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Can a Low Carbohydrate Approach to Type 1 Diabetes Management Be Successful?

Over on the on the TuDiabetes T1 and LADA forum, Jessica Strickland, a woman with Type 1 diabetes, posted a question about low-carbohydrates diets

I’ve been looking at Diets lately. And I’ve came across Low Carb High Fat Diet (LCHF) and noticed that a lot of people have had success with this way of eating. Have any of you Type One Diabetics ever tried it and had success? And was your Endocrinologist on board with it?

Thanks in advance, for your advice! Jessica Strickland

This sort of question tends to engender heated debate and hurt feelings when ever the topic comes up. I wanted to post a response that was both informative and without emotion. I wanted to make sure that my answer did not cause any hurt feeling that their choices about how they manage diabetes was wrong. Here’s the text of my answer.

My endocrinologist has always been onboard with reducing carbohydrates in my diet. She has no particular recommendation on diet — paleo, low-carb, south beach etc. Together we define success or failure based on the numbers — are my A1C, triglyceride, cholesterol, frequency of hypo/hyper glycemic episodes within the normal range?

We don’t discuss the emotional side of diabetes. We don’t talk about whether I like eating only one slice of pizza or never eating cake or ice-cream. We don’t discuss what I’ve given up to help manage my diabetes long-term. From both our perspectives trying to eat like normal people is irrelevant. It’s a recipe for depression to focus on what has been lost instead of focusing on what is possible. I spoke with a friend who is a clinical social worker and he helped me put “D” into perspective when I was at a low-point.

Whether or not your diet is low-carb or not is relative. There is no one definition.

According to Institute of Medicine, the organization that sets the recommended daily intake of nutrients, adults and children over the age of 1 should eat 130 grams of carbs a day. ~ WebMD

Here’s one very specific definition from a 2008 study.

Low-carb ketogenic diet (LCKD): less than 50g carbs and 10% calories daily of a 2000kcal diet
Low-carb diet (LCD): 50-130g carbs daily and between 10-26% of calories of a 2000kcal diet
Moderate-carb diet (MCD): 130-225g carbs daily and between 26-45% of calories of a 2000kcal diet ~ Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndromel

My current average daily carbohydrate intake is about 100g. My most recent A1C was 6.2 and has been as low as 5.5 (back when I tried eating about 70g carb per day and actually exercised).

Some people need more daily calories than others. A 165 cm man who sits in front of a computer most of his day needs a lot fewer calories than a 165 cm man who hikes/jogs/runs everyday. My advice is to reduce your carbohydrates and eat more fat and protein but design your own diet. Call it the @Jessica_Strickland88 diet. If your diet helps you meet your diabetes management goal — whatever they are — then continue. If not, then adjust as needed.

As stated above, my diabetes management goal is simple. Do what I must in the present to reduce the risk of complications in the future. It’s long-term versus short-term thinking. It’s similar to retirement planning — look at the numbers, adjust, leave out the emotion.

I won’t get into arguments about whether low-carb is can be done or not etc. There are many sources of credible information on this topic. Do your own research, make your own decision, and live with the consequences1 of your decisions.

You may have to decide for yourself how low you want to go, depending on your meter readings and how you feel. ~ Low-Carb Diabetes: What You Need to Know

  1. The word consequence means: the effect, result, or outcome of something occurring earlier: Consequence is not a bad word. It’s just often used in that context. The consequence of me going to graduate school is that I have skill that I allow me to sometimes negotiate a higher income. The consequence of me eating a slice of cake at dinner is a sleepless night spent fighting hyperglycemia. ?