Friday, January 31, 2020

Why I Understand Low-Carb Proponents for Type 1 Diabetes

Originally published January 2017

Some people are very strong supporters of a low-carb diet for people with type 1 diabetes (or any diabetes). Historically, this group of people has not been well-received by many with type 1 diabetes or those who have children with type 1 diabetes because of the way that insulin can be utilized to not deny a person certain foods and the joy they bring.
I can sympathize greatly with the idea that we all deserve a treat from time to time and I can understand why some want to eat what they want and just learn to manage with their insulin timing and dose. I can certainly see why raising a child with type 1 diabetes and having them never eat sugar or many carbs can seem like a daunting and almost cruel route.
I’ve long made the case for reducing carbohydrates on a personalized level. For example, I do believe that some people cannot feel well or thrive on an extremely low carb or ketogenic diet (I can’t) so it makes sense to take symptoms in consideration. I do think that facts indicate how reducing carbs increases the chances for more stable blood sugar levels but, there are different degrees one can take when it comes to carb intake. I’m not extremely low carb but I have a low enough carb intake that my blood sugar management is pretty good, my triglycerides are very low, and I avoid extreme highs and lows on a consistent basis.
The “I can eat that” movement of the past decade has seemingly fizzled out. Or maybe I’m not reading as many diabetes blogs as I used to. Either way, I can’t help but wonder if people have endured experiences like the ones I have which bring me to the conclusion that “yes, I can eat that, but I will likely suffer the consequences of doing so, so in a way, no I can’t eat that”.
Early on, during the first decade or so with type 1 diabetes, these consequences seem acceptable to many of us. The future is far away. As someone who has now lived with type 1 diabetes for over 22 years, I see things differently.
After 20 years with type 1 diabetes, there is a much higher likelihood for a great number of horrible complications. These are ominous when you aren’t experiencing them but when you are…well let’s just say that it is an entirely different story. There is a pain on top of the pain of those complications and it involves the question “What if?” “What if I could have avoided this?” “What if I had just managed to have better blood sugar management during those first 10 years?” “What if I had just ate fewer carbs?” Those questions are brutal. I endure them on a regular basis. I sometimes wish I could relive my childhood and rip all those carbs out of my hands.
So because of those questions and the pain associated with them, I feel that it is a good idea to share with others what I wish I could have done differently so that they may be better armed to avoid the complications I’m getting a taste of now. Everyone should do what they think is right for them, of course but, I didn’t even have a chance growing up because no one said “low carb eating can help you avoid dramatic blood sugar swings” and my healthcare team encouraged eating pasta, oatmeal, and cereals-all the things I avoid like the plague nowadays. (The other negative side effect is I’m now working really hard to learn to trust doctors again.)
I respect any diet a person chooses if it works for them. I totally understand not having the level of willpower required to deny pizza or ice cream on occasion (I haven’t got it). Most people with type 1 have an A1c that is too high, though. I’ve had an A1c between 5- 6% for the last 11 years and stuff is starting to happen. And some of this can’t be alleviated much or fixed with any medication or treatment. I’m only 33 years old. Not everyone is as sensitive as me but we don’t find out until it is too late.
That said, I’m generally doing very well. Life is good and I am healthy enough to do the things I want to do every day. I’m just choosing to recognize that some unfortunate things are starting and I still have many decades to go–and that is terrifying. I’m picky. I want to be AS freaking healthy as a non-diabetic. I don’t deserve less than that…but I know I have to work for it.
Some Dr. Bernstein supporters are kind of known as bullies in the online diabetes community. I hear comments about them where people express annoyance at how passionate they are about pressing others to consider a very low carb diet for type 1 diabetes. While I want people to engage myself and others in a respectful way and most of these low carb supporters have been very respectful to me personally, I have never been able to deny that even when someone is rude, they have a point. An A1c that is at or near normal levels is probably the best defense when it comes to complications.
Yet, at the same time, I acknowledge that I can’t eat as disciplined as I’d like. Well, not that I can’t, but apparently, I won’t, although I do better than I used to which gives me hope about the future. Kudos to those of you who do. You have my bewildered awe and respect and to those of you who struggle like I do, don’t stop trying and please stay open-minded about what you are capable of. Many years ago I saw no way of getting my 9% A1c down until I learned about low carb eating and I slowly began to implement it.
That said, we are all on a different part of our own journey and I support you where you are at. I share what has helped me because I wish I’d known some of these things sooner. Time has a way of flying by and I find it telling that I am not traumatized by a childhood full of insulin shots and finger sticks and being different and having sugar-free jello for my birthday. No…it was those crazy blood sugars.

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