Planning the Low Carb Journey
This article is an attempt to give you a perspective on low carbohydrate eating (Low Carb), as a way of managing type one diabetes.
A little about myself and why am I striving to spread the word and share our experience with others.
I'm a freelancer Mamma of a beautiful T1 child. I hope to help atleast one family, if they are in a similar situation as us. Another reason is to let people know that an option called 'low carb' exists. We did not know it for 2 years after diagnosis.
Our daughter was diagnosed as a type one diabetic in October 2015. She was approximately 4.5 years old. We put in all our efforts on 'management' of her diabetes as per the recommendations. We soon reached a point where we were constantly increasing her insulin doses to get the sugar levels to target ranges, while she looked exhausted and tired despite the best healthy regular food, wholesome carbs, healthy habits and despite good physical activity. We were stuck, depressed to use more than 40 units of insulin for a 6+ year old girl. She seemed to have gained an unhealthy amount of weight, had mood swings, her insulin worked like water and we didn't see anything odd with her lab results, except that her HbA1c was in 8s. That was the starting point. We desperately wanted to get things in control.
After a year of diagnosis, we opened up about my daughter's diabetes by sharing the symptoms of type one diabetes in a public forum. We never hid it and taught our daughter the same. I went around posting in online groups about what I felt about my daughter's then condition. I was scared how long we should be struggling, juggling with sugars when the insulin didn't seem to work at all. Slowly, but surely we learnt about low carb as a way of eating, and decided to give it a try. We saw wonderful improvements in the health of not just our child, but for the entire family! We understood the reasons for several of our health issues.
There were still questions because we were changing diet of a child - what to believe, how to go about it, what if we were attempting to reduce HbA1c but getting into some other complication in the process? Though we knew what we should achieve, we needed to know how to walk the path.
We learnt some important information from people already following low carb. We were surprised to know that there are also huge platforms like dlife.in to support low carb in India, when 90% of the people around you do not know or recommend low carb. It was in these forums that we witnessed a few thousands of children with non diabetic sugars, thriving well, marvelling in sports and education, with improved physical health and how they feel, which cannot be just anecdotal. This was the game changer!
Soon enough my daughter's insulin dosage came down by half, HbA1c came to 6 and eventually in late 5s, with much flatter lines on her BG graph. But there is still a lot of scope for improvement. We have shared our daughter's story here.
What is low carb? Why low carb works? how it works? Why it is safe? Why it is the best? How it remarkably changes your life for good?
Everything is in depth in the information given below. A brief take on the philosophy behind low- carb has been covered in this blog. What I would like to do with you in this post, is curate is watch and read list. Ready?
1. About Dr. Bernstein
Dr. Bernstein's "Diabetes solution". Considered a bible on low carb eating for T1's. This book details the principles of low carb diets for diabetics through Dr. Bernstein's experiences. We ordered hard copy for anytime easy reference. But you find a soft copy here .
2. Don't care about reading? YouTube!
There is an introduction to low-carb playlist on YouTube. This is some solid information to get you started. You got everything in the book that you need to know.
Looking for more?
3. Online Communities
With the advent of facebook groups and communities, a wide array of knowledge is now freely shared between those who seek it. An inspirational community that leads the low carb revolution is TypeOneGrit. You can join their public/community Facebook page. All the researches on LCPE (Low carb protein emphasis) are being shared here.
Once you have read Dr. Bernstein's book, for guidance, you can apply to join the Bernstein closed group here.
The 'photos' section of this page gives reminders from the basics of Dr. Bernstein's book in the form of slides.
4. Lectures / Talks/ Blogs.
Bethany McKenzie - a mom who raises awareness on low carb way of eating. Follow "let me be 83". What a striking phrase it is! I imagine my child pleading me to let her be in non diabetic range. Doesn't she deserve it? Don't all our kids deserve complication free happy lives?
And there are many others. Like Sai and Nupur's talk on how low carb changed the game for them here. There are several wonderful articles on why and how people chose low carb journey.
5. Google Groups.
There is some collection of useful information shared by T1D parents in a Google group. You need to request to access.
You can choose to start with one meal at a time, preferably evening snacks or dinner for small kids as you can see the effect of diet on BG.
9. Basic Readings - whys and hows?
Why high carb cannot work for normal sugars is set out here.
Trouble shooting guide on what all can effect blood sugars. Please also click on the hyperlinks in the article to read more highly knowledgeable articles written by her.
Below are two other gems.
"Although insulin therapy carries the risk of weight gain, with careful management of diabetes-related therapy, weight gain is not inevitable. A variety of lifestyle changes and targeted therapies are currently available to achieve the lowest possible weight change while maintaining adequate glycemic control.”
Another good read on optimal blood sugar control.
What are healthy fats?
You can seek about keto diet here and you can compare with low carb high protein diet. The purpose of sharing this is to know the ranges of nutritional ketosis and DKA. Are ketones monsters for typeone diabetics? Is ketosis same as DKA, a life threatening condition?
10. What about kids and low carb?
I read this question multiple times on my whatsapp chat group for low carbers. Are we restricting them good food? Waiting for my child to take decision until she grows up big enough? Will I make it tough for my kid? Getting kids adapted to good dietary habits at a small age will be much easier on them rather than leaving them at a position of regret on a later phase of life. As parents, it is nothing wrong to show a right path from the begining. We show the best path, show the best results and leave it to their choice whether they wish to continue or not. I am sure, most of the grit kids continue as they experience feeling better, already! Constant blood sugars are so addictive! My reading suggestions for parents are here and here.
Wish to know how kids have mood swings with blood sugar swings? Wish to know how awful kids feel in high blood sugars? Wish to show your kids some kids-programs on this so that it's easy to make them understand? This video can help.
The above should give you enough motivation to already get started. Still not?
If you are looking for even more, here is the pediatrics study on low carb.
I did not want to wait for many long term studies or clinical trials on low carb because by the time it is proved to the medical community, I do not want my child's body to pick up a complication. We need a cure but we are not waiting! I do not want to lose the precious time.
11. Looking for medical professional to give you support? Good news. Some doctors are on-board with this. You can check them out here.
There are many more wonderful knowledgeable articles, research studies. If you read articles and watch talks about insulin resistance, hyperinsulinemia and metabolic syndrome in diabetes in general, and how low carb works, you will be surprised to know how much we are wrong about the basic dynamics of diabetes, our guidelines, recommendations and habits we developed as a consequence.
I really do not want to overwhelm people with more information. You will bump into so much more when you are doing your own research.
I read a quote recently - " While people try their best to take away the glucose from their system , they do not try to put less glucose in the system". The simple no nonsense logic, that agrees with Dr. Bernstein .
Why should Low Carb make sense to you?
There is some breathtaking information and research on possibilities of contracting complications with the conventional way of managing T1D. We will eventually have to study, understand its implications on general health as well. We cannot and should not ignore diabetic complications. They are real. Thinking our kids cannot have complications is like closing our eyes and thinking we are hiding them and ourselves safely. Therefore it is fair to argue that introducing low carb eating is a safe and sustainable safety blanket that may slow down or altogether eliminate long term complication risk.
So how do you approach it? I personally believe, reading authentic information first, collecting a good database of recipes, connecting with encouraging people who can understand the pace of your learning, and can genuinely understand your questions/confusions are the first necessary steps to chalking out the journey to the low carb way of eating. I would rather this, than getting depressed that some damage has already happened. If it started with depression, that should evolve into learning. The learning is the outcome that should be saving us.
What we are trying to do here is improve from 'our best' way of managing diabetes to 'the best'- way-of-managing-diabetes-to-keep-away-the-painful-diabetic-complications, in a systematic manner.
Complications is a very complex subject in my opinion. While blood sugars and standard deviation are primary sure-shot predictors of whether the chances of diabetic complications increase, there are several other factors as well which may decide whether one may get complications or not. Everyone is still equally susceptible to non diabetic complications. We try to be in safe ranges as per Dr. Bernstein's book (which you will know from the book) to avoid the diabetic related complications which is 'the best' we can do. If we chase the best, we will at least reach excellence.
How to transition? Reduce carbohydrate intake (what ever carbs are yet to be eliminated should be non sugar low glycemic carbs, taken in very small quantities) in every meal and replace with protein and fibrous vegetables, until you reach Dr. Bernstein recommendations, which has to be the ultimate goal. The problem with slow transition is, people may go back and forth because of the cravings of the carbs which haven't gone off totally. The good thing is, you will have a little more time to adjust yourself psychologically and for some people physiologically as well. If you're a parent, cooperation of your child is another thing that is important too. We need to explain and encourage the child to incline to low carb in any of the cases above- low carb at-once or gradual transition. We need to show them the inspiring people, inspiring graphs and need to appreciate every small step and decision taken.
There is no ideal route, though the destination (Normal blood sugars) is same. There is no 'this way or no way' kind of managing diabetes. There is no 'one size fits for all' kind of management. All of us are so different, that we can't be even in a competition. How can we be, when our family conditions, financial circumstances, age of the child, general health condition of the child, metabolism, methods of management, modes of insulin delivery etc are so different from each other.
I have shared this read and watch list on various support groups from time to time. I've noticed, this very information, when given has different results - some people worked out their plans very quickly and efficiently, with their hard work and others obviously didn't. We cannot expect some one to prepare a ready made meal plan and ready made insulin doses. We will have to work them out with hard work and determination, and often medical guidance. Also unless one moves to low carb at once changing the doses, please do not expect very quick magical results. There is struggle, there is an adjustment period. The last of all, this is not a temporary diet. It is a way of living. It includes general health, general happiness, learning about adjusting insulin doses and learning in depth, the science of diabetes. We plan such a way that it is sustainable.
Now it is upto you my friend, how you use this drop of information and explore the ocean. Good luck!