Anyone who knows me will know that I love my food. I’ve come a long way from the fussy 10 year old whose favourite meal was chips, Bernard Matthew Turkey slices and salad (sorry this dragged on so long, Mum), but these days, trying new foods and new restaurants has become a bit of a hobby of mine – I dread to think how much of my student loan was invested in this ‘pastime’ …
But after taking a bit more care and interest over my diabetes in the last few months, this has recently become more of a ‘tough love’. After spending hours searching through blogs, forums and nutrition websites, scrolling through Instagram and even reading a few books, I’ve become quite ‘pro’ the idea of following a ‘low-carb’ diet. Note that this is not for weight reasons – I’ve never been one to mind too much if I have a bit of a tummy or not – but to help control my T1 diabetes.
The way I think about it – which is probably a collaboration of the explanations I’ve read and interpreted over the past few months – is that when you have type 1 diabetes, your body just doesn’t ‘do’ carbs. Just like those suffering from a nut allergy, or gluten intolerance – when we put carbohydrates into our body, it can’t really deal with them. Because we no longer produce insulin, without physically injecting or pumping it into our body, we don’t have the ‘key’ (as my paediatric diabetic nurse used to describe it to me as) to allow that carbohydrate to be taken up into our cells and used for energy. So instead, it just chills in our bloodstream, making us feel groggy and tired, and definitely not energised.
Anyway – of course – the reason that we’re all still here is that we do inject/pump insulin into ourselves. Every day. Loads, really. Which is great – because when I do want a McDonald’s, an almond Magnum, or half/all of a sharing bag of Tangy Cheese Doritos, I can simple count the carbs, jab in some Novorapid, and enjoy.
And I do. Don’t get me wrong – I believe T1 diabetics should be able to eat whatever they want – heck, I just spent a fortnight in Italy, and there was no way I wasn’t eating pasta, pizza or gelato. I ate SO MANY CARBS. But, what I (and many others) have started to twig is that actually – as great as carb-counting and injecting is – it’s just not the same as the result from a ‘proper pancreas’ (i.e. one that works). Basically – if I were to eat 50g carbs and inject 5 units of Novorapid to cover this at exactly the same time – the carbs would win the race. The sugars in carbohydrate will reach my blood stream quicker than my insulin would be able to counteract this – and yep, you guessed it – this leads to blood sugar spikes.
The spikes could be small – you may be lucky and carb-count PERFECTLY to suit your body that day – but as all T1’s know, however carefully you count and inject for your carb intake, our bodies just do not do the same thing every day. Everything and anything affects our blood sugars – hormones, exercise, time of the day, time of the month, sleep, carbs, mood, – and I’ve pretty much come to the conclusion now that ‘T1 has no rules’. This was confirmed recently when I split my (amazing) Domino’s pizza in half and bolused 6 units for the first half and ended up with BS’s in the 6 mmol/L’s – perfect – yet when doing the same for the second half the next day, ended up with BS’s in the 15’s. Which, if you’re wondering, was reaaaaaly, really annoying.
So low-carb. Does it work? In essence – yes. These pictures below are my blood sugars over the last 2 days. I’ve eaten things like soup, omelettes, ‘slim’ pasta (pasta that’s not actually pasta at all but has no carbs so win) and a roast dinner with just a couple of teeny potatoes (couldn’t resist), whilst snacking on cheese, walnuts and salami in between.
I think the graphs speak for themselves. I’ve still been injecting 34 units of Lantus as normal, and giving myself a few units of Novorapid for the few carbs I have been eating – but the reason I think that this lower-carb focus works is, in the words of Dr. Bernstein, due to the ‘law of small numbers – big inputs make big mistakes; small inputs make small mistakes‘ e.g. if I carb-count/guess incorrectly, but it’s only over an intake of say 5-20g carbs – the likelihood is that yes, my blood sugar may spike – but it won’t spike loads – as whether or not I’ve given myself the right amount of insulin, it won’t matter toooo much, as I’m not taking in a lot of carbohydrate anyway.
Flip that to if I’m carb-guessing for much larger amounts – say 50-80g of carb. Suddenly, due to me eating a lottttta carbs, this error could leave my blood sugars soaring real real high – or even very low, if I’ve overestimated my insulin. In short – the more carbs we play with, the more sugar our insulin had to ‘chase’ and try and deal with – and the more room for error.
So in a nutshell, that’s why I’m starting to shift my diet towards a low-carb one. Many diabetics take this one step further and move their body towards a state of ‘nutritional ketosis’, where (I think – if I’m honest, I don’t 100% understand this yet…) you limit your carbohydrate intake so much that your body instead starts to burn fats, as opposed to carbohydrates, as its primary energy source. There’s a lot of interesting stuff out there on how beneficial this can be for T1 diabetics if done properly, and I’ve seen some amazing results from it (T1 diabetics achieving HbA1c’s of 4-5%, for example). However, I’m not looking to do that right now – because honestly, it’s not a lifestyle change I’m ready to commit to (to remain in ketosis, you need to stick to it – no cheat days, no one-off chocolate brownie etc etc.). I would call myself a more ‘5:2’ low-carber (or maybe even 6:1 on a good week) – I stick to it pretty well during in the week, but if I want to have dessert with my meal or a cider or 2 on the weekend, I do, and I inject accordingly.
So there we have it. The start of my journey to a life with more dark chocolate, courgetti and Babybels, and less milk chocolate, cereal bars and chicken chow mein (cry). Whether or not I can keep this up for good, I don’t know yet – but I’m going to give it a good go, as believe me – graphs like the ones in the pictures above were pretty few and far between before I watched the carbs.