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.