Low-Carbohydrate Diet for Type 1 Diabetes

Low-Carbohydrate Diet for Type 1 Diabetes

Disclaimer: The information contained in this blog is for information purposes only and should not be considered to be professional medical advice. I have formal medical training but I am not a doctor and information found here is not a substitute for consultation with your physician.

What is the Purpose of this Forum?

The purpose of this forum is to educate, and be educated by, Type 1 diabetics on the use of a low-carbohydrate approach to treatment. We do not diagnose or treat diabetes on this site. We do open up a dialogue and share experiences, ideas, lab results, etc. so that we can better understand the benefits of a low-carbohydrate diet approach to Type 1 diabetes.

My experience with Diabetes

When I found out at age 44 that I had Type 1 diabetes I felt a sense of panic. How would I effectively manage a disease that has so many complications and implications? I was fortunate that my husband worked for an educational institution that was affiliated with a prestigious diabetes center where I sought treatment. However, even with the best care I found myself questioning why it was safe to eat a diet with over 100 carbohydrates a day, if carbohydrates raise blood sugar in the first place. My reasoning was this: the more carbohydrates you ingest, the more insulin you need. The more insulin you need, the more chance of error in medication and incidence of low blood sugar episodes (hypoglycemia).  The higher your blood sugars, the more complications in the short and long term.

Why carbohydrates affect blood sugar

When you eat carbohydrates, either simple or complex, your body breaks them down into sugars, which are absorbed into the bloodstream. The blood sugar level rises, and in response, your pancreas releases a hormone called insulin. Insulin helps take the sugar from the blood and put it into the cells, where it can be used as energy to fuel your body. In Type 1 Diabetes, the pancreas no longer can produce insulin and we become reliant on insulin medication for life.

Recommended Carbohydrate Intake Rates

I have found myself dissatisfied by the lack of information on low-carbohydrate diet options for treatment of diabetes. We hear about dietary restriction of carbohydrates for people with Type 2 diabetes, but we rarely hear about how we can adjust our diet to effectively help in the treatment of Type 1 diabetes.

The following link discusses daily carbohydrate intake recommendations of the American Diabetes Association and a comparison of blood sugar response compared to a low carbohydrate diet:

http://www.healthy-eating-politics.com/american-diabetes-association.html

The Low-Carbohydrate Approach

Diet alone cannot cure Type 1 diabetes and daily insulin demands are affected by a variety of factors. However, common sense tells us that the amount of insulin needed to control our blood sugar should be greatly reduced when we lower our intake of carbohydrates. When I tried a low carbohydrate diet, I found that it greatly lowered my demand for insulin injections. I limit my dietary intake of carbohydrates to about 30 saccharide units (‘carbohydrates’) a day. I also try to limit the type of carbohydrates I ingest in a manner recommended in the book “The Diabetes Solution”, written by Dr. Richard Bernstein. He is a Type 1 diabetic and also an endocrinologist. He discovered through trial and error over several decades that with low carbohydrate ingestion (limited to approximately 30 carbohydrates a day), and a regimen of insulin and exercise, he is able to maintain a Hemoglobin A1c (average blood sugar over a 3 month period) in the non diabetic range while also keeping his cholesterol, liver profile and kidney function in a safe, non-diabetic range. If you want to learn more about Dr. Richard Bernstein’s approach, the following link will help you get started:

http://lowcarbdiets.about.com/od/bernsteinsdiabetesdiet/a/howtostarttips.htm

 Safety of the Low-Carbohydrate Diet

When you lower your intake of carbohydrates to 30 carbohydrates or less you begin to burn fat for energy. This is called ketogenesis. I live in a sustained state of ketogenesis. A diet that is very high in protein and fat is generally believed to cause elevated cholesterol. If so, if we eat a diet that is a low in carbohydrates and high in fat and protein, aren’t we just trading one problem for another? As a Type 1 diabetic, I worried about this. I monitored my cholesterol and lipid profile closely and I have found the opposite to be true. A diet high in fat and protein has actually improved my blood cholesterol. My HDL ( "good" cholesterol) is high and my LDL ( "bad" cholesterol) is in a safe range. In addition, my triglycerides and total cholesterol are also in a safe range.

 I have added a link below to a study of the safety of low-carbohydrate diet.

http://www.hopkinschildrens.org/high-fat-ketogenic-diet-to-control-seizures-is-safe-over-long-term.aspx

 This study is explores the safety of a ketogenic diet in children with uncontrolled seizures (a sensitive population).  The research shows that the diet is safe for these children. You should consult your endocrinologist before you begin a dietary change. You may also wish to have baseline laboratory blood testing done before you begin.

Kidney disease is a cause for concern for people with Type 1 Diabetes. A high protein diet may put extra strain on the filtering abilities of the kidneys and kidney function should also be monitored when using this approach. Here is a link to a study on the positive effects of a low-carbohydrate and high protein diet on kidney health in Type 1 diabetes:

http://www.newsmaxhealth.com/health_stories/ketogenic_diet_diabetes/2011/04/21/385751.html

The research suggests that low-carbohydrate intake may actually reverse symptoms associated with kidney disease in Type 1 Diabetics. While further studies need to be done, this research is promising. I have found, thus far, that my kidney function has remained within a normal range on the low carbohydrate, high protein diet.  

The Benefits of a Low-Carbohydrate Diet

I have adopted a low-carbohydrate diet and have had success for over 2 1/2 years now. My hemoglobin A1c ranges between 4.6 and 5.5 and I feel healthy and generally have a lot of energy.  

For me, a low-carbohydrate lifestyle meant a radical change in the way that I thought about food in my life. We are culturally trained that food should be available in great abundance as well as variety. It was difficult to reduce my carbohydrate intake by 80-90%. However, I learned that I had to change my lifestyle to achieve a low-carbohydrate diet and cope with diabetes, but that I didn’t have to completely eliminate my dietary pleasures or variety. Make no mistake, it is life changing to implement a low-carbohydrate lifestyle. But I also found it to be incredibly empowering to gain control over my blood sugar and my health.

I hope that you find this information useful and I hope that it can help you change the progression of your Type 1 Diabetes, like it has for me. I welcome you to share your experiences with me and other readers of this forum. Together, let’s improve our health.