Hi Everyone,
Since my LADA diagnosis in late January 2023, I have been very careful about what I eat. A fairly low carb diet of 20-30 carbs/meal (fresh veggies, yogurt, nuts, occasional legumes). Oh, and a serving of blueberries with my breakfast. I’m also walking pretty much after every meal - at least 15min but up to an hour or so. I am in my honeymoon period and not yet on insulin. I take Metformin 2x daily.
Ok, so 2 of the endocrinologists I’ve seen have said, “Diet and exercise will not help you. You have Type 1 diabetes. Unlike Type 2, diet and exercise will not make a difference.”
But I know it’s helping me. My food choices are absolutely helping (there’s a huge difference between fresh blueberries and a blueberry muffin) and I can actually see evidence on my CGM of the exercise helping my glucose levels. I mean, I have a metabolic disorder for crying out loud, why wouldn’t my food/exercise choices have a major impact?
Is this just their way of trying to make sure I’m not in denial about the disease that I have? Does diet and exercise not really matter to T1 diabetics? I’ve read a lot of posts on here about diet and exercise and I see a lot of people eat a low carb diet - even those who take insulin. I am confused about the messaging from the endos and what I feel to be true about my body.
Anyone out there with a similar experience? Do you find that diet and exercise make a difference?
A healthy diet and exercise most definitely helps everyone, including us T1s. Exercise is key to maintaining insulin sensitivity, among other benefits. It won’t “cure” T1 diabetes, but it certainly helps maintain good control.
Btw, you mention that you take Metforim 2x day. I might be wrong, but isn’t that medication for T2? Perhaps it is prescribed for T1 honeymoon period?
Type 1 diabetes is caused by mistaken attack on pancreas, where insulin is secreted from. In my case, a quick attack at age 5, and within a few weeks I had suddenly lost weight, yet kept asking for more food. My beta cell were quickly destroyed (by my own body).
With LADA, the attack is much slower, but i don’t know the range. By injecting insulin, and doing less carbs, my speculation would be a much longer time before your pancreas wears out, with significant reduction of insulin.
But some think its more challenging when injecting and also have a sputtering pancreas. Lower carb helps because fats and proteins require much less insulin.
You can track your insulin from pancreas with the C-peptide test, since injected insulin does not release C-Peptide.
“Biguanides like metformin work by controlling the amount of sugar, or glucose, in your blood. Specifically, metformin works to reduce production of glucose by the liver, decrease absorption of glucose by the gastrointestinal tract, and increase target cell insulin sensitivity.”
So a person with LADA is still making some insulin, but not enough. So metformin can help for awhile. Like a crutch!!
This is somewhat of a context thing.
The doctors could phrase it in different ways, and what you get out of the statement really depends a lot on how they say it.
So here is the WRONG way of saying it:
Diet and exercise will not help you. You have Type 1 diabetes. Unlike Type 2, diet and exercise will not make a difference.
And this is a much BETTER way of saying it:
You are in the early stages of LADA (latent autoimmune diabetes of adults). Over time, your pancreas will make less and less insulin. The disease progresses, and eventually you will probably need to be on some form of insulin therapy.
With all people - regardless of any diagnosis - diet and exercise are both very important to our well-being.
In the case of people with insulin-dependent diabetes, a healthy diet can help minimize blood sugar spikes. And exercise will help you maintain better insulin sensitivity - the ability of your body to utilize insulin. Exercise helps your body use insulin much better.
So eventually you will need to start using insulin regardless of diet and exercise. However, diet and exercise will definitely be helpful for you.
AMEN! Brother Eric! Preach it.
Thanks Everyone for your replies. I needed a reality check. The diet and exercise do help my body metabolize glucose. They also give me a sense of agency - not that I am ‘controlling’ my disease but that I can make a difference in a real tangible way against a disease that I have no control over. If that makes sense.
Thanks again!
I’ve been lurking here on your thread, @jpf but holding off on posting as I am what I call a stage 4 type 2. By that, I mean, the disease has progressed from good management with diet and exercise alone to being on an insulin pump and still using diet and exercise for good BG managment.
With type 1 LADA it is true that you will not ever have completely normalized BG levels using diet and exercise, but those are important pillars in upholding ones health. It is something that we can do that doesn’t come out of a pill bottle or syring.
I saw red 
when I read, * 2 of the endocrinologists I’ve seen have said, “Diet and exercise will not help you. You have Type 1 diabetes. Unlike Type 2, diet and exercise will not make a difference.” text*
I just can’t image any doctor, much less an endo saying such a thing. Eric gave a much better way of explaining it.
We have some intrepid athletes and daily exercisers in this group, both type 1 and 2. One thing, when you do finally start insulin, it can become challenging to figure out how to adjust food and insulin to keep BG in a reasonably safe range.
I would hope that you will be getting a CGM monitor, that is a real help in learning trends up and down form food and activity. But they will have to pry my glucose meter from my cold dead hands, before I give it up.
33 years ago when I was diagnosed as a type 2 because of sudden, extreme blurry vision, I had very good diabetic care from the health plan we had at that time. My wife and I attended several classes with certified diabetes educators, some one on one and other group. I am looking at a hand out from one of the group sessions, Titled “How To Play the Game of Life with Diabetes” This was for both type 1 and 2.
They used the analogy that it is a team sport with us as the captain of the team. This means we need to be really involved in our care.
The team members are the physicians which can be you PCP, ophthalmologist, endocrinologist,podiatrist. At some point urologist and cardiologist may be added. This is where I am with doctors currently. At the time I had really good support from the nurse diabetes educators. The dietitians (3) were not particularly helpful as they were on the ultra low fat fad at that time, and all 3 had an anorexic look. When it comes to food, it was self testing that taught me more than those dietitians.
The rest of the team are family members and community support - well you found that ins FU diabetes.
Always remember you are the captain of the team.
Finally Education, I see stories of people with diabetes never having sessions with CDE or that it was unsatisfactory. In my own region which has grown exponentially since I was diagnose there is a lack of CDEs. Regardless, self education is extremely important. Some books that should be on your shelf or Kindle:
RIchard Bernstein MD “Diabetes Solution” - While I don’t accept Dr. Bernstein’s ultra low carb diet, this book is a treasure of good information.
Gary Scheiner’s “Think Like A Pancreas”
John Wash et al “Using Insulin”
Sheri Colberg’s “The Athletes Guide to Diabetes”
In conclusion, Diabetes regardless of type, is more than a problem with insulin and glucose levels. It can affect every organ system of the body. Proper diet and regular exercise can maintain good cardiac health, even in those with type 1. Keep moving to delay rigor mortis, is my motto at 73.
I hope this is not too much. I am living a really good life. I feel good. I hope what I wrote has been helpful.
I think diet and exercise are very important for everyone. And for type 1s as well. Most t1s will find it is much easier to control their blood sugar with certain eating patterns (which will differ for different people.) And exercise is helpful for t1s in that it reduces (slightly) how much insulin you need, helps with elevated heart disease risk, and, assuming it involves some impact or weight, will help protect bone density. The latter doesn’t seem to be tied to blood sugar levels, so exercise is one of the few things you can do to keep your bones strong.
But once your insulin-producing cells are mostly dead, diet and exercise cannot make up for what your body needs: insulin. You are honeymooning so you probably don’t need injected insulin yet. But if you’re t1, you will, whether it’s months or years down the line. Over time, your blood sugar levels will worsen and no diet in the world will counter that. When that time comes you should not hesitate to start taking insulin.
For what it’s worth, low carb has never worked for my son. It makes his insulin resistance skyrocket, so he winds up using the same amount of insulin or more for fewer grams of carbs. And with rapid acting insulin, it’s much harder to control a spike that occurs 4 or 5 hours after the food was consumed.
So while diet matters, I don’t think being low carb is one-size-fits-all for T1s. I know it works for a lot of people, but I think it’s important to note that you can be well controlled on a high-carb diet as well.
I think the one thing that absolutely DOES help everyone, as far as diet is concerned, is eating with a fairly regularly pattern. Eating the same food or types of foods, and eating around the same time every day, for at least a little bit, is super helpful.
With type 2 diabetes at an early stage, sometimes losing weight (like 15% of body weight) and exercising can put the diabetes into full remission. And if lucky, this remission can last for years or decades.
But with type 1, there is an autoimmune attack that is destroying the body’s insulin-making ability. It is not possible to stop this attack by diet or exercise. I think that’s all the endos were trying to communicate.
Clearly, diet and exercise affect the insulin dosing for a type 1, and affect the general health and well-being of everyone.
Thanks for the continued replies Everyone! It’s so helpful to hear other people’s experiences - I get something from all of the stories. I plan to keep lovingly embracing my pancreas on our honeymoon until death do us part.
I think that a lot of us adult LADAs get a little obsessed with the idea that the perfect diet or lifestyle can extend our honeymoon and keep us off of insulin forever. Such as a low carb Bernstein Diet or a low fat diet like Mastering Diabetes. At least I did. Maybe your endo was referring to that notion and didn’t want you to waste your time and energy. Especially if he thinks you already living a healthy lifestyle.
Diet and exercise definitely matter to a T1D. Don’t let anyone tell you otherwise. I have been a T1D for the last 49 years with no complications. I ‘micromanage’ my BG levels and try to keep my BG levels in the range for a normal person but still have an A1C between 5.3 and 5.8.
I try to do anerobic and anaerobic every day. I also do multiple daily injections, no pump. I have a Dexcom CGM that is a very reliable device to keep from any highs or lows. I also have a standalone smartwatch that for the last 7 years has been my best tool for keeping my BG levels in the normal range.
If an endo told me that diet and exercise do not matter, I would very quickly get another endo.