To low carb or not to low carb
I've been reading a lot of the threads here and see a lot about a low carb diet. However, I have a question or series of questions. First let me start out on this premise: Let's say I am a type 1 diabetic (how about that, I am!) and I know my I:C ratio is 1:20 as an example. As long as I give myself proper insulin for the carbs I don't have a problem with my BG being out of control after meals regardless of whether I have 200 carbs a meal or 60. In this type of situation, what is the benefit to me as a diabetic, not just general health benefits anyone could get, from being on a low-carb diet? In essence, I'm doing what my pancreas would normally do and dose for the meal (although my pancreas was much more efficient and precise of course).
If this is a hot-button issue here then forgive me, I don't intend to open up a can of worms. My books from Dr. Bernstein and 'Think Like a Pancreas' are still on their way, so maybe they will answer this question. I've just seen a few people here who seem to feel very guilty that they were still "living like they didn't have diabetes and dosing for the meal." If you're BG's are in check and your otherwise healthy and doing okay, why is this a problem? Again, we're discounting the benefits anyone could get, and focusing on why it's beneficial specifically for diabetics.
NOTE: I DO count my carbs religiously (I don't see how that could be optional as a T1) and try, in general, to eat fewer than I did before I was diagnosed. Also, the ratios and scenario above do not fit me, they are just setting the stage for the discussion.
Replies to This Discussion
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Permalink Reply by nel on
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And we are all " different " ( in 2013 : 30 years ...time to celebrate another milestone with supporter Hubby in tow )
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Permalink Reply by Jerry on
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Ok, an answer based on my life as a T1 for 37 years.
Low carb diet, probably not, but as long as you test yourself then you should be OK . . . and if that ratio doesn't work for you then figue out what the proper ratio should be ~ 1:15 is commmon, mine is around 1:12. You simply do it by testing yourselk around 1:30 minutes after you eat, and see how far you are from your target.
When my BS is high I need to use 1 unit of novolog for every 40 points too high to bring it down. So if 1 am 200 and i want to be at 120 then I take 2 units, and it brings me to right when I want to be. What I have observed is that it is 1 unit for every 40-50 points too high ~ but, as you can imagine, that varies with each diabetic.
I know a T1 who have gone low-carb when she probably should nopt have, and it caused nothing but problems for her. Including (a hot topic where I live) drivng with diabetes.
I have always been right around 7.0 and after 37 years I have no complications whatsoever from my diabetes. In my opinion (only MY opinion) doing that low carb thing for a T1 can really cause problems.
After I wrote this, I skimmed some of your replies, and yes, activity is a big factor here.
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Permalink Reply by acidrock23 on -
Driving doesn't have anything to do w/ the number of carbs, it's having the carbs and insulin balanced correctly. Which is certainly easier said than done.
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Permalink Reply by Laddie on -
But to carry this discussion a bit farther, the fewer carbs you eat the less insulin you take and therefore fewer peaks and valleys. So low carb is probably safer for driving. But you need to know how to adjust your insulin to reflect a change in your diet. As acidrock said, it has to be balanced.
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Permalink Reply by acidrock23 on
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I agree with that as I think that w/ the lower bolus amunt for lower carber options your risk goes down and is likely easier to control, all of which are really helpful benefits from consciously reducing ones carb intake. I am driving my mother-in-law crazy this week but am pretty much ignoring her demands to "eat more".
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You are right, driving has nothing to do with carbs . . . I guess I drifted there a bit.
What I do feel strongly about is people who try to keep their blood sugar too low, which can obviously cause drving problems. Part of that is eating less carbs and/or taking too much insulin. Yes, a balance is needed there.
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Permalink Reply by Ann on -
What a great discussion this is! I've just read the whole thing, from the beginning, and I am deeply, deeply impressed not only by the breadth of knowledge, but also by the compassion and modesty.
I have only a few things to contribute. Jenny Rhul has a calculator at Blood Sugar 101 that converts A1cs to BG in mg/dl or mmol/L. Fill in any one value and it will give the other two--very useful!
I calculate my Standard Deviation for my BG on my Excel spreadsheet--which is where I keep my records of my BG, carb intake and insulin use. Excel will figure out the SD for a range of numbers, so I don't have to. My control is pretty good these days. I can see that from the list of numbers and don't really need the SD to tell me. But if I have a low or a high, then the SD will increase. It's useful to me to see how much difference that makes overall, but I suspect this is most meaningful because I tend to have the same pattern for testing my BG from day to day. It's not as good as a pump, of course, because I have to do every test myself. The numbers that interest me most these days are my BG before bedtime and when I get up in the morning. If those two numbers are the same or very close, I feel good because I know that my BG was very stable all night long.
A1cs can be in the normal range for many reasons, as we've noted already. That's why the number can't be relied upon all by itself. For me, the A1c is a general measure of my progress over the last couple of months. I was only dx'd in October so a steadily lowering A1c is proof that what I've been seeing on my meter is pretty accurate and that means that I'm doing a lot of things right. I'm happy with that.
Low carbing nearly always works for people who are trying to bring their BG down. Bernstein's way of eating will do it if someone is willing to give it a try. A lot of people can eat more carb than he advises and still maintain excellent BG control without gaining weight. I think that's absolutely fantastic and I am happy to cheer for them. I don't follow Dr. B to the letter, but the general direction he describes does work for me and I'm grateful to him for it. For me, 30g of carbs is plenty every day. But I'm 53 years old and have a fairly sedentary life. I walk a couple of miles every day, sometimes more, but I'm not and don't have any plan to be an athlete. If I were a lot more active, I might need to increase the amount of carb I eat, but I'm not sure. I might only need to increase the amounts of protein or fat. I don't plan to make this experiment, though things could change in the future.
In the end, the thing we all need to do is whatever works for us. Clearly there's no single, magic answer and no high, golden road to perfect control and complication-free life.
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