Do/can Type 1s have a lower carb diet?

[pawprint91]

Hello all,

2 weeks into this new journey now and I'm back with another question. Still only on basal insulin and having to alter the doses all over the shop as I seem to be in the 'hoenymoon' phase. Have next appt with diabetes nurse on Monday, has been delayed as she has been on holiday. Before she left, she left me with the advice to practice some carb counting with apps etc but to eat normally avoiding the obvious e.g. pizzas, mars bars, coca cola. I've been off work with blurred vision, which has left me a bit too much time on my hands, so I started a food diary. I have been eating things like bread, potatoes, rice etc but have just managed the portion size rather than doing it 'freehand' as it were. I generally eat between 145 and 160 carbs a day it would appear. However, I have made a few 'swaps' when I started realising that some things I enjoy were quite carby (namely snack things like cereal bars, breakfast biscuits, fruit yogurts) and have started having only one wrap rather than 2 etc (how does something so flat have so many carbs??). I also bought a few 'low carb' treats to try as I do have quite a sweet tooth.

So my question is, as a suspected T1, am I doing the right thing? I'm still eating my three meals a day plus snacks, I've just cut out the crazily high carb things as I don't want my bs to spike, particularly whilst I'm not on novorapid. I have seen online that low carb diets are beneficial for Type 2 rather than Type 1, so I'm guessing I don't need to cut down any more. Do Type 1s on novorapid eat whatever they wish (within reason, maybe not a mars bar!) and then bolus for it to cover it, or do you bolus but be 'sensible' and choose the best option going for carbs without making wild adjustments (e.g. having no potatoes as opposed to having some)? Is there a limt to the amount of insulin you can bolus with in a day, or do you need to keep it within a ballpark figure? Any advice greatly appreciated, thank you! 🙂

 

[helli]

One thing you will learn on your Type 1 journey is that we are all different.
There are certainly some people with Type 1 who prefer to eat a lower carb diet as they find it easier to dose for an with smaller insulin doses, a mistake is likely to be smaller.
However, I have found very low carb difficulty to dose for - in the absence of carbs, our bodies break down the protein into sugar and we need to protein count. For me, the protein to insulin ratio varies for different protein and the absorption rate differs. AS a result, I gave up on low carb and decided I wanted to focus on a "healthy" diet without going over the top on carbs. I still eat pasta, bread, pizza, rice ... but maybe less than my partner

 

[pawprint91]

One thing you will learn on your Type 1 journey is that we are all different.
There are certainly some people with Type 1 who prefer to eat a lower carb diet as they find it easier to dose for an with smaller insulin doses, a mistake is likely to be smaller.
However, I have found very low carb difficulty to dose for - in the absence of carbs, our bodies break down the protein into sugar and we need to protein count. For me, the protein to insulin ratio varies for different protein and the absorption rate differs. AS a result, I gave up on low carb and decided I wanted to focus on a "healthy" diet without going over the top on carbs. I still eat pasta, bread, pizza, rice ... but maybe less than my partner

Thanks for the advice 🙂 would/do you eat chocolate/cake in very small amounts, or is this to be avoided on the whole?

 

[helli]

Thanks for the advice 🙂 would/do you eat chocolate/cake in very small amounts, or is this to be avoided on the whole?

Avoid cake and chocolate 😱
Definitely not!
I prefer dark chocolate which has less carbs in it but that does not mean I don't enjoy a cheeky mint Aero.
And I enjoy baking so often eat cakes (not every day or even every weekend) and usually have some scones in the freezer which are quick to defrost and eat with my Mum's homemade raspberry jam.

 

[Inka]

Thanks for the advice 🙂 would/do you eat chocolate/cake in very small amounts, or is this to be avoided on the whole?

Avoid chocolate?? What madness is this? I eat chocolate, cake, cheesecake, fruit crumble, etc etc. Diabetes U.K. used to do a good poster that tried to counteract the incorrect idea that Type 1s needed special food. It said something like “The recommended diet for Type 1 is the same diet recommended for everyone - low fat, low salt, low sugar, high fibre” etc

So, two things limit my cake intake: firstly, eating vast amounts of cake isn’t healthy for anyone; secondly, although someone without Type 1 could eat a whole cake themselves, I would find that amount of carbs harder to dose for in one go. I could do it, for sure, but I find approx 100g carbs per meal is my sweet spot. After that, I need to space out my boluses because the rate my body can process that food is extended.

I just eat a normal diet but limit my cake portions to a normal size and don’t have them everyday. I eat cereal, bread, pasta, rice, quinoa, beans, lentils, cake, desserts, whatever. The only thing I was told to avoid was sugary drinks except when treating hypos or before exercise.

Type 1 is a very different condition to Type 2. Even if a Type 1 ate zero carbs, they’d still die without insulin. Some quickly, some slowly. That’s the blunt answer. The solution for Type 1 is insulin not diet.

 

[Sally71]

If you are carb counting and dosing for it you can theoretically eat what you like, which is what my daughter does. We do find however that the blood sugar spikes are less severe and insulin doses easier to manage if she tries not to go too crazy on the carbs. It’s entirely up to you how low you go, eat whatever feels like a healthy diet to you that you can stick to. Cakes and so on should probably only be reserved for occasional treats whether you have diabetes or not.

 

[rayray119]

I don't stick to a certin amount of carbs however if i had a bad blood suger day and I had controll over what i was eating( and by not round someone elses house etc) i may not go for that pizza or huge pasta dish.

 

[pawprint91]

Avoid chocolate?? What madness is this? I eat chocolate, cake, cheesecake, fruit crumble, etc etc. Diabetes U.K. used to do a good poster that tried to counteract the incorrect idea that Type 1s needed special food. It said something like “The recommended diet for Type 1 is the same diet recommended for everyone - low fat, low salt, low sugar, high fibre” etc

So, two things limit my cake intake: firstly, eating vast amounts of cake isn’t healthy for anyone; secondly, although someone without Type 1 could eat a whole cake themselves, I would find that amount of carbs harder to dose for in one go. I could do it, for sure, but I find approx 100g carbs per meal is my sweet spot. After that, I need to space out my boluses because the rate my body can process that food is extended.

Thank you (again!) for this. As a newbie currently not bolusing, what do you mean when you say spacing out your boluses because of how your body processes the food?

 

[khskel]

Thank you (again!) for this. As a newbie currently not bolusing, what do you mean when you say spacing out your boluses because of how your body processes the food?

Some foods take longer to digest than others, so taking all your bolus (fast acting) up front could lead to a hypo, so some people split the dose with an interval between.

 

[helli]

Thank you (again!) for this. As a newbie currently not bolusing, what do you mean when you say spacing out your boluses because of how your body processes the food?

Different food is absorbed/processed at different rates. For example, we have fast acting carbs such as jelly babies to treat a hypo whereas adding fat to anything slows down the rate at which the carbs affect our blood sugars so chocolate and pizza are not good for hypos.
Whilst food is processed at different rates, the fast acting insulin you use will work at the same rate regardless what you eat. NovoRapid, for example lasts about 4 hours and has a peak about 30 minutes are injecting. If you bolused and then immediately ate something fast acting like a packet of sweets would result in a spike even if you calculated your dose correctly. Whereas, if you pre-bolused (injected 15 to 30 minutes before eating) for a pizza your levels may dip as the insulin starts working before the carbs in the pizza.
So, over time, as well as getting good at carb guestimating on sight and calculating your insulin dose, you will start to learn whether to take all your insulin 30 minutes before eating or half when you start eating and the other half an hour later.

Few people get this right and before the introduction of LIbre, we only knew what our levels were before we injected and before the next meal so had no idea of the ups and downs in between. And 20 years ago, people with diabetes only tested once or twice a day. Given there are people who are celebrating 60 years with Type 1, I try not to get too obsessed by the bumps in my Libre graph and remember people without diabetes can also have a graph that looks like a rollercoaster.

 

[rayray119]

Thank you (again!) for this. As a newbie currently not bolusing, what do you mean when you say spacing out your boluses because of how your body processes the food?

a higher carb meal will be take longer to diggist so if people dose its for all at once some carbs might be not disgesited until all hours after the insulin has stooped being active so this could lead to hyping then ended really high hours after(the amount of carbs and types of food people need to split dose for will depends on the person) the pizzas offen trickky because of all the fat slowing the digestion and as well as the high amount of carbs heence why i might consider not having it if i was having a bad blood sugar day

 

[rayray119]

i happened to be typing this as the same time as others so so sorry for the repeatability

 

[trophywench]

Even as a child without diabetes, I ate the boring carbs first to get them over and done with before enjoying the other things on my plate - this was the 1950s so nothing exotic was ever on offer hence cereal and milk for breakfast (cooked brekkie once a week on a Sunday only) lunchtime was a cooked meal - meat spuds and one other veg followed by a pudding, once a week fish and chips + pudding. Teatime would be bread and butter with jam or cheese, once a week, with cooked meat, followed by cake. On a Saturday and Sunday, tea would include salad items with hardboiled egg, or a tin of salmon and on a Sunday tinned fruit and evaporated milk (fresh cream only at eg Christmas) AND cake. Sweets were on ration so the week's worth were bought on Saturday morning and were duly divided up so we could both have a bit every day - one Mars bar and either a Bounty or a Crunchie, cut into as many slices as poss, or a box of Smarties (not a tube), so big sis and I had one of each colour of them = 8 plus one tube of fruit gums and one of fruit pastilles. Sometimes a tube of Munchies - whey hey! Mom also bought a quarter of grown up individually wrapped sweets for her and dad - different ones every week, all tipped into a metal tin on a higher shelf in the pantry, it was a treat when us two were offered one of those, and always best to have a little rummage, cos below the boring toffees and fruit drops you might find the treat of a humbug, a Mintoe or a Bluebird toffee ie a chocolate coated one. No good whingeing about it whatsoever - my mom & dad really didn't have enough money to indulge us more.

But anyway after that nostalgia trip - before I had diabetes I never liked stodgy stuff anyway and once I was a teenager in the early-mid 60s nobody wanted to be podgy or Eeek! have spots and OMG once Twiggy put in an appearance, that was who we all wanted to be. Nobody cared she was 5ft8 and blonde so a dark haired 5ft1 girl was never going to look quite the same, but come on, you have to try, don't you! It was brill when I could run up a presentable summer dress from a yard and a quarter of cheap 36in dress material off the market - but obviously needed to rely on mom's benefice to treat me to the Sylko to sew it with and the zip ......

So here we are 50 years later and I generally eat getting on for 100g per day of carbs - sometimes as low as 80g, rarely as high as 130g.

I have already put on a good stone during lockdown and as I really can't/don't move as much as I used to there's no way I need any more, so I won't be increasing my consumption of anything, any time soon.

 

[pawprint91]

So here we are 50 years later and I generally eat getting on for 100g per day of carbs - sometimes as low as 80g, rarely as high as 130g.

Is this a conscious decision to eat 'lower carb' (smaller portions etc) or is it just naturally how you would eat anyway without diabetes coming into it? I do find when trying to eat the less sugary things I seem to be eating more fat, but then I suppose for now I've cut out the pizza and chocolate so it's probably swings and roundabouts, really!

 

[Drummer]

Although we were not well off in some ways there were always hens and eggs, and pork/bacon/sausages when I was growing up - and yet I never had a spotty face or greasy hair whilst those who were constantly avoiding fats and cleansing etc, they broke out dreadfully all the time.
It was my job to collect the eggs - I soon learned to grasp the neck gently with one hand and remove the eggs with the other - they were quite protective of their nests.
When I was a bit older I used to wear mini skirts, waistcoats and long boots of suede and leather - some of those skirts I still have - it would be difficult to make a good sized handbag from any one of them. I found the white jeans I wore to the Isle of Wight pop festival the other day - I think they are a 30 inch waist, and I had to find a belt narrow enough to go through the loops to hold them up for dancing.
The 'normal' diet back then was so very different.

 

[Inka]

Thank you (again!) for this. As a newbie currently not bolusing, what do you mean when you say spacing out your boluses because of how your body processes the food?

I simply mean that instead of injecting all the meal-time (bolus) insulin in one go before the meal, I spread it over a period of time because if I eat a large/carby meal my body takes longer to process the food, so if I injected all the insulin in one go, I might go hypo (because not all the food would have been processed by my body) 🙂

With a pump, I can do an extended bolus (it spreads the insulin out over a period of time) and with injections, I’d inject a bit of insulin before the meal, then decide when to inject the rest. This is called a split bolus.

 

[nonethewiser]

Of course they can do lower carb diet, did below 60g for 3 months once, it had its own challenges mind having to double amount of injections & test more often to spot bg rises but it is doable.

Enjoy food so have rich variety of foods in my diet now, it includes chocolate pots pasta oats beans bread such like, only last weekend went out with wife to local garden centre & had coffee & cake, it was chocolate éclair & delicious it was.

With right skills knowledge tech & bolus timing you can eat what you want within reason with type 1, that is my view anyway after 4o years of living with condtion

 

[Inka]

And, of course, the normal things apply to us too eg if we want to lose or gain weight that would obviously affect our dietary choices, depending on our sex we may eat more or less, we might be an athlete or sedentary, we might be pregnant or breastfeeding if we’re female, we might be older and need less calories overall, etc, etc.

You shouldn’t need to choose your diet for your Type 1. I eat pretty much what I would have eaten if I hadn’t got Type 1. All we have to do is be our own pancreas and use our insulin(s) appropriately.

 

[trophywench]

I don't 'low carb' whatsoever and never have in my own view - I just eat exactly what I happen to want to eat. The fact that I don't eat less of anything than I actually wish to, means that I don't need to replace the missing anything with summat else. I won an After Eight Easter Egg in a quiz in a presentation package with a box of AE mint creams on a camping rally not long after Easter. I opened the mints and took 2, Pete also had a couple. Neither of us has been tempted further since. I found them unbearably sweet with nothing to relieve that. If you choose eg a cream cake there will usually be a variety of tastes and textures, to enhance the experience of eating it. Last week, we won a smallish box of Quality Street as a minor prize in a raffle. That's unopened too, but I fully expect we'll both enjoy them more, because of the variety within them. I haven't given anything up. If I facy X, if I can eyeball it, and therefore roughly estimate the carb content and therefore the bolus needed for it - I'll have it unless I'm so full already I'd throw up if I ate it. If my guesstimates were wrong, I'll soon find out by what my Libre and my meter both tell me - so I can correct either with more crabs or more insulin. Nothing's rocket science with Type 1 diabetes so nothing much is insurmountable - except I expect death will be once it comes knocking. (But I would like to meet Binky!)

No way am I deprived either nutritionally or in texture or taste.

 

[AndBreathe]

@pawprint91 - I'm not T1 so won't comment specifically, but if you are interested/curious to explore T1s who do live low carb lifestyles, the Dr Ian Lake (a GP) is a decent enough starting point. This Google search throws up plenty of stuff he has done, including endurance exercise, if that happens to be your bag.

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