Breaking up is hard to do – life without carbs

by Elizabeth Snouffer on 05/05/2013

It all started with a gift—a year’s worth of personal training sessions for Christmas.  To maximize this wonderful opportunity, I decided that I should try to master type 1 diabetes with even more EFFORT and although I use an insulin infusion pump, CGM device and test anywhere from 6-12 times per day – to this mix, I would add-on a low-low carbohydrate diet (<30-40 grams per day), the training sessions and extra cardio fitness.

To my surprise,  my life with very little carbs didn’t work out quite the way I thought it would or should.

While the information below will give you an idea of why and how it failed, I believe there is a great need to fund studies on best nutrition practices for the type 1 diabetes population.  There is evidence that a zero/low carbohydrate diet works for people living with type 2 diabetes, but I am now convinced that they are less effective for people diagnosed with type 1 diabetes (who don’t also suffer from double diabetes or any other complications).  Type 1 patients still rely on a synthetic version of the insulin discovered in 1922 which has a muted but similar delay in its ability to quickly manage post-meal excursions.   More assistance is required for type 1 nutrition.

My mantra: less than 30 grams per day

Before I started my extreme break-up with carbohydrates on the 1st of February 2013, it is important to point out that my normal diet consisted of zero refined sugars (an occasional serving of ice-cream or a small piece of chocolate doesn’t count).  Whole grains, veggies, chicken, fish and other low-fat proteins always worked OK for me.  Processed food was out and I utilized the white rule (no rice, potato or white flour).  Snacking was a no-no too, focusing on meals.  My daily totals for insulin were about 25-30 units.  I was already maintaining a low carbohydrate diet.

However, what I really desired was to minimize the inconvenient truth of living with T1 diabetes (for nearly 4 decades now) and eliminate what wrecked cognition – wild blood glucose excursions, both the ups and downs.  In an effort to reduce-eliminate carbohydrates, I hoped to beat those high sugar blues as well as achieve A1c’s below 6.5%; reduce hypoglycaemia; feel more energized; look better and test the hypothesis that eating almost NO carbs with type 1 diabetes is the only way to master the condition.  (Google Type 1 diabetes and zero carbohydrate to see the hype).

What happened?  After only about 4-6 weeks, things started to get worse.  Very slowly my daily blood glucose results became poor and I became insulin resistant, something I have never experienced.  I gained weight.  I needed more insulin, BUT I also had many more unpredictable hypo episodes or low blood sugars.  I was exhausted all the time and I had trouble sleeping.  I was moody.  My HbA1c rose from a 6.8 to a 7.4%.  I looked terrible and felt worse than I ever had.   It was an epic FAIL. 

I ignored these symptoms thinking my body was transitioning and I still wasn’t doing all the things I could do.  My new regime included but was not limited to  organic oatmeal – every morning (30 grams of fuel for my work-outs) and for the rest of the day green salad and chicken, fish or lean beef.  Fats were included in my plan in the form of saturated and mono-satuated fats – olive oil, nuts, avocado, eggs and even butter (never margarine or any hydrogenated fats).  This was no starvation diet.  I managed to pretty well attain less than 40 grams everyday and some days even less.  I found that my appetite was diminishing quite quickly and eating became a big effort.  Around week 10, I flew to California to see my diabetes team for an already scheduled visit. The results were not good.

My cholesterol increased and the weight I gained became waist weight (aka belly fat).   In my effort to reduce carbohydrate, my body was not receiving adequate fuel and my liver began converting proteins for energy, which is a workable weight-loss strategy used by non-diabetics, but not for me.  My liver began storing fat, which led to my weight gain.  The metabolizing proteins and my liver plus other hormones all required more basal insulin on a regular basis.

However, one fact remained – I was not getting adequate nutrition, and that’s a problem.  Even worse, in my brain-body’s search for more fuel, the breaking down of muscle for additional energy initiated incredible “waking up in the middle of the night” leg pain and ironically – all of the toning work in the gym was being lost.  Two last side-effects worth mentioning – on many days I felt like I was starving; other days, I felt too sick to eat.

Three weeks ago, I resumed my normal low healthy carbohydrate intake of about 100 grams a day and already I feel better.  I am happier.  My insulin requirement has been cut down by 1/3rd overall.  Today, I find that when I take my BG it is a surprisingly great number (90-120 mg/dl) whereas when I was on the low-low carb, it was usually 180-250 mg/dl unless I had a painful and unpredictable low which usually came on in the early hours of the morning (when my body had no fuel, no protein to metabolise and too much insulin).

A few Last Pointers

  • My “test” was not scientific
  • We are all individuals who require different things.  Some people may be successful with eating zero to extremely low carbohydrate diets (One example is Richard Bernstein – although his books are really written for the type 2 diabetes population)
  • I currently suffer zero complications of diabetes (not bad for 37 years) – but I felt the zero carb/very low carb diet had lifted me straight to the edge of serious conditions, i.e., high cholesterol and poor immune system
  • More studies for nutrition are needed for type 1 diabetes – most people don’t know how or what to eat
  • More nutrition education is needed all over the world but for the type 1 diabetes patient – knowing what foods to avoid and what foods to depend upon will help provide a chance for a longer healthier life

It’s time for all the nutritional experts who work with pharmaceutical companies or hospitals or academic centres on how to improve the lives of people with type 1 diabetes to dedicate more energy and attention to the nutritional needs of type 1 patients.   Devices will never do it all.

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{ 11 comments… read them below or add one }

T May 5, 2013 at 07:24

All I can say after reading “My new regime consisted of organic oatmeal – every morning (30 grams of fuel for my work-outs) and for the rest of the day green salad and chicken, fish or lean beef.” is “well duuh”. When you cut out carbs you NEED to eat more fat or else you don’t get ANY energy from ANYTHING, and your body get stressed and starts to convert energy from protein.
You should try this again but try adding fat in the diet.

Elizabeth Snouffer May 5, 2013 at 07:54

Dear Duuh – there were plenty of healthy fats in my diet – this was not the cause of the epic fail. Good try though! There is nothing I did or didn’t do that would have made my no carb diet work – except for possibly one thing – zero exercise. Although, this would have led to other problems.

Melanie May 5, 2013 at 08:10

I am a T1D and eat a very low carbohydrate diet and maintain excellent blood sugars throughout the day. I, too, was surprised that you were choosing oatmeal–a grain–as the source of your carbs for the day. Is that something you were already eating for breakfast? I can’t handle that many carbs at breakfast without really changing how I bolus and I am often chasing the highs from that with insulin.

One other thing I had read about cholesterol is that it’s not necessarily a terrible thing for your cholesterol level to go up if you’re going low-carb. It doesn’t necessarily mean that you now have lots more cholesterol molecules floating around, but that the ones you had might be bigger now. The test just measures volume of cholesterol, not the number. The larger molecules are more innocuous than the tiny ones.

Interesting experiment, though it doesn’t match my results. Thanks for the article!

Elizabeth Snouffer May 5, 2013 at 08:19

Hi Melanie,
How many carbohydrates do you consume per day? Hovering around 100 grams is not a lot. 30 grams of oatmeal (a low GI food) was for daily workouts. That 30 grams was easily absorbed by aerobic and anaerobic exercise – without that I would have collapsed. I am still required to take insulin regardless of the food I eat. I think what my experiment told me is this:
Managing life with exogenous insulin only (no endogenous insulin available) without a predictable amount of carbohydrate per day is impossible. The brain requires 100 grams a day for fuel – less than that – management becomes very tricky.
It gets complex from here but the short of it is this – type 1 diabetes is not just about not having the hormone insulin – not having that hormone has a broad range of effects on digestion, metabolism, the liver and more.

Leanne King May 5, 2013 at 09:28

Hi Elizabeth….your article is very interesting for me because I have had a similiar experience and this makes sense. I was first diagnosed many years ago as a type 2 and immediately went on a very low carb diet and it worked . I would eat a protein based diet and get on an exercise machine after every meal. It wasn’t long before I was on insulin and then they re-examined me following my six year old developing type 1 and discovered that I had late onset type 1 myself. About 5 years ago we both got pumps and since then I have struggled with my weight and control has been difficult but I continued on with the very low carb diet to supposedly keep my insulin needs as low as possible. A few weeks ago my son put the family on a plant based regime which alarmed me because of the amount of Pasta and Brown rice I was having to consume to replace the meat (so it went up to about 100 grms a day)…the result is that my weight is going down and so are my insulin needs and Im eating twice as many carbs as before. I also have maintained a ‘diabetic’ no added sugar fairly healthy diet but restricting the carb intake for years…so this makes sense to me more than any of the professional opinions I have sought over this time ….and you are right about there needing to be a study….so thanks :)

Elizabeth Snouffer May 5, 2013 at 09:42

Thank you for sharing Leanne! The upshot is that we all need a large-scale clinical study. There is just too much confusion. Until then, I am sticking with a 100 gram diet of healthy carbs – whole grains, fruit, veggies + lean meat and dairy. I would add that a large part of success with carbs is paying strict attention to portions. (why I show a photo of a scale – 1/4 to a 1/2 cup of any grain is considered “one” portion for a meal.)

Cynthia May 5, 2013 at 11:22

I am always stunned to hear how people with T1 diabetes feel that people with T2 diabetes don’t deal with the same struggles. There are T2 diabetics that have to take insulin, they have to check their BG constantly their lives have gone through a rapid turn around as well. Many T2 patients eat zero carbs are on a protein and veg diet, walk every day and still struggle with their disease. So please stop with this is being done for T2 and not enough is being done for T1. Not all T2 diabetics are overweight, there are those that have other serious health conditions they are born with and the onset happens after they are diagnosed with a condition far more serious. So please stop comparing it like it’s oranges and apples one type is no easier control than the other.

We all struggle with it everyday whether you are the person with this awful disease or you are the caregiver. Diabetes is a disease and there needs to be a cure.

Elizabeth Snouffer May 5, 2013 at 22:07

Dear Cynthia, I totally agree with your perspective. I don’t think I said anything negative about type 2 diabetes in the post above. However, there are some critical differences between Type 1 and Type 2. When Type 1 diabetes is diagnosed the body is not producing insulin, but when Type 2 diabetes develops the cells are not responding properly to insulin, and/or there is not enough insulin being produced. People living with Type 1 diabetes and people living with Type 2 diabetes require different treatment plans, and therefore, different clinical research is required for each population. You’re right, many Type 2 patients take insulin, but some come off insulin and manage to reverse their condition. Type 1 diabetes is incurable and cannot be reversed. I hope this helps you understand the difference between Type 1 and Type 2 diabetes. Type 2 diabetes is a serious metabolic disorder and Type 1 diabetes is a serious autoimmune disease.

sten b May 23, 2013 at 08:10

I am sorry to say but carbs raise blood sugar rise and proteins raise it a little and fats doesn’t raise it at all. Nothing! But stay awau from all omega 6 . Tallow from grass fed cattle is the best, plus some omega 3 from fish. Omega 6 stirs up inflammation and the country with the largest omega 6 usage in the world has also the highest Diabetes rate in the world (Israel).

I got rid of a 7 year old severe angina pectoris by going to zero carbs. It took me 6 weeks . I cut out ALL carbs except salad, broccoli, cauliflower.
Ate fatty meats when possible. Melted butter, garlic- when possible on both veggies and meats. Less protein than otherwise. Less food intake overall as the fats are filling. Coconut oil. Breakfast bacon and egg twice a week, Bullet coffee other days: High speed hand blender , coffee, butter and coconut oil. Keeps one going well after lunch with no break, Coffee can be replaced by pure cacao powder +hot water. Pure cacao powder without sugar, never oboy or similar!
If you add cheese, recall protein converts to BS after a while and you may need a brisk walk in the morning to get rid of the BS liver produces overnight. Zero carb is hard to reach. Occasional “ice-cream or a small piece of chocolate ” or strawberries are totally out, at least during the first month or until you can see BS is not moving after a meal. 85% + dark chocolate is ok in moderation. If you feel for snack pour 1/8 glass with cream and just drink it, or put into coffee.
That’s just my 2 cents. Cheers and Good Luck next time around!

Fred Hahn June 3, 2013 at 09:08

Hi Melanis –

My 3 cents:

1. For breakfast you had oatmeal – every morning. This is nothing but a bowl of sugar. Instead, you should have had 2-3 eggs, bacon or salmon or a Florentine omelet. But this alone is not the only issue.

Feeling moody and low on energy is a completely normal response to a VLCD. You’re just shifting from glucose to fat as your main source of fuel. For some it takes a few weeks of adjustment.

Q’s: How did you determine that you became insulin resistant in just 4 weeks? And how did you determine that you were gaining liver fat? Sonogram?

You said:

“…whereas when I was on the low-low carb, it was usually 180-250 mg/dl”

When did you take your BG reading? After the bowl of oatmeal? It had to have bene then because carbs raise BG much higher than protein though, it is true that in a T1D, almost anything can raise blood sugars according to Dr. Bernstein. Maybe for YOU protein caused a higher rise in BG than carbs?

You didn’t mention anything about adjusting your insulin amount – did you? On a VLCD AND with added ecercise, you need FAR less insulin. If you were taking the same amount, this could be why you gained liver fat and had other hormonal issues. Possible.

Your rise in cholesterol is not necessarily a bad thing. In fact, women who are 50 and older who have cholesterol levels in the mid 200′s have LESS CVD and strokes. Read The Great Cholesteorl Con by Malcolm Kendrick M.D. You definitley don’t want low cholesterol as a woman in her 40′s +.

Did you make sure to get enough protein? You should be eating about 1 gram per pound of body weight especially if you are lifting weights – and weight lifting is a potent means to lower BG.

Good luck in the futire!

Charlotte June 14, 2014 at 13:03

I am also a type 1 diabetic, I experienced the exact same thing, I tried to do the very low carb dieting by adding more lean protein and fats to my diet and by eliminating bread,pasta, rice,… and by doing more exercise but over the past months my blood sugars are much higher than before, I am going to reintroduce carbs and hope that my blood sugars stabilize again.
My diet before the very low carb diet was like yours not very high in carbs and only on special occasions something sweet.

I must say that it was quite comforting to see someone who experienced the same results as I did because I always read about type 1 and zero carb and the great results but for me it clearly doesn’t work !

Thanks for sharing !!

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