Low Carb vs High Carb, Micha

Do you follow a low carb or high carb lifestyle? Or neither? There is a lot of hype in the diabetic community on the advantages of eating low carb versus high carb. However, from my own observations, there do not seem to be very many high carb diabetics with A1Cs less than 6%. So I’ve asked around and was able to find a few type 1 diabetics who do fall into this category, as well as those who eat low carb with a fantastic A1C. They’ve all been so kind to do a Q&A with me! For this post, Micha has shared his high carb approach. As part of the series, read this post for Abby’s low carb approach.

But first, what IS low carb and what IS high carb?

The definition of low carb and also high carb, probably depend on who you ask. If you ask ME, I’d say low carb is less than 75g of carbs per day and high carb would be over 150g of carbohydrates per day. There’s a middle carb hanging around too!

Why am I interested in diabetics who eat high carb and are still maintaining A1Cs below 6%?

Why wouldn’t I be? Are you? I know from my own experience that I cannot live a high carb lifestyle. My body just does not respond nicely; however, this does not mean that it doesn’t work for others. So many people have their own agenda and beliefs, but we all need to realize that what works for us may not work for others.

So, without further ado, meet Micha, who will share his experience for Part One of this blog series, low carb VS high carb.

Please share your name, a bit about yourself, your recent A1Cs, and your general approach to a high carb lifestyle.

Hi, my name is Micha, I’m  28 years old and am living close to the middle of Germany. I live with Diabetes since January 2011. I have just finished with university (Chemistry and political science) and will be (hopefully) a teacher in school from spring 2018.

My last HbA1c was 4,9% in 09/2017 (the lowest ever for me), my next one will be around 5,5% (according to my cgm). My diet is a combination of daily intermittent fasting and a whole foods vegan high carb diet.

Have you always eaten high carb? What other perspectives can you share that led you to eat high carb?

Before I changed my diet to high carb vegan in September 2014 (it was more an ethical reason to become vegan), I tried nearly every other diet which is suggested for diabetics. On a low-carb, high protein diet I had massive problems with different organ inflammations, generally speaking, I didn’t feel good at all. My A1Cs weren’t really bad with that diet, somewhere in the 6-7% ratio, but the other health issues came across. In the first year after my diagnosis I followed the standard DDG-diet (I guess it is the same like the ADA-diet). My A1Cs were also around 6-7%.

On average, how many carbs do you consume per day?

My daily carb intake most of the time is around 70-90% of my daily calories. I eat 2600 calories on non-active days, on days with sport around 3000-4000. So 500g+ of carbohydrates per day. My average insulin to carb ratio is 1 unit per 15g.

What is your approach? Do you eat EVERYTHING, do you focus on certain foods, exercise, etc?

On a normal day I avoid highly processed foods, especially (white) sugar, oils or processed protein. I try to get as much of my calories from raw or cooked fruits, beans, veggies and different grains as possible.
My exercise routine is a mix of cycling, running and weight training in the gym. It averages around 4 hours per week, sometimes more, sometimes less.
Of course I have my lazy days or weeks over the year where I eat highly processed and don’t exercise.

One of the biggest issues with eating high carb, in my opinion, is the fluctuation of high blood sugars after a meal. How do you mitigate your blood sugar from spiking after consuming a high carb meal?

For high carb meals with low or no fat (like fruits) I use an extended pre-bolus up to 40-50 minutes (with Novorapid/Novolog) before eating. Normally I prepare a bigger bowl of food and eat that over a longer period of time (2-3 hours). My blood sugar stays under max. 130 mg/dl and is stable around 100 mg/dl the hours after (not always of course, but for 95% of meals this works for me) . In addition to using Levemir for basal insulin, I also use it for fat and protein boluses. For every 100kcal of fat/protein, I bolus 1 unit.
My first meal is always around 12 pm, last meal is around 6pm-8pm.

How often do you have low blood sugars? Just like above, using so much insulin at one time brings a lot more into the playing field, ie: high blood sugars followed by low blood sugars.

For me a low blood sugar is everything under 60 mg/dl where I have the typical hypo-symptoms. I rarely have a low reading, maybe once or twice a month, normally during/after sports. If I used to much fast acting insulin for a meal, my CGM/FGM helps me to eat early enough.

If you use a CGM, what is your blood sugar standard deviation? This is interesting to see the overall control of blood glucose values.

According to my CGM data, my standard deviation is 20 mg/dl.

What do you think is the biggest key to eating high carb and maintaining an A1C less than 6%?

The possibility to see how and when Novorapid is working with different foods. When I got my CGM a year ago, I experimented with different foods + insulin timing and was able to find my individual timing for fast carbs like fruits and noodles or for carb-meals with a higher fat and protein content.

My high carb diet is also supported by endurance sport followed by increased insulin sensitivity.

Thanks so much Micha. What other questions do you have for him? Leave your comments below so that he may answer them. AND if you’re wondering about something, chances are someone else is wondering the same thing!

And check out this post about a low carb approach!


P.S. Micha is not a medical professional, neither am I. This is his personal experience and is not meant to be taken as medical advice.


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