[princesslinda]

This may sounds like a stooooopid question, but i'm gonna ask anyway.

If you are a T1 and make no insulin and have to take insulin to compensate for anything you eat, why do you have to watch what you eat? If you take a consistently high dose of insulin, will it eventually stop working? I see some T1s who are low-carb and some who are more lenient and i'm curious as to why it matters if you have to take insulin anyway.

[Oradev]

I think that the less insulin you take, the less variability is involved. At least that's the understanding I got from Berstein's theory.

Also, some diabetics (Type I) can not handle a bunch of carbs. Their sugars spike regardless.

[Gary_W]

The way I see it is that you have carbs raising the BG and insulin packing them away.

If you eat something that is pure, simple carbs they cause a rapid rise in BG, same as they would for you. Whilst the insulin will get rid of these, it takes time to do so. Novorapid in me takes about 4 hours to fully do the job. For that reason, some people try to eat low GI food or to reduce carbs to reduce the extent of the spike (both in terms of how big the spike is and how long it lasts).

Modern insulins are far quicker than the old stuff which is why it is increasingly easier to eat more or less anything.

The Bernstein approach (as I understand it) is that if you keep the number of carbs small, you keep the units of insulin small and therefore any mistakes you make will be small. Personally, I have pretty good control with a highly varied diet which is why I don't limit the carbs. I go sensible, but not restictive.

And no, it wasn't a silly question

[LancetChick]

Many type 1's have trouble matching the digestive action of certain foods, or a certain number of carbs, to the action curve of the insulin. I'm not one of those people, I don't trust Dr. Bernstein because he sounds too much like an infomercial, and I frequently eat very high carb meals, along with huge doses of insulin (I eat just once or twice a day, though). Some people just cannot handle high carb meals without experiencing an unacceptable spike. I do get Dr. Bernstein's theory that small doses of carbs and insulin minimize mistakes, but in fact, small doses of carbs and insulin give me much greater spikes than large doses. We're all different, that's for sure.

Not a "stooooopid" question at all
I try to use as little insulin as possible due to what I've read about the correlation between elevated insulin levels and inflammation. Also, I don't do well with fast acting insulins--the more I use them, the more trouble I get into--the faster an insulin works, the less time I have correct a crash. I follow Dr. Cousens' diet rather than Dr. Bernstein's, but they are both low carb. A low-sugar/starch vegan diet is what has worked best for me.

[notme]

For me it is a matter of weight. I know that sounds vain, but the more insulin you take, the more weight you gain. I try to keep the carbs limited and the fat limited so I don't need a ton of insulin.

You can become insulin resistant if you are type one. That has always been a concern for me since I have a family history of type two. I think it would become very frustrating to have to take insulin because of type one and then be resistant as well.

Good question!

[JediSkipdogg]

Most do it because they want to tighten their control. Unfortunately, there are no insulins that match every food item perfectly. It's a game the user has to play. So the easiest way to minimize the increase in BG fluctuation is to lessen the food items eaten. I however don't do that and pay the price on occasion which is why my control is less than perfect.

[HelenM]

Weight is also an issue with me. Pre diabetes I found it all to easy to gain weight and much more difficult to lose it . I do eat a fair amount of carbs. Quite frankly I don't see how I could run without them and I have always found exercise the best way to lose/stop gaining weight.
I try to eat not too many 'empty carbs' in the form of fast sugars which only serve to spike BS.
I eat very little saturated fat since not only does fat have higher calories than carbs but I'm convinced ( I know some people aren't) of its links with cardio/vascular problems and I did have some plaque in my arteries when diagnosed.

[kgm0612]

As a type 1, my pancreas is still producing a small amount of insulin. I mainly stick to eating the same foods only because I know exactly what the carb count is and how those foods will effect my blood sugars. I hate the "guesstimate" game. Most times I'm way off on the carb count and it shows in my numbers.

I'm one of the lucky insulin users (pumper) in that it hasn't caused any weight gain. I'm not sure if it's genetics or if it's the Metformin that I'm also taking.

Karen

[mark-TN]

Great question Linda! Like Kevin said it is a matter of how tight one wishes to control blood sugars (at least that is how it works for me). One has to do what works best for them. Bolusing a large amount of insulin to cover large amounts of carbohydrates just does not work for me. I find limiting carbs gives me the control I want for myself. This week I have been adjusting my basal insulin amounts (the warmer weather has necessitated lowering my total basal amount by about 10%) After dialing in my basal I did meal bolus testing yesterday. The results are below.

Over four years ago when I was not limiting my carbs or eating a structured meal plan, after meal BGs would not have been near what these are and that is just not acceptable to me anymore. But every one is different and every one needs to do what they are comfortable with.

Mark

[rzrbks]

Weight is the main issue for me as well.

That being said, CARBS are what your brain runs on---------I like my brain and what it does and how it works------------I'm going to kept my Brain Well Fed.

[mark-TN]

Originally Posted by rzrbks

That being said, CARBS are what your brain runs on---------I like my brain and what it does and how it works------------I'm going to kept my Brain Well Fed.

Mine runs mostly on GLUCOSE. It could run on glucose and ketone bodies, but since I’ve been at a steady weight for the past couple of years it runs mostly on glucose which it gets from adequate serum glucose levels, not from carbs.

Mark

[Cyborg]

I find that most carbs work faster than the insulin. So if I eat a meal high in carbs, I bolus a good 1/2 hour (if possible) before eating to allow the insulin to get a head start on the carbs. Eating less carbs, makes it easier to control the post meal spikes. Eating lower glycemic index based carbs also helps.

BTW, calories, not carbs, cause weight gain...

[owlyn]

Aside form all of the issues others have mentioned...

I look at it as using insulin makes you like anyone else (more or less). Taking insulin allows you to maintain the relationship between food, exercise, and weight that everyone else has. So, yes, I eat literally whatever I want, but then I must take some combination of insulin and exercise to compensate. For example, last night we went out for dinner at a sushi restaurant. As it turned out, I happened to have ordered almost no carbs. The only carbs were in a very small serving of rice (about 30g carbs- you get good at looking at a plate of food and estimating the number of carbs).

Afterwards, we went to a place for desert. It is a fairly new place in town. It serves nothing but chocolate (in many forms). I wound up having a small cup (about the size of a double espresso) of dark "sipping chocolate" (essentially some dark chocolate melted down and maybe diluted a slight tad), which is served with some whipped cream on the side, along with a small, light tubular cookie (forget the name), and a sprinkling of cinnamon. I had no idea how many carbs there were, but it sure was good. So, I waited two hours, and checked my BG. "Only" 239. Not bad at all, considering. SO, it worked out thusly:

Since my I:C ratio is 1:15...

Rice, 30g CHO = 2 units
Yummy chocolate = 3 units

5 units x 30 points per unit = 150,

so 239 - 150=89

Now, I know next time I get that, it will cost me 3 units.

Normally, I would have only taken enough insulin to get my level down to my 2 hour PP goal, 150, but I knew I had no rapid insulin in my system at that point, as it had been 8 hours since my last injection, so I needed to take a full amount.

Now, if I had decided to exercise to reduce my insulin need, I could have done about 40 minutes and cut my insulin by 2 units, saving some amount of weight gain, but it was midnight, so sc**w that.

[Cyborg]

Protein, and fat to a lesser degree, also affect bg...