New study on managing T1D in kids and adults with a very low-carb diet

My son eats 120-150 carbs a day, most days. We consider this low carb, but certainly not Bernstein level of low. I have no worries, he is still growing and for baseball he has plenty of carbs to perform. We eat this level of carbs, because we test, and more carbs results in less control. It is really that simple.

We know through testing that my son is far more carb sensitive than other people. We don’t really question this too much, it just is, and we have arrived at what works for us.

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i used to be on a low carb/ high protein/ high fat diet. then i got the D Gastroparises and the high fat just made me sicker. i switched to low fat /higher (not high high) carb when i began swimming and have found that i am easily able to modify my insulin regiment and my ICRs to suit the new needs. also, just another plug for higher carbs and LESS fat: i dont get as symptomatic with the GP anymore. (and i am pretty certain that the exercsie has had something to do with that as well).

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I would agree.

I’ve actually historically steered away from reading Bernstein’s suggestions and work and generally only hear about them here at FUD. So the numbers thing doesn’t really click with me. I think we are more like @Chris’s son - lots of carbs (especially when exercising isn’t happening regularly) is harder to manage. So we eat fewer carbs generally.

You didn’t come across as specifically anti-carb in this thread either. :slight_smile:

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I also think many people automatically think of Dr. Bernstein when they think low-carb, which is unfortunate. He has very specific recommendations that go beyond just eating low-carb. There are lots of people who follow a low-carb diet (myself included) without following Dr. Bernstein’s recommendations.

From what I understand, the people in this study, though, were following the Bernstein diet as much as possible, right? I think that’s why it came up.

This study was, yes, But I’m referring more general to discussions of low-carb eating and how divisive some of the discussions can get.

The good news is that I don’t feel any of our discussions here on FUD have become divisive. Only different people expressing their own personal opinions (from their own due diligence and research) about low -vs- high carb diets. That’s what’s wonderful about being individuals…we can all choose what works for us!

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Yup, I agree. :slight_smile:

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Interesting discussion, I have very recently lowered my carb intake to between 60 and 100g per day, not a big issue from a preparation perspective as we usually prep all our own food and eat a pretty healthy diet that doesn’t make it hard to ditch some of the carbs.

Why did I do it? It makes my life a huge amount more pleasant, or has so far. On paper, my HbA1C was pretty good (40-44) and all my blood markers were excellent. I was a sugar surfer and kept a close eye on things (I weighed most of the food I ate), I documented, tested, experimented, documented and so on, I tested different doses of insulin on a stable BG, tested the response of carbs at different times and starting points. One of the key points for me was that with higher carbs and higher insulin doses, there were just too many sources of error and too many unpredictable reactions, although I could catch and prevent most extremes, it was still very frustrating at times. I also have inflammatory bowel disease which was quite unpleasant and funnily I couldn’t eat much fat without symptoms, overall IBS also complicated everything. Steered quite a bit by Michael Mosleys clever guts diet, I have played around with various diet changes, with one of the key positive changes for me being low carb, funnily I can now eat fat again and I don’t have constant stomach pain which is a bonus.

Where am I now? Still in the early stages of this, but as long as my insulin doses are < 2 units my life is much nicer. I don’t have quick swings and my BG is usually around 5.5 mmol, I’m a lot more comfortable running it lower, even when I exercise it doesn’t plummet like it used to on occasion. Interestingly as the weeks pass, I’m also needing a lot less carbs during exercise and not having issues post exercise either. I exercise most days, running, mountain biking (usually 60-120 minutes and a fair bit of ascent), weights etc. I will see how it goes and keep an eye on my blood markers. My bodies response to insulin and carbs has been quite variable in the past, so it is still early days.

Re the last point on blood markers, there are now quite a few intelligent, rigorous medics and researchers supporting lower carbohydrate diets from a cardiovascular health perspective, follow Dr Aseem Malhotra on twitter if you want to see lots of vigorous disagreement about this topic with both the for and against groups. There are a number of expert groups formed now in the UK supporting lower carbohydrate (“lower” being a key point?). There have been various articles in the last 18 months in the British Journal of Sports Medicine and similar on this topic and there should be a Cochrane review on its way in the very near future.

I am currently leafing through Dr Bernsteins book, and although he makes some interesting points generally, I couldn’t be described as a fan of his overall attitude and approach.

A final thought, I don’t think I’ve ever enjoyed food so much :smile: when we talk about unlimited, I just want to live the best life I can and be healthy, happy and wise (or least listen to wise people :joy:)

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It is interesting that you are experimenting so much, and have landed around the same amount that many of us have, i.e. 80-120 carbs a day. It really seems that this diet is nice because it isn’t too restrictive and is healthy in that you are avoiding most of the processed grain products which have dubious health benefits anyway.

Having eaten less carbs myself for weight loss, going to less than 30 carbs a day is really restrictive, albeit with some interesting side effects.

I am curious about why the fat treats you differently based on your carb intake. Must have something to do with the digestion pathway being used.

Dr Mosley and several researchers would say it is more to do with our microbiome and how the food we eat changes that which then affects inflammation… his book is an interesting read and points to some interesting studies and researchers. :smiley:

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This is usually where I live too and I have seen similar benefits to your description. That is less varibaility in BGs and less random BG behavior.

The only time I really go about 100g of carb a day is when I am fueling exercise or on the odd day I want to “pig out”.

I tried the “full Bernstien” for a while (a couple of months) to see how it worked. That was levemir/humlog (ok I did not use R) MDI and his food/carb recommendations. I managed to loose weight rather quickly (which I was trying to) and it did help with my BG control, but I could never quite get this magical flatline thing that others where getting.

Then I switched to an insulin pump, and raised my carbs to 60-100g a day and I was able to get a pretty flat-line. I have very different basal needs throughout the day, so I found that levemir was not the best solution for me.

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A link to an open access paper on this topic that some of you might find interesting:

http://bjsm.bmj.com/content/51/2/133

I also like using the term lower carb, compared to low carb. Seems to result in less controversy, and better describes my diet.

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I think diabetes can be looked at quite personally and in many cases pragmatically, it doesn’t matter what your dietary approach is, as long as it works for you (add, in the short AND long term?). Personally, lower carb has given me more freedom, probably one of the best benefits for me. Randomly doing exercise didn’t work brilliantly for me in the past, it took lots more planning and lots more adding carbs. Above is a fairly typical trace, pre lunch to after dinner. Added to that, I got out on my bike for a short ride and did a weights session, neither of which were planned and neither of which needed extra carbs or reduced insulin, I couldn’t have managed that kind of trace with just Sugar Surfing. It will be interesting to see if I can keep these profiles going, I still get some odd little dips but every day is a learning day:)

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