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Can a low carb diet improve glucose levels for Type 1 Diabetics?

Endocrinology Sport Medicine Diet & Nutrition

I am a 22 year old female with Type 1 Diabetes. My blood glucose swings a fair bit, and even tends to the low side (3.8mmol). I am looking to see how I can better control my blood glucose level (BGL) within a good range. Does a low carb diet help improve blood glucose levels, and which health professionals should I seek out to help improve my blood glucose levels? 

DOCTOR’S ANSWER (3)

A low carbohydrate diet typically means a diet which is less than 30% of carbohydrates. A typical Asian diet usually consists of more than 60% carbohydrate.

For patients with type 1 diabetes, certainly, taking less sugars will improve glucose levels per se.

However, it is important to realise that people with type 1 diabetes do not have any insulin in the system and therefore, must continue to take insulin to keep themselves healthy.

Though the low carbohydrate diet will result in less insulin required for the individual, it is still important that insulin continues to be injected but at lower doses.

This is not the same situation for people with type 2 diabetes mellitus, where the body is able to actually lower sugar in the blood although in a much slower and more ineffective fashion.

Taking a low carbohydrate diet in this case, will improve blood sugar levels and give the body more time to adjust and metabolise the sugar levels. I would encourage patients to discuss this in greater detail with your doctors as low carbohydrate diets may not be healthy or suitable for all individuals.

628 views 30 Aug 2018

In type 1 diabetes, you are insulin deficient, hence require insulin injections. A typical regime would consist of a long acting insulin that gives you 24 hour background coverage, and rapid acting insulin that you inject prior to each meal to give you the burst of insulin to cover the food that you eat.

It is a good idea to include some carbs with your meals as without carbs, your insulin may cause your blood glucose level to drop too low. You can choose healthier carbs like wholegrains.

If you can learn to calculate the amount of carbohydrates you have with each meal, you can dose your insulin according to the amount of carbohydrates you're eating so as to fine tune your diabetes control.

I would suggest seeing an endocrinologist for an evaluation and management.

697 views 6 Aug 2018

Your question is certainly an interesting one.  As Dr Marilyn mentions, insulin injections are important in type 1 DM as you are deficient in insulin.  Your glucose control needs to be achieved through a balance between insulin doses and food intake.  

Of course it is mindful to note the different types of foods and the types of carbohydrates contained.  On this point, in addition to seeing an endocrine physician, it might be worth consulting a dietician.

One area of interest is diabetes and exercise.  Often, there can be significant variations in blood glucose depending on the 

1. Type - cardio vs resistance

2. Duration 

3. Intensity

4. Timing

Again, it might be worth consulting an Sports Physician with experience in exercise prescription or an exercise physiologist.  There have been a number of elite athletes with type 1 diabetes, who have had successful careers in sport.

Some safety points to consider are:

1. Exercising with someone else in case of a hypo

2. Informing someone where you will be exercising and for how long

3. Keeping your phone handy and some sweets in case of a hypo

Good luck with your diabetes control and please do contact again if you have any questions.

Bw

Dr Dinesh

686 views 7 Aug 2018
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