again at night with some form of protein, fish or meat.
If you check out the groups on this list you will find several low carb groups that give recipes, ideas, low carb websites to help you along your way. You need, however, to check your blood sugars 2 hours after meals to see what foods spike you and which do not.
Check out bloodsugar101.com. It was created by a Tudiabetes member named Jenny. She presents lots of information in a simple format. There I learned how to “eat to my meter” which is the method Pastel was talking about. Also, if you go to the Tudiabetes Search at the top of the page you can enter “eat to your meter” and lots of past discussions will come up. Welcome and good luck!
Good for you, Xanthe, for figuring out that the way you were taught wasn’t working for you and being willing to do something about it! Unfortunately I think the U.S. approach is beginning to echo what you describe with “no bad foods” the buzzwords.
I wouldn’t say that most of us put drastic curbs on our carb intake, and any sentence that starts with “Most people…do this or that”, is bound to be inaccurate for some. Mainly because there is a great variety in how people on here do it, from Bernstein low carb (30 carbs per day) to more like what you describe you were taught in London. I’m kind of in between, keeping it to under about 100 carbs a day, eating no sugar at all, and pretty much never eating rice or cereal. I eat pasta very occasionally if I go out and there is nothing else on the menu I can eat (I’m a vegetarian). I eat a small serving of very thin crust pizza I make myself very occasionally. I tried all types of cereal and yogurt, fruit and granola which used to be my favorite breakfast and they all spiked me badly and unpredictably so I gave up. Breakfast is, I think the easiest meal, because there are endless combinations of eggs and vegies (and meat if you eat meat) you can have. With my eggs I have 1/2 C homemade refried beans which works better than one slice of artisan bread and I really like.
But bottom line as others are saying is to eat to your meter. You seem to have discovered already which foods you can’t accurately bolus for, so you have a start on the trial and error of finding what works to keep you in your chosen target range two hours later. That’s what matters, that and your personal preferences (like for me, I could eat less carbs if I ate meat, but I choose not to do that). You will get all sorts of different perspectives on here but you have to find what works and what feels comfortable to you.
I don’t eat very many carbs for 8 hours/ day but then I pig out. I find that being conservative for breakfast and lunch gives me a pretty good “benchmark” to keep my rates set closely so that when I let 'er rip @ night, it is generally smooth sailing too?
Ugh still no like button for replies
I carb count and general do about 150 a day, but there is nothing stopping me for eating what I want a 300 - 400 carb day will happen sometimes more just not often.
Of course its been over almost a year since I have had a milkshaje
Thanks so much for all the responses- really appreciate all of it and hope I can change my habits!
i eat lots of carbs (most days…some days i’m just in a steak and salad mood!), have a low A1c (5.0), and manage in a couple of ways:
- i take an aggressive dose of basal insulin, which i find helps my post-meal numbers stay flatter and keeps me running tighter throughout the day. i don’t have a pump, and can’t control hour-by-hour basal rates, so i just keep my BG on the lower side and strategically feed the basal before going to bed or other times when i need a higher BG.
- i test a ton, 10x a day generally.
- most of my favorite high-carb meals are things that i eat regularly, and know how to bolus for. i always err on the side of taking more insulin rather than less when i’m not sure what’s in a meal, and then adjust accordingly later.
- i try to play with bolus timing to match the macronutrient profile of what i’m eating.
- i lift heavy weights 3x a week.
of course, if this sounds like a lot of work, you can go lower carb. i did that for a few months and it was a bit less effort to manage, but i missed eating a lot of my favorite foods and i looked like a stick. if you’re trying a higher carb approach and it’s not working, i think that trying to cut down on carbs significantly and then adjusting upwards as your meter allows is a smart move.
I’m coming up on my 1 year D-date, and got my A1C from over 11 when I was diagnosed to into the 5’s the last three times i’ve been tested. I’d say on average my blood sugar goes over 140 or under 70 about once a week. Every once in a while I’ll miscacluate and get up to around 170-180, but i haven’t seen anything over 200 since thanksgiving :). my success is in large part to reducing my carb intake, which was initially advice given to me by gerri on tudiabetes. when you restrict carbs, you have to eat more protein and fat to get enough calories (if you’re trying to avoid losing weight), and protein and fat keep you full for longer than carbs.
Foods I’ve learned to love over the last year:
Eggs - usually just hard boiled for convenience, but I’ll make an omelete if I have time
Greek yogurt - a lot of the other stuff has high-fructose corn syrup or added sugar that causes spikes. this stuff still has around 20 grams of sugar per cup, so you’re still getting carbs, but your blood sugar stays steady because it’s got way more fat and protein
cottage cheese with about a half cup of fruit
I have bread for the occasional sandwich - there are a few that are ok, like extra high fiber ones, flax seed bread, or thin slices so the net carbs are pretty low
Salads with high fat and protein for calories, like chef salads with ranch dressing - yum
almonds and walnuts - recommended by my endocrinologist, filling, lots of calories, almost no effect on my blood sugar, and high in omega 3s. i have these as snacks
for dinner i usually have stir fried veges with a little bit of protein, like tofu, beef, pork, or fish.
cheese is also a good snack - lots of calories, no effect on blood sugar.
also, there are some specialty products around that are pretty good - shirataki noodles are virtually carb free, and are almost the same as normal noodles. almond flour can be used as a substitute for wheat flour in many things if you do your own baking. i even found a low carb, high protein pancake mix at the grocery store last week and had pancakes for the first time in a year. my breakfast this morning was 3 pancakes, only 9 grams of net carbs, 1 unit of insulin, no blood sugar spike, and they tasted damn good too.
in total i have around 50-75 grams of carbs a day when i’m just at home. when i go out and i’m walking around i bring a bottle of gatorade with me and slowly sip it down as i go. when i do my exercise i usually eat a banana to compensate for the glucose i’m using up.
when it comes to tempting things like cake or cookies, i’ll usually just have one bit and let it go - that way i feel like i’m not completely depriving myself, but i’m not harming myself either.
based on the dietary and lifestyle changes i’ve made in the last year, i think my overall health is actually much better than it would’ve been if i hadn’t been diagnosed with diabetes.
Thanks a lot for the advice Judith- I feel very encouraged to change my approach towards carbs and will let you know how it all works out. I do think that maybe the general British mentality about diabetes has become a bit too relaxed, which makes the A1c targets impossible…
i was dx’d t1 just a couple months ago. i tried eating normally meaning 150-200 carb per day and sugar was all over the place. i couldnt get my boluses right ever. i switched to low carb meaning less than 50 per day. this is totally subjective mind you, and now my avg bg is about 110. it was over 150 just 45 days ago. i eat good food, am not hungry and have lost weight. good luck to you in your endeavors.
I do pretty much the same thing… except #5 and I use a pump. I eat pasta and rice with dinner but since I do it often I know exactly how much insulin to take.
I eat around 30-40 carbs a day, and believe me I eat well. Love food too much not to! My average BG according to my pump download is 99.
I also get the wonderful 6 carb tortillas - you can do almost anything with them. They are part of my favorite lunch, wrapped around any combination of greens, cheese (melted brie is awesome), meat, sour cream, an artichoke/garlic dip I get at Costco that’s 2 carbs per tbsp, avocado… the list is pretty endless. I usually have meat or fish for dinner with a veg. My current favorite is zucchini baked with tomato and fresh mozzarella.
I use acorn squash (5 carbs per cup) as a pasta substitute. It’s great with ricotta, cheese, sausage, lc tomato sauce and parm. I often make a large fritata in a square corning pan with onions, peppers,cheese, bacon, etc. I square is 5 carb - great on the go breakfast or lunch. I love greek yogurt with berries and a tad of sweetener.
This is what works for me and makes me feel good and well fed.
With out reading the thread, I have been eating Paleo using Dr Berntein’s principals for insulin management. Working very well. My last A1C 2 months was also in the 8’s, and like you I was worried. My readings now are consistently between 5-7 and this only varies when my Carb intake is greater then 15 gms per meal. I also noticed tighter control whne I started measuring the protien and taking a small dose to account for same. Ahhh, Diabetes, always a learning curve even after 29 years.
If I ate what I liked and liked what I ate, my glucoses would still be all over, too! The only way I was able to get the glucoses to stay where I could predict was to eat low carb and dose low insulin. To prove it to myself when I started, for breakfast I ate an egg and two sausages. The blood glucose went up lightly but not enough that I needed more than one unit of insulin. Then I changed to a piece of toast (low carb bread-5gm) plus an egg and two sausages. And I needed a second unit of insulin. To me, that meant I could figure 1unit to 5 grams + most of a unit for all the protein. To this I’ve added Dannon’s diabetic friendly yogurt at 3gm from time to time.
I could not eat even 1 pancake made of regular flour because I could not give high enough units to cover e.g., to keep the blood glucose from skyrocketing into the 200s. Same with a dish of fruit. BUT, I found 10 blueberries were manageable if I gave 1 u. The glucose remained below 140. I have found a half cup of orange juice puts me up 100, e.g., 15 grams raises me 100. That means I won’t drink that much OJ. If OJ is in the fridge and I want some, I figure 1/4 cup is going to raise me 50mg/dL all by itself and I need a unit and a half.
When I ate lunch I did two pieces of toast with lettuce, ham, mayo and two slices of tomato on the side. About 13 gm & 3.5 units. If I ate a big salad, I counted out the toast in it to determine what the starch was. Again, I used a 1:5 ratio.
I have taken little steps, always protein, and my suppers are always meat/fish (no hamburgers with too much fat), a good half dish of vegetables and maybe a 1/4 piece of white chocolate (4 grams). when I bake rolls, I take 1/2 of one, not a whole. I figure 1/2 is 10 grams. The veggies are another 10-15 grams. I don’t miscalculate much with using small amounts, and I am honest with myself about what I see on my plate.
When I went to Madison last week I had a patty melt. Way off the diet since I ate the roll it was in, too. I figured 25 for the roll, and the cottage cheese side was 10. I gave myself 8 units. Set my internal alarm for two hours later, tested and gave another 8 units. Set my alarm for two hours later and gave another 5 units. Set the alarm for 2 am and ended up giving another 4 units. In the morning I was at 100. A lousy 25 units for a patty melt. If I were to eat like that all the time I would be absolutely stressed out over how my glucose was.
But the meal served to show me once again that taking small numbers of carbs makes D manageable and me happy. And I won’t need another patty melt for another 5 years or so!
Go to the Bernstein group and read some of what they eat. I’ve had wonderful things made out of DaVinci liquids, almond flour, and non-sugar coconut. But I’m not really a cook, so I keep it pretty simple with veggies, salads, eggs, shaved ham, tilapia, salmon, chicken, shrimp, perch … I eat around 30 gm a day. I neither gain nor lose weight. My A1c is 5.7 and has been for a couple/few years. And they called me a brittle diabetic.
Thanks a lot for the input… really feel that I’m on the right track now… in theory of course… it will take time to really get the hang of this method, especially with my very unhealthy love for sweet foods! But I’m hoping that seeing good blood sugars on my meter will encourage me even more to keep going…I’ve already tried one of the recipes I found on the diabetes101 website that someone recommended- amazing!.. Here in Mexico, it was a bit tricky to find the exact ingredients but I found the equivalents… and made some incredibly delicious cookies!.. And Leo, I really do agree with you- eating what you like and liking what you eat is never going to bring about stable sugars… I can only feel relieved that I didn’t figure that our years down the line…
Good for you on making the changes, Xanthe! I don’t know where you live in Mexico but I lived in Antigua, Guatemala for two years and it was definitely a challenge to find the ingredients I wanted to make dishes I like and that are diabetes friendly. But I actually considered it a challenge and it made it more of an adventure. By the way if you like frijoles I found that 1/2 cup of refried black beans (Guatemala style) are much better for my blood sugar than a slice of artisan bread with my eggs in the morning, and I like getting the extra protein (I’m a vegetarian).
I actually disagree that “eating what you like and liking what you eat is never going to bring about stable sugars”. I’m a foodie as well as in recovery from an eating disorder in which one of the things I learned is that I have to enjoy the food I eat. I may not eat the same things I did before diabetes but I eat a diet that is both healthy and enjoyable.
Based on my own experience, I think how/what you eat when you have type 1 diabetes really has to be adjusted for activity levels, age, and those factors that are unique to each of us. I grew up under the exchange system, and the approach was generally to have a balanced diet that DID NOT include sweets and was heavy on the protein. Granted, this was also during a time when insulin doses were based on weight and you had to work your activity and meals around the insulin dose prescribed. When things shifted to carb counting, I think something was lost - specifically, dieticians developed this attitude that all carbs were equal and you could eat whatever you wanted, so long as you took the insulin to cover it.
This works to a point, but it is not (IMO) a healthy approach with dealing with T1D.
We all know that all carbs are not the same. That’s why so many of us have trouble with things like rice, pasta, and pizza. Even using the “advanced” features on my pump, I still find it almost impossible to eat things like pasta, pizza, and rice without having really bad highs and lows.
Personally, I have found the following works best for me (I am 32 and moderately to very active):
I generally limit the number of carbs I eat to around 90-130 per day.
I avoid sweets and refined sugar as much as possible.
I tend to eat a high fat/high protein diet. Lots of eggs, fish, avacados, oils, etc. I find that increasing my fat intake in particular helps to keep my BGs more stable, especially when I avoid carbs. I do not eat red meat, chicken, or pork (just don’t like the texture).
What carbs I do eat, I try to keep in the form of fruits and veggies. As much as possible, I avoid things like white flour, grains, etc.
I’m not ALWAYS strict about these rules (I follow them about 90 percent of the time) - for example, this past weekend, I had pizza and beer. I didn’t have a lot, but I just felt the need to treat myself a bit and feel “normal” while out with friends. I did, however, pay for it. My BGs ran in the 250s for quite a few hours and I had trouble getting them down.
I exercise at least once a day, sometimes twice. I stick to using gluco tabs and juice to treat lows when needed. I try really, really hard to avoid over-treating lows. But it’s hard.
If I am over 180, I don’t eat. I correct and wait until I’m under 120.
Again, this is just what works for me. Despite the large quantity of eggs and cheese I consume (at least 2 eggs a day and quite a bit of cheese…I love cheese), I do not have high cholesterol. My endo was sort of shocked by this, but it is probably due to my activity level.