Basics of Low Carb and Type 1 Diabetes

I share a lot about my life with type 1 diabetes. In the past, I sparingly shared my low carb lifestyle. But as I’m getting more and more questions, and I’m 100% convinced in my choice, I’ve decided there’s no point in being quiet anymore.

Low carb has saved my life and I truly believe it can help every one with diabetes gain control of blood sugars.

My A1C has been below 5.5% for three years, and it was between 4.5-4.9% during my pregnancy. I accomplish this by following a low carb (LC) lifestyle – one that I can and will maintain for the rest of my life.

So how do I do it?

*quick note: I will reference Dr. Bernstein a lot. He has been T1 for 70+ years (diagnosed at age 11) and quickly realized the ADA guidelines were killing him. He went on to receive his medical degree and has since been practicing. He believes that T1s are entitled to normal blood sugars just like everyone else.

Basics

How many carbs do I consume per day?

I aim for 25-30g of carbs per day. I’ve found this to be a sweet spot and anything over 30g tends to lead to unpredictability – which I try and avoid. I treat lows with glucose tabs only, and don’t count them in my daily carb intake.

The best way to start: cold turkey or ease in?

When I first started, I made a goal of 75g per day. After a while and once I became comfortable, I lowered again to 50g per day. Following the same procedure, I eventually landed where I am now at 25-30g per day. Whether or not this would work everyone, I really cannot say. And in all honesty, I didn’t actually work out that well for me. I struggled with still eating chocolate and such because I felt like I could. I allocated a certain amount of carbs and made sure to fit in the chocolate, but this ended up making it hard for me to just stick to low carb in a much more pure sense. I’ve since cut out the chocolate I used to eat (I don’t miss it) and switched to 85% dark chocolate. This has helped me and I wish I would have just gone cold turkey to begin with. I’m actually less likely to binge NOW than when I let myself just have some….because what’s some? However, I think it’s individual and depends on who YOU are and what you think you can sustain.

Do I have a lot of low blood sugars?

Well, that’s a subjective question. What constitutes a lot? And what constitutes a “low”? Anyway, I would say no, I do not have a lot of lows. I use so little insulin for so little carbs, that my blood sugar is predictable and I don’t experience big blood sugar swings that often lead to sudden lows. I typically stay between 70-100 all day, and my CGM parameters are 65-120 (65-110 at night). Lows with LC happen much slower and less sudden. I don’t experience going from 180 to 50 in a half hour, for example, which often happens with high carb. I may go from 85 to 60 in three hours. There’s a big difference.

Did my insulin needs change?

Yes and no. Although many people do experience a need to reduce basal (long acting) insulin after switching to a LC lifestyle, I did not experience that. My basal rate is the same and actually hasn’t changed for YEARS. I think I’m an anomaly here. *Don’t worry, I do basal tests and know that it’s still up-to-date. I did however reduce my overall daily insulin levels. Before LC, I would use about 50u daily for basal and bolus. Now I use 30u daily.

But aren’t carbs necessary?

NO. There is simply no such thing as an ESSENTIAL carbohydrate. Amino (protein) acids and fatty acids are essential. Essential means that it is required for life and cannot be synthesized by the body. I’ve got Dr. Bernstein (again) to thank for teaching me this. And the past year and a half has proven this to me. I am the healthiest I have ever been, thanks to eating LC.

Nutritional Ketosis and Diabetic Ketoacidosis (DKA)

Lots of people get confused when they hear low carb or keto because eating low carb often puts people into ketosis. Do not confuse ketosis with ketoacidosis. They are not the same thing. Period. This article explains the differences.

Exercise

A quick thought that Dr. Bernstein discusses: “Brief, strenuous exercise can raise blood sugar, while prolonged exercise can lower it.” (Diabetes Solution, pg 227)

What type of exercise do I do? AKA sustaining blood sugar while exercising.

I ride bike to work, which is a 7km ride, or 20-25 minutes. In the morning, I can hop on my bike and just go, without any problems. However, the afternoon is a bit trickier. I’ve learned through trial and error to eat 1-2 glucose tabs before I leave to prevent a drop in blood sugar. I suspect the drop happens from lingering lunchtime active insulin.

Dr. Bernstein suggests using glucose tabs for brief exercise (under an hour);  and for longer exercise periods, slower acting may be more appropriate. Someone asked about marathon training and LC, but I just do not have enough knowledge to give educated input; however, I do know that Tamsin has great experience that she shares on her blog and instagram. It is not impossible. In fact, I would argue that the unpredictability of high carb and high insulin levels actually leads to more issues than high protein, low carb, low insulin levels (much less chance for error and blood sugar swings).

Food

Taking insulin for protein, fat, and carbs can get a bit complicated, but it’s not impossible. I think a lot of people give up on LC because their blood sugar still spikes and “it doesn’t seem worth it”. I would assume then, that they are not bolusing correctly for the other macros besides carbs.

For carbohydrates, here’s how I get to 25-30g per day: for breakfast, I aim for 6g of carbohydrates, and for lunch and dinner, 12g each. Protein is the building block of all my meals. It is what satiates and satisfies.

Dr. Bernstein has rough guidelines for how much protein to eat. Here’s what he says for the average physically active person, “… 1-1.2g of protein per kilogram of ideal body weight (.55g/lb). Athletes will require more, as well as growing children”.

**I am not a food photographer, so hopefully it all looks appetizing! 

What do I eat? …besides eggs!

I discussed this in another blog post, so check this one out, and the list below!

What is my go-to low carb meal?

Right now I am obsessed with LC pancakes (recipes are below).

Breakfast

• Omelets, all sorts of variations. Three cheese, bacon, hamburger, more bacon, avocado, etc! Get creative.
• Chia seed pudding. I mix two spoons of chia seeds with one spoon of PB protein powder (or any other LC protein powder) with unsweetened cashew or almond milk. I eat this nearly every work-day morning. It’s delicious and keeps me full until lunchtime without any BG spike (I still bolus for it).
• Keto Porridge from Diet Doctor
• Low carb pancakes. Try them with almond flour, or with coconut flour.

Lunch and Dinner

• 90 second bread (toast after making!) sandwich with various fillings.
• Bunless hamburger, or wrapped in iceberg lettuce, I swear, it still tastes just as delicious!
• Cauliflower Mash from Diet Doctor with a side of pure protein, delicious!
• Grill – it’s innately low carb!
• Quiche with a LC crust (an example from All Day I Dream About Food)
• Sushi, see pic below. Filled with a cream cheese horseradish spread, cucumber and avocado. Drooling?
• Zoodles, spiralized zucchini with spaghetti sauce.
• Fat Head Pizza 
• Salads. I eat a lot of them because I think they’re delicious. I also never get sick of them because I always switch up the throw-ins and type of lettuce.

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Looks good, huh? I eat delicious, nutritious, homemade meals. Do any of these look like I deprive myself? That’s another common misconception about LC.

Pre-made LC foods are hard to come by, but a few brands that I trust are: Real Good Foods (use “theinsulintype” for 15% off) and Real Phat Foods (use “theinsulintype” to save 10%). I buy their products and use them for lazy cooking days! From RGF, I buy: personal pizzas, enchiladas, and poppers. From Real Phat Foods, I literally buy everything they have, crackers, bread, pumpkin bread, edible cookie dough – they’re amazing!

I get a lot of my recipes from Diet Doctor and just around the web. I also frequently update my Pinterest, so you can see what I am eating or what’s on my list. And if you’re craving something particular, I dare you to google, “low carb XYZ”, and I guarantee you’ll find a great alternative!

If you have any questions about low carb, feel free to send me a message or comment below. And remember, sharing is caring; use the buttons below to repost.

P.S. A few notes about doctors and the LC debate. It is widely and unfortunately true that most medical professionals will try and push an outrageous carb intake on patients with diabetes, thanks the the ADA. In the end, it is up to you to have that discussion with your doctor and to choose what is best for your body. My doctor does not voice concerns over my LC lifestyle, but I am always prepared for the battle and to continue to do what is best for myself.

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