Type 1 & low carb

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Thank you so much!

I’ve really found this illness difficult to deal with and it’s giving me a lot of anxiety (both highs and lows), so anything that makes life a little easier is welcomed!

I’m going to try and eat a few more carbs daily just because I’m wondering if that can actually help me in the long run, but it’s very comforting to know that I can go low carb for a bit if I’m having a particularly difficult time with the ratios to make things a little easier for myself 🙂
 
Evergreen said:
Hello everyone!

I am just looking for some opinions/advice on low carb eating with type 1 diabetes.

I tend to eat low carb, have done for years (even before my diagnosis), like the foods and as I find it incredibly difficult to find the right ratios for insulin low carb eating makes this much easier. Now some of the nurses in my team aren’t phased by this and some don’t like it.

Can someone tell me whether I should start to eat more carbs (and try and figure out my ratios), or whether it’s ok to eat low carb with type 1? And if ok, are there things I should watch out for? I’m aware of DKA, is the risk of getting DKA higher with low carb eating?

Hope someone could shed some light on this for me!
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If it works it works so crack on with diet if your happy with everything, often gets said on here but there's no one diet thar suits all, it's worth repeating IMHO.

Many many years back tried doing low carb as in 50g a day, lasted 3 months & give it up as it created more problems than it solved, found diet was to restrictive & didn't like fact that I would be having to do loads of corrections to keep bg steady, even during night was having to do them.

Basically it took up to much head space for my liking, so switched back to more normal diet, don't keep records but would say I'd average around 200g, sometimes less occasionally more.

Think with some extreme diets it can mess with your head where you start to see food as evil or bad & feel guilty for eating them, when that happens its time to rethink things so keep that in mind @Evergreen as it can lead to eating disorders.
 
Evergreen said:
it’s very comforting to know that I can go low carb for a bit if I’m having a particularly difficult time with the ratios to make things a little easier for myself
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Sadly my experience is that low carb made the ratios harder not easier.
As with all things diabetic, we are all different. Other people's experience is useful but we end up learning what works for our body, our lifestyle and our anxiety tolerance through trial and learning.
The great thing is that many of us started this lesson before CGMs like Libre became affordable and are now able to learn more.
 
I ate a bagel for lunch and completely got my blood sugar messed up! It went ok for about 2 hours, but then went up 8 mmol!

Please tell me this will get better!
 
Evergreen said:
I ate a bagel for lunch and completely got my blood sugar messed up! It went ok for about 2 hours, but then went up 8 mmol!

Please tell me this will get better!
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Yes, it will get better 🙂 If you’re going up after 2hrs, it could be a basal problem and/or a high fat accompaniment. Also, when I have blips, I like to eat the same meal again a few times until I perfect the dose and timing. Remember too that it will take a little while to undo any insulin resistance.
 
Yes, that’s a good idea. I’ll try that.

The bagel had avocado, houmous and spinach. I suppose that might have been high fat, I didn’t think about that. Should I have split the dose?

I’m also not convinced I’ve got the right basal, it’s been a pain from the beginning and I feel it’s basically different per day!
 
I’m on Abasaglar, fairly low amount (seem to go between 7 and 8 units). When I’m on 7 several days I can see it going up, but when I change to 8u after 5 days or so I can see it go down in the night. Nothing dramatically (which I’ve had in the past and was scary!), but definitely more than 2 mmol. It’s like it’s building up over the days and then gets too much and I go back down to 7 and it’s ok until it then goes up again.

the consultant I spoke to said this issue should be resolved with a pump, but wondered about changing me over to tresiba in the meantime. I’m a little worried about this however as I’ve read it’s extra long working and I am worried about having to change the dose as often as now and it taking me even longer than several days. Hope that makes sense
 
It makes sense @Evergreen 🙂 Personally, I’d refuse the Tresiba and ask to swap to a twice daily basal like Levemir or one of the isophanes. Levemir will also mean you can get a half unit pen. With a twice daily basal, your evening dose can be determined to keep you safe overnight, and you can have a different amount for your morning dose if needed. When I have a pump break, I always use a twice daily basal. I take basically twice as much in the morning as I do at night. I could never achieve that with a once daily basal. I’d either be going high during the day or risking nighttime hypos.
 
Yes, I’m sure you mentioned levemir to me before. It’s never been offered to me, but I will ask (just have to figure out which team as I haven’t a clue who to contact at the moment!)

I probably feel safer overnight if I can change it. Can you really just change the dose day to day and the result is instant? Because that’s my main source of anxiety with Abasaglar, it takes a couple days before I see any changes. That’s ok if my blood sugar goes up overnight, but it really scares me when it goes down overnight and having to wait several days to see a change is frustrating.

Sorry for all the questions! I feel I’m learning more on here than I have in the year I’ve had diabetes!
 
Don’t wait for it to be offered @Evergreen - just ask (firmly). Every insulin change I’ve had has been my choice. I’ve been offered changes of insulin but I prefer to choose my own. The offers from the clinic are often based on what’s newest or cheapest or what’s popular that season, but I’d rather choose what’s right for me as an individual.

Yes, you see changes made to your Levemir dose ‘immediately’. As you’d only be taking a small dose, each dose would probably last a max of 12 hrs. So if you had 3 units one night, but went a bit low, then the next night you could change that dose to 2 or 2 and a half units and that would have an effect that very night.
 
Inka said:
Don’t wait for it to be offered @Evergreen - just ask (firmly). Every insulin change I’ve had has been my choice. I’ve been offered changes of insulin but I prefer to choose my own. The offers from the clinic are often based on what’s newest or cheapest or what’s popular that season, but I’d rather choose what’s right for me as an individual.

Yes, you see changes made to your Levemir dose ‘immediately’. As you’d only be taking a small dose, each dose would probably last a max of 12 hrs. So if you had 3 units one night, but went a bit low, then the next night you could change that dose to 2 or 2 and a half units and that would have an effect that very night.
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That sounds ideal! I’ve just sent an email to request it so will see what they say!

Thank you again so much, honestly don’t know what I would do without the support on this forum!
 
Inka said:
I don’t think Abasaglar comes in a half unit pen?
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it doesn't. I asked, as i am on 2 units so a half unit pen would have been useful
 
Evergreen said:
I think I’m still in the honeymoon phase and working out my basal is a complete pain, with differences every couple of days which isn’t helping me feel reassured or comfortable. I’m changing diabetes teams as I have been quite unhappy with my current one (especially after my experience in hospital which is another story), the new team is keen to get my on a closed loop pump to help with my basal requirements and I’m hoping this will in turn make it slightly easier to deal with my bolus.
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I am using a closed loop system, and certainly find that it irons out some over/underestimates of carbs. I still tend to make sure that I finish my evening meal 4 hours before be, but if I eat a bit later I am generally confident the looping adjustments will take any wobbles in my levels back to a nice flat line, most of the time. Well worth a try.

I am another one who gave up on low carb meals. With those smaller carbs meals, the proteins then came into play and my head doesn’t have space for that info alongside the carb information I store. I find it is just easier to have meals of around 30g carbs but then that it only a vague target, and like others when a yummy cake is offered I just have some extra insulin and enjoy the cake.

Your honeymoon period certainly does make things more difficult and unpredictable, which seems a bit unfair as at the start you want things to be easier. Tap into the support and experience on here as much as you want, or even just pop in for a rant. People ‘get it’ on here.
 
@Evergreen a minimum of 30gm carbs per main meal is a figure I got from the author Gary Scheiner and his book "Think Like a Pancreas". He suggests this is a useful round number to feel sure that there are sufficient carbs for one's body to not need to start converting proteins and fats into carbs. Ignore the 30 gms for snacks - let whatever their carb content is be bolused for if that bolus is needed and whatever extra comes from proteins or fats is not greatly significant.

So even if only 2 main meals daily, at least 60 gms carbs emerges as a quantity that doesn't need trying to juggle with the differing conversion ratios for proteins or fats and the associated mental juggling. And 60 or even 90gms for 3 meals is still low carb. I don't try to force a meal a couple of carb gms greater just to make the nos up to 30!
 
Thank you again everyone!

I’ve been aiming for 30-40 grams of carbs per meal. It’s useful to hear that 60 grams seems to be a number where you don’t need to wrestle with the insulin resistance and protein! I actually have that book, might need to read again!

I’m not going to lie though, it’s been tough doing this! I clearly have a lot of learning to do (and I’m probably a little too impatient..)

For most meals I’ve not given myself enough insulin, even though I’ve gone from 1:15 ratio to 1:10 and I’ve only been back in ‘green’ just before my next meal which has been frustrating. This might be a silly question, but does this put me at a higher risk for DKA?

Randomly I thought I got my ratio perfectly for dinner yesterday but nearly went low overnight (I’ve got a young child who woke up so I noticed before it went low), I ate at 6.30pm though so I’m making an assumption that that was my basal (even though I’m currently only on 7u!)

I’m feeling pretty frustrated about it if I’m honest and like I’ll never get it right. It’s also making me pretty anxious, which I’ve never experienced before getting this diagnosis.
 
SB2015 said:
I am using a closed loop system, and certainly find that it irons out some over/underestimates of carbs. I still tend to make sure that I finish my evening meal 4 hours before be, but if I eat a bit later I am generally confident the looping adjustments will take any wobbles in my levels back to a nice flat line, most of the time. Well worth a try.

I am another one who gave up on low carb meals. With those smaller carbs meals, the proteins then came into play and my head doesn’t have space for that info alongside the carb information I store. I find it is just easier to have meals of around 30g carbs but then that it only a vague target, and like others when a yummy cake is offered I just have some extra insulin and enjoy the cake.

Your honeymoon period certainly does make things more difficult and unpredictable, which seems a bit unfair as at the start you want things to be easier. Tap into the support and experience on here as much as you want, or even just pop in for a rant. People ‘get it’ on here.
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Thank you, I really appreciate this. My family and friends are really trying but they just don’t really understand it.

I feel you might see quite a bit of me on here! So sorry! Hopefully in the future I can give some advice too!
 
Getting your basal changed should help a lot @Evergreen You won’t believe how much a wrong basal throws everything off. Remember too that this is a gradual process. You’re not going to switch your diet just like that and have everything work immediately. As you’re sensibly doing, you have to be cautious to avoid hypos, and you have to inch your way to the correct ratios for meals.
 
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