Rethinking Diabetes: Lower Carb Diets in Type 1 Diabetes

Rethinking Diabetes: Lower Carb Diets in Type 1 Diabetes

Rethinking Diabetes: Lower Carb Diets in Type 1 Diabetes

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Why I Follow the Medical Medium Way of Eating

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Video Transcript

I have over 25 years experience working with people with type 1 diabetes for many years people with type 1 diabetes have been advised to have a high carbohydrate diet and they have been told that they can eat whatever they like as long as they eject the correct amount of insulin for their meals now while this might be true in theory it requires that the injected insulin gets into the blood at exactly the right time and at the right rate and in the right amount to deal with the glucose that’s coming from the guts in practice that very often just does not happen and the result is that blood glucose level could go too high or too low or very often both as a result and so for many years now i have explained to my patients that if this is a problem that they experience then one option is actively to reduce the carbohydrate in their meals as a means of improving their blood glucose control in many this leads to less hypoglycemia less variation in glucose levels significantly less insulin requirement and very often they also lose weight but don’t just take my word for it listen to the experiences of the following people with type 1 diabetes who have done just that hi my name’s jim evans and i’ve been a type 1 diabetic for nearly 20 years now and despite living a healthy lifestyle for that time i’ve never felt better than on a low carb diet and that’s reflected across various figures i’ve been eating low carb now for six weeks my hba1c has come down from 60 millimoles to 52 millimoles already in that time i’ve lost 10 kilograms reasonably in weight to just above 80 kilograms and importantly without the feeling of hunger remarkably my basal insulin has dropped from 46 units across two injections to just six units in the morning and no more than about five units of total bolus across the day my body feels less sore and i need less recovery time say after a run i feel fantastic on this way of eating and i just want to carry on having seen those results i was lucky enough to find some good support and i’d like to see others getting similar support as well um you know i have days now where i am a hundred percent in a normal blood glucose range uh and to be honest i’ve never known that before long may it last hello my name is emma porter 16 years ago i was diagnosed with type 1 diabetes with a blood sugar of 56 millimoles and i was 17 years old at the time i was seen by a dietitian and i also did a carb counting course i was told that in order to achieve good blood glucose control that i should be eating a higher carbohydrate diet which was low in fat i was told that because i had insulin i could eat whatever i wanted whenever i wanted which is what i did for about eight years i never had an hva1c below eight i never saw blood sugars really in the in the fours or the fives a hypo for me felt like an eight i never had energy i never had much mental clarity i was always tired i was really really overweight and i didn’t have periods i felt like i had no control of my diabetes and yet i questioned why because i was following the advice i was carb counting and yet i was still seeing these crazily high numbers i just thought that was what what it what it was and what i should be living with then in 2013 i suddenly stumbled across the lower carb lifestyle and when i say lower carb i want to say lower carb because people get confused and believe that the low carb lifestyle is no carbs i still eat carbohydrates i just eat them in the form of vegetables and things even things like eggs have a tiny bit of carbohydrates in them so i now eat a really really delicious and very diet i really love the food that i eat and my hba1c is always in the fours i have periods which is something i never had before and i was able to conceive two little girls naturally which was something i would told would never happen i now eat a delicious nutritious varied diet and i have so much more energy even with the sleep deprivation of having children and i really wish that the advice was given and to people when they were newly diagnosed with type 1 diabetes to try a lower carb lifestyle or at least give people the choice because if i’d had the choice back then i probably would have tried it and seen for myself the benefits without waiting all these years the problem for me was that by the time i’d found the lower carb lifestyle i had background retinopathy and that was terrifying the idea of potentially losing my sight but now eight years on i have finally um got the all clear of any background retinopathy and i’m certain that that is because for years and years and years now i’ve achieved a really tight time and range target with my blood sugars so thank you bye my name is john furness i’ve had type 1 diabetes for nearly 9 years i wish so much that i’ve been given the patient choice of opting for a low carbohydrate dietary approach to managing my type 1 diabetes rather than having to find that out myself um after i’d been diagnosed i did reduce my carbs and my insulin insulin use started off quite low i’ll show you my data here this is diagnosis and you can see insulin rising and what was going on here was my carbohydrate was creeping up and my average blood sugar was also creeping up i could see the writing on the wall which was heading for double diabetes type 1 plus type 2 which i really didn’t want and all the complications that come along with with with diabetes um dr bernstein has the law of small numbers and that is lower carbohydrates require lower insulin requires lower corrections and less overshooting and undershooting for me type 1 diabetes has always been a very stressful condition to manage and if you can reduce that stress by making your journey easier that’s a hell of a benefit you can see that the variation in blood glucose reduced dramatically as well as the average reduced dramatically when i introduced a ketogenic dietary approach that’s less than 50 grams a day so both of those things have a massive benefit to my diabetes management the other things that changed for me i lost a lot of weight 15 kilos my eczema disappeared overnight less need to brush my teeth and clean my skin um i don’t get any food cravings anymore i haven’t had a cough cold or a sneeze in in two years um and i basically developed a new target in life and that’s to drop dead at 90 fit as a fiddle and sharp as a razor free from all the diabetic complications and vascular diseases and etc thank you hi my name is ian lake uh i’ve had type 1 diabetes for 26 years for the first 20 years i managed it with a usual care that is high volumes of carbohydrates with each meal chasing that with insulin which didn’t serve me very well at all so i adopted a keto lifestyle six years ago which transformed my life i met somebody a couple of weeks ago who had had type one diabetes for eight years they were highly educated and said that they had a top diabetes management team so they were quite concerned when two months ago they accidentally bumped into keto on the internet adopted the lifestyle and it transformed their life too the obvious question was well why wasn’t i given this information earlier well i couldn’t answer that either i think it is incumbent upon all of us healthcare professionals working in diabetes to provide information that is measured to patients so that they can make their own minds up and we can support them safely through it a ketogenic lifestyle reduces the volumes of insulin required increases day-to-day insulin safety reduces hypos by up to a factor of five and enables a reduction in hba1c to near normal levels in fact ninety percent of patients achieve an hpa1c of 48 millimoles per mole on ketogenic lifestyle care compared with just fewer than 10 on standard usual care this difference is so great that it is it is surprising that no one in the diabetes field with influence has picked this up and i hope that in the very short term the situation will change and we’ll be able to give out people with taiwan opportunities to transform their lives in the way that has been the case for myself thank you hello i’m dr david unwin a gp from just north of liverpool and i want to tell you about low carb and type 1 diabetes we’ve been offering this as a choice for the last few years and i’ve been amazed how few problems we’ve had i think the thing is people with type 1 diabetes really understand blood sugar control and diet and in fact they’re used to upping and downing their insulin dosage over the years the advantages that i’ve noticed are far fewer hypos and hypos are less serious from a practice point of view on average these people are using 50 to 70 percent less insulin every day so we’re making uh significant savings but really the greatest advantage is how these people feel about their type 1 diabetes they’re so much less frightened they’re very very grateful it’s so worth helping our patients with type one have a go with low carb thank you hello my name is sarah chapman and my son oliver was diagnosed with type 1 diabetes 15 years ago at the age of four when oliver was diagnosed the dietary advice we received was biased towards the use of a moderate to high carbohydrate low-fat diet he could eat whatever he wanted as long as he bollished the corresponding insulin in the early years oliver’s control was excellent with an hva1c of around six percent however as a very active and very tall 17 year old at six foot five his carbohydrate and insulin demand was huge control became very challenging and he started to suffer with physical symptoms such as weight gain background retinopathy gastroparesis and painful joints at no stage was it suggested that we could resolve these issues by reducing the carbohydrate and in fact when it became clear that he was insulin resistant he was actually off of metformin we started to research how we could help him when we came across the low carb and high healthy fat approach i immediately adapted everything we were eating to low carbohydrate and the results were almost immediate in terms of his vastly improved blood sugar and timing range of 90 percent compared to 20 previously his physical symptoms completely resolved within a matter of weeks our experience and all of the supporting data demonstrate the huge benefits that can be gained as a type 1 diabetic following a low carbohydrate diet it is my view that anyone being diagnosed with type 1 diabetes should be advised as to the considerable benef considerable benefits and those that choose to follow this method should be actively encouraged and supported by their diabetes teams thank you my name is elizabeth and i have a 10 year old daughter with type 1 diabetes she was diagnosed two and a half years ago and we initially followed the standard medical advice to eat what you want and dose for it which inevitably led to blood sugars that resembled a roller coaster anxiety around meal times and frequent miscalculation of insulin doses i started to do my own research online and came across a book chapter called the law of small numbers which was from dr bernstein’s the diabetes solution it made so much sense to me that i ordered the book immediately and joined a facebook group for parents of recently diagnosed children that was set up by people who followed this approach and wanted to share it with others we took quite some time to fully adopt the low carb way of eating starting with breakfast and then snacks i then negotiated a month’s trial with my daughter of fully low carb eating after that and we haven’t looked back transitioning the whole family to this way of eating during this time we’ve had no support from our hospital team for this way of managing her diabetes although we have had recognition from them that she was indeed receiving enough nutrition and that she is growing appropriately i have asked for a slower insulin to deal with the protein rise explaining why we need it but they’ve refused me point blank the improvements that we have seen from following a low-carb way of eating have been slower hypos that usually only require half a glucose tab to treat sometimes a whole tab smaller insulin doses and therefore smaller errors in dosing decisions far less anxiety about meal times and the ticking insulin time bomb that is inevitable when you try to pre-bolus appropriately for a fast carb high carb meal we now only ever have to pre-boil us for breakfast the thing i haven’t mentioned yet is the elephant in the room when it comes to pediatric diabetes consultations no one ever talks about the long-term complications that come with running higher than normal blood sugars it’s my firm belief that diabetes management should be aimed at maintaining blood sugars as close to normal as possible and that parents should be given the option to choose a low-carb way of eating and educated about proper insulin dosing for it including the use of slower insulins at the point of diagnosis my daughter was diagnosed with type 1 diabetes 5 years ago at the age of 10. at the time we were advised to keep eating a healthy balanced diet things changed when my daughter started using a cgm i remember her eating a tiny piece of birthday cake and watching the cgmro shoot up and that was when i began thinking that the advice i had been given just did not make sense when my daughter was diagnosed i was given a sheet detailing target hba1c this said to stay fit and healthy for as long as possible the targets you are aiming for is 53 to 58 millimoles i felt uncomfortable with the for longest possible part of that sentence and a quick google told me that the average hba1c for a girl of my daughter’s age was 30 to 31 millimoles i was horrified why was it okay for my child to have an hba1c that was not normal and my next question was could it be normal and more research gave me a resounding yes well i discovered that others were maintaining excellent hba1cs with a low-carb approach we changed and we have never looked back since her diagnosis my daughter’s hba1c has never been above 48 millimoles for the past three years it has been below 42 millimoles and over the past year it has been 37 millimoles the dietary changes have been easy to incorporate and my daughter has grown she’s five foot six and a healthy weight perhaps most importantly she’s been able to live her life without diabetes taking center stage her blood sugars are steady and she’s able to get on with her day without constantly dealing with highs and crushing lows low carb beating with a couple of low gi editions works for us and i really hope that soon everyone will be told about this option at [Music] diagnosis [Music] you

 

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