Thursday, February 28, 2019

Low Carb for Type 1? Not Me!!

I have read that many type 1 people eat very healthy, low carb meals. That certainly helps with the control of blood sugar levels, but I do not find that to be necessary. For so many years, starting in 1945 when I was diagnosed, I ate anything I wanted as long as it did not contain sugar. My portions could be as large as I wanted. Not eating sugar was the only limitation made by my doctor. My typical day saw me eat hundreds of carbs, many of which were very fast acting. That was poor diabetes management, but my parents and I did not know any better. I lived on a farm, and there was a lot of exercise. My doctors knew very little about diabetes back then. I was very fortunate that my diet did not cause any diabetes complications.
In 1988 I read an article in a magazine that mentioned carbohydrates. I saw that carbs were very much involved with blood sugar management.That was the first time I had that knowledge. I was still using injections with animal insulin, so knowing about carbs did not help me very much. I did, however, start eating smaller portions of food that had fast acting carbs.
In the mid 1990s Humalog was introduced. That was my first fast acting insulin. I started carb counting. Trial and error showed that I needed one unit of insulin for every 10 carbs I ate. Before breakfast my carb sensitivity was greater, and I needed 1 unit of insulin for every 7 carbs, but only for that meal. Carb counting, and eating only small portions of carbs with fast acting foods greatly improved my blood sugar control. My A1c's began dropping, as you can see in the graph below.
I began using a pump in 2007. Programming my insulin:carb ratios, and my variable basal rates at different times of the day on the pump gave me so much improvement in my control. Fluctuations did occur because of scar tissue, and occasionally forgetting to bolus at the right time, but my management was very good. I started using a Dexcom CGM in 2015. I have set my CGM to alarm when my BG reaches a high of 170, or a low of 70. That has resulted in my staying in my 70-170 range 90% of the time.
At the present time I eat an average of 130-140 carbs per day, and my A1c's have been in the 5.4-6.4 range for more than 20 years. Here is a typical day in my current schedule:
8:30 AM....A slice of toasted bread (9 carbs), a slice of ham, berries (16), one egg, and coffee.....total....25 carbs
12:00 noon....A medium size baked potato (30), a pork chop....total....30 carbs
2:00 PM....Before going to the gym for a one hour workout....one half cup of ice cream with sugar...(25)...only a 1.5 unit bolus since I was going to get a lot of exercise
5:00 PM....Five corn chips with salsa, and coffee (10)
7:00 PM....Pastrami sandwich with mayonnaise, slice of cheese, and slice of tomato... only one slice of bread, 9 carbs per slice...(12)....cottage cheese (6)....strawberries (10).....total....28 carbs
10:00 PM....My BG was 79 so I needed a small snack....peanut butter and crackers (12)
TOTAL for the day....130 carbs
I never eat anything with sugar (table sugar) unless I am going to get exercise afterwards, or I have a low. I carry a small ziplock bag of skittles with me when I am away from home.
Note: My meals vary a lot, but the carb counts and the times that I eat are very stable. I do like a lot in my food choices so no two days are the same. As long as my diabetes management is stable, I see nothing wrong with that. My A1c is good, and I am not overweight. My BMI is 23.6.
I like variety in food, TV programs, movies, activities,
exercises, and most all things......but not women. My wife is
wonderful and I do not need variety there. ;)

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