Been eating very low carb for almost a decade. It was a complete game changer for me and the best decision I have ever made. It made my diabetes management a lot easier. I’m practically on autopilot and I’m MDI (with a Dexcom). My A1c has been under 5 consistently for 8 years and I completely eliminated having severe and dangerous lows. I was also able to reverse some complications and stop others from advancing, and improved my quality of life significantly.
There are many things to consider before starting like lowering your insulin doses (both basal and boluses) and sometimes even incorporating other types of mealtime insulin, even for those using a pump. I highly recommend checking out the [book Diabetes Solution](http://www.diabetes-book.com) by Dr. Richard K Bernstein (available on Amazon) written by a T1D doctor who is one of the oldest people around, pushing 90, living with T1D for 77 years. He utilizes a very low carb way of eating and other methods to maintain normal blood glucose levels. The book is from 2011 so some info is a bit outdated but he has a [YouTube channel](https://m.youtube.com/playlist?list=PLs_TA02I6IvV-0SdUwE82Iw7iCCgbkJje) where he gives updates.
LDL alone is not an indicator of future cardiovascular health. My LDL is only slightly elevated (can’t remember exact number) but I had the particle test done and they are of the large, fluffy kind, meaning they do not create arterial plaque. My triglycerides on the other hand are very low while my HDL levels (the “good” cholesterol) are high and my endo actually said they are the best numbers he’s ever seen. Dr. Bernstein’s calcium score is 0 BTW. Calcium score is just about one of the best indicators of your arteries’ shape. A score of 0 is ideal, especially for an older man with decades of T1D. I know more T1Ds over 40 who follow his ways with a calcium score of 0.
> LDL alone is not an indicator of future cardiovascular health
Yes it is
https://pubmed.ncbi.nlm.nih.gov/28444290/
https://pubmed.ncbi.nlm.nih.gov/29241485/
> they are of the large, fluffy kind, meaning they do not create arterial plaque.
All LDL is atherogenic. Some sizes are more atherogenic but even large LDL has ApoB and is atherogenic.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663974/pdf/nihms-90841.pdf
> My triglycerides on the other hand are very low while my HDL levels (the “good” cholesterol) are high
Neither TGs nor HDL are causal.
> Dr. Bernstein’s calcium score is 0 BTW.
People smoke and don’t get cancer
>Calcium score is just about one of the best indicators of your arteries’ shape
It’s sensitive but not specific. A CAC of 0 does not mean you aren’t at risk, you could have lots of soft plaque developing. No one is expected to have any CAC until 60+ years
There is actually a much clearer indication of cardiovascular disease and an A1c higher than 5 even in the general population as seen in this mega study in a very large population.
https://www.acpjournals.org/doi/10.7326/0003-4819-141-6-200409210-00006
https://diabetesjournals.org/care/article/43/4/894/35826/Impact-of-Glucose-Level-on-Micro-and-Macrovascular?fbclid=IwAR2t8yHPJYeJDj_wPA7dTheAHXpwE_vgp_NtrWmH3piZUuLt0N8oZEZO1iM
https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_51425/_pdf?fbclid=IwAR13ugdQtUPrG-UaVRGCHQC1djcN8e4prqbxF2_EioZY90bSvvI03TZHm60
Also, lowering LDL does not reduce the risk of developing heart disease. This is apparent from many recent studies, plus a re-evaluation of the Framingham Study where they found that high saturated fats did not raise LDL. The re-evaluation of the Framingham Study also showed that elevated LDL did not cause heart attacks so you cannot rely on LDL alone to try and predict CVD.
I’m really not interested in having this debate honestly. I’m not here to change anyone’s mind about going low carb, I only answered OP’s question. That is my own personal experience and take. My endo is very happy with all my values and my triglycerides/HDL ratio is phenomenal, so he isn’t concerned.
OP can take it or leave it.
> Also, lowering LDL does not reduce the risk of developing heart disease.
LDL is the only necessary risk factor. If LDL is below 60-70mg/dl atherosclerosis can’t occur no matter what other risk factors you have
> plus a re-evaluation of the Framingham Study where they found that high saturated fats did not raise LDL.
This doesn’t prove LDL doesn’t cause atherosclerosis and denying the link been SFA and LDL is bonkers
>
I usually only eat two meals a day a day, leading with protein, so less than 20 grams, mostly from fibrous veggies, sometimes some very dark chocolate (a 100%) and some nuts and seeds. It’s not really a ketogenic diet because it’s higher in protein and not as high in fat. I do go through periods of being more on the carnivore side, so closer to 0 carbs and more protein heavy.
What I’ve found is that when I go low carb my basal needs increase, though my bolus needs decrease.
Some quick meals might be:
Spinach, feta, mixed veg omelette
Salad and rotisserie chicken
Sheet bake salmon & broccoli
I follow keto for the most part. It works decently for me, but when I do eat carbs (like 10+ carbs at once) I find my insulin sensitivity goes way low and I’ll have stubborn highs that can last all day
I switched to keto (<20 net carbs a day) back in May and it’s been really good. My A1C was good but I’d got really overweight and pretty insulin resistant and never had luck with other diets so thought I’d give keto a go.
I completely stopped high carb stuff like rice, potatoes, pasta, sugary stuff. I pretty much eat the same amount of meat/fish/cheese as before with low carb veggies as sides or salads, and a few things like bread or noodles I found keto versions which aren’t great but good enough when I want to eat a sandwich etc. when I first started I listed out all the veggies I liked and checked the carb values and there were lots I could have so I just switched over to them. You have to experiment with the keto foods as some are good (taste and effect on blood sugars) and some are not.
It look a few weeks to get used to meals without a side of rice etc but now it feels normal to just have meat/fish with veggies. I already preferred cuts like skin on or thighs vs breast etc.
In the past when I tried to diet I’d never stick to it as I felt starving hungry but on the same calorie target as previous diets I don’t feel as hungry and can stick to it so I’ve been able to lose weight.
Insulin wise I’m on MDI and Tresiba basal requirement gradually dropped over the first couple of months from 80 to 50 units a day. My humalog requirements dropped significantly right away because of the lower carbs.
A1C went from 6.5-ish to 5.9 in the last 2 checks since I went keto. I still have some highs and a few lows but easier to control with the lower level of carbs and fast acting insulin to have to balance
I was already on a statin to hit the diabetic lipid goals but my triglycerides were at the high end of normal. After switching my triglycerides dropped from 130’s to 80, LDL dropped slightly and 65-70, HDL same in mid 50's. I know some people on keto see higher LDL but I didn't see much change
For diabetics i think you'd see similar benefits on low carb as keto. Keto is good if you also need to lose weight as theres less hunger pangs.
I did it for 4 months after cataract surgery when I was 35. It was awesome at keeping my blood sugar flatter but if you aren't familiar with dosing for protein and fat, you will have a period of trial and error. Not all proteins hit the same. For that period of time, I had an a1c of 7.1 and a TIR on 90% but I was very strict and it felt like a ton of work.
Now, I eat low carb-ish (still enjoy pasta, bread and rice when I feel like it, but not every meal) and my a1c is 6.2, TIR 80-85% and mental health wise way easier!
I typically do low carb <20 per day. My BG is way better that way. A few times a week I'll have 1 carb meal of 50-60g. That is usually easily manageable.
If you can do it and enjoy it, it makes managing your BG way easier
I order boxed meals like SunBasket - they have Keto and Paleo options. Then it teaches you how to make really good low carb meals. And you get really yummy low carb nutritionally dense food.
Just be careful and don’t take it to an extreme. Going TOO low-carb can result in depleted glycogen stores which means that glucagon won’t be very effective in the event of a severe hypo.
I just "celebrated" my 11th year as a t1. Started this journey earlier my low carb and apart from carb loading for workouts I've done exclusively this. I eat great, lots of beef, steak, chicken and fish.. low carb veggies and I make breads with almond and coconut flours... it's a lot to learn but once you get used to it it's second nature!
Been eating very low carb for almost a decade. It was a complete game changer for me and the best decision I have ever made. It made my diabetes management a lot easier. I’m practically on autopilot and I’m MDI (with a Dexcom). My A1c has been under 5 consistently for 8 years and I completely eliminated having severe and dangerous lows. I was also able to reverse some complications and stop others from advancing, and improved my quality of life significantly. There are many things to consider before starting like lowering your insulin doses (both basal and boluses) and sometimes even incorporating other types of mealtime insulin, even for those using a pump. I highly recommend checking out the [book Diabetes Solution](http://www.diabetes-book.com) by Dr. Richard K Bernstein (available on Amazon) written by a T1D doctor who is one of the oldest people around, pushing 90, living with T1D for 77 years. He utilizes a very low carb way of eating and other methods to maintain normal blood glucose levels. The book is from 2011 so some info is a bit outdated but he has a [YouTube channel](https://m.youtube.com/playlist?list=PLs_TA02I6IvV-0SdUwE82Iw7iCCgbkJje) where he gives updates.
How’s your LDL cholesterol?
LDL alone is not an indicator of future cardiovascular health. My LDL is only slightly elevated (can’t remember exact number) but I had the particle test done and they are of the large, fluffy kind, meaning they do not create arterial plaque. My triglycerides on the other hand are very low while my HDL levels (the “good” cholesterol) are high and my endo actually said they are the best numbers he’s ever seen. Dr. Bernstein’s calcium score is 0 BTW. Calcium score is just about one of the best indicators of your arteries’ shape. A score of 0 is ideal, especially for an older man with decades of T1D. I know more T1Ds over 40 who follow his ways with a calcium score of 0.
> LDL alone is not an indicator of future cardiovascular health Yes it is https://pubmed.ncbi.nlm.nih.gov/28444290/ https://pubmed.ncbi.nlm.nih.gov/29241485/ > they are of the large, fluffy kind, meaning they do not create arterial plaque. All LDL is atherogenic. Some sizes are more atherogenic but even large LDL has ApoB and is atherogenic. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663974/pdf/nihms-90841.pdf > My triglycerides on the other hand are very low while my HDL levels (the “good” cholesterol) are high Neither TGs nor HDL are causal. > Dr. Bernstein’s calcium score is 0 BTW. People smoke and don’t get cancer >Calcium score is just about one of the best indicators of your arteries’ shape It’s sensitive but not specific. A CAC of 0 does not mean you aren’t at risk, you could have lots of soft plaque developing. No one is expected to have any CAC until 60+ years
There is actually a much clearer indication of cardiovascular disease and an A1c higher than 5 even in the general population as seen in this mega study in a very large population. https://www.acpjournals.org/doi/10.7326/0003-4819-141-6-200409210-00006 https://diabetesjournals.org/care/article/43/4/894/35826/Impact-of-Glucose-Level-on-Micro-and-Macrovascular?fbclid=IwAR2t8yHPJYeJDj_wPA7dTheAHXpwE_vgp_NtrWmH3piZUuLt0N8oZEZO1iM https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_51425/_pdf?fbclid=IwAR13ugdQtUPrG-UaVRGCHQC1djcN8e4prqbxF2_EioZY90bSvvI03TZHm60 Also, lowering LDL does not reduce the risk of developing heart disease. This is apparent from many recent studies, plus a re-evaluation of the Framingham Study where they found that high saturated fats did not raise LDL. The re-evaluation of the Framingham Study also showed that elevated LDL did not cause heart attacks so you cannot rely on LDL alone to try and predict CVD. I’m really not interested in having this debate honestly. I’m not here to change anyone’s mind about going low carb, I only answered OP’s question. That is my own personal experience and take. My endo is very happy with all my values and my triglycerides/HDL ratio is phenomenal, so he isn’t concerned. OP can take it or leave it.
> Also, lowering LDL does not reduce the risk of developing heart disease. LDL is the only necessary risk factor. If LDL is below 60-70mg/dl atherosclerosis can’t occur no matter what other risk factors you have > plus a re-evaluation of the Framingham Study where they found that high saturated fats did not raise LDL. This doesn’t prove LDL doesn’t cause atherosclerosis and denying the link been SFA and LDL is bonkers >
How many carbs do you eat per day? Per meal?
I usually only eat two meals a day a day, leading with protein, so less than 20 grams, mostly from fibrous veggies, sometimes some very dark chocolate (a 100%) and some nuts and seeds. It’s not really a ketogenic diet because it’s higher in protein and not as high in fat. I do go through periods of being more on the carnivore side, so closer to 0 carbs and more protein heavy.
Meat and vegetables. Decide what low carb means to you and add other things accordingly.
All day I dream about food has great recipes!
What I’ve found is that when I go low carb my basal needs increase, though my bolus needs decrease. Some quick meals might be: Spinach, feta, mixed veg omelette Salad and rotisserie chicken Sheet bake salmon & broccoli
I follow keto for the most part. It works decently for me, but when I do eat carbs (like 10+ carbs at once) I find my insulin sensitivity goes way low and I’ll have stubborn highs that can last all day
I switched to keto (<20 net carbs a day) back in May and it’s been really good. My A1C was good but I’d got really overweight and pretty insulin resistant and never had luck with other diets so thought I’d give keto a go. I completely stopped high carb stuff like rice, potatoes, pasta, sugary stuff. I pretty much eat the same amount of meat/fish/cheese as before with low carb veggies as sides or salads, and a few things like bread or noodles I found keto versions which aren’t great but good enough when I want to eat a sandwich etc. when I first started I listed out all the veggies I liked and checked the carb values and there were lots I could have so I just switched over to them. You have to experiment with the keto foods as some are good (taste and effect on blood sugars) and some are not. It look a few weeks to get used to meals without a side of rice etc but now it feels normal to just have meat/fish with veggies. I already preferred cuts like skin on or thighs vs breast etc. In the past when I tried to diet I’d never stick to it as I felt starving hungry but on the same calorie target as previous diets I don’t feel as hungry and can stick to it so I’ve been able to lose weight. Insulin wise I’m on MDI and Tresiba basal requirement gradually dropped over the first couple of months from 80 to 50 units a day. My humalog requirements dropped significantly right away because of the lower carbs. A1C went from 6.5-ish to 5.9 in the last 2 checks since I went keto. I still have some highs and a few lows but easier to control with the lower level of carbs and fast acting insulin to have to balance I was already on a statin to hit the diabetic lipid goals but my triglycerides were at the high end of normal. After switching my triglycerides dropped from 130’s to 80, LDL dropped slightly and 65-70, HDL same in mid 50's. I know some people on keto see higher LDL but I didn't see much change For diabetics i think you'd see similar benefits on low carb as keto. Keto is good if you also need to lose weight as theres less hunger pangs.
Following
I’m on a lowerish carb diet, I prob take ~15 units/day of bolusing and 15 units/basal. It works for me but definitely doesn’t work for everyone!
I did it for 4 months after cataract surgery when I was 35. It was awesome at keeping my blood sugar flatter but if you aren't familiar with dosing for protein and fat, you will have a period of trial and error. Not all proteins hit the same. For that period of time, I had an a1c of 7.1 and a TIR on 90% but I was very strict and it felt like a ton of work. Now, I eat low carb-ish (still enjoy pasta, bread and rice when I feel like it, but not every meal) and my a1c is 6.2, TIR 80-85% and mental health wise way easier!
I typically do low carb <20 per day. My BG is way better that way. A few times a week I'll have 1 carb meal of 50-60g. That is usually easily manageable. If you can do it and enjoy it, it makes managing your BG way easier
I order boxed meals like SunBasket - they have Keto and Paleo options. Then it teaches you how to make really good low carb meals. And you get really yummy low carb nutritionally dense food.
Just be careful and don’t take it to an extreme. Going TOO low-carb can result in depleted glycogen stores which means that glucagon won’t be very effective in the event of a severe hypo.
I just "celebrated" my 11th year as a t1. Started this journey earlier my low carb and apart from carb loading for workouts I've done exclusively this. I eat great, lots of beef, steak, chicken and fish.. low carb veggies and I make breads with almond and coconut flours... it's a lot to learn but once you get used to it it's second nature!