[Editor’s note: This article was originally published in 2017.]
I was identified with sort 1 diabetes about ten years in the past, as a school pupil. During my hospital keep, I discovered concerning the day-to-day administration of diabetes, together with common blood glucose checks, insulin administration, in addition to weight loss plan.
A nutritionist suggested that I ought to eat 210 grams of carbohydrates each day, together with three meals of 60 g and a bedtime snack of 30 g. I adopted the recommendation diligently and logged my blood glucose 4 to 6 instances a day for my physician to assessment.
After the primary few weeks, my A1C was properly on its manner down, however I was nonetheless logging many leads to the 150-350 mg/dL vary. My physician defined experiment with making insulin changes primarily based on my pre-meal outcome, in addition to progressively titer insulin doses in response to blood glucose developments. Making my very own changes primarily based on my observations grew to become my largest instrument in managing diabetes.
After gaining virtually forty kilos within the span of simply a few months, I thought that maybe the nutritionist’s carb consumption suggestions have been too excessive for me. I stopped attempting to eat 60 g of carbs with each meal and added flexibility to my weight loss plan, generally consuming 60 g a meal, however many instances consuming 30 g or 40 g and adjusting insulin accordingly. I was comfortable to lose twenty kilos and to be at my optimum weight.
For a few years, I ate this manner — consuming wherever from 100 to 200 g of carbohydrates a day. I would merely calculate the carbohydrates in what I was consuming and take insulin for it. My A1Cs vacillated from the low 6 p.c vary to the excessive 7 p.c vary for many of this time.
My docs at all times mentioned that I was doing properly. I nonetheless had many highs and lows, however I was assured that this was regular for a diabetic. However, the stress of worrying about my blood glucose dropping throughout train or when I was instructing was taking its toll. It felt simpler to run greater to keep away from going low.
A couple of years in the past, my A1C got here again at an all-time excessive since analysis. At the time, I had began a new job after finishing graduate faculty, had a irritating commute, and had little time to give attention to diabetes. However, understanding that I needed to start out a household quickly prompted me to hunt a simpler and constant manner of attaining higher blood glucose management.
I began to put on my Dexcom steady glucose monitor (CGM) extra often to attempt to perceive the place I was going mistaken. Seemingly, irrespective of how a lot effort I was placing in, I was nonetheless experiencing frequent blood glucose spikes above 200 mg/dL. This was irritating as a result of I was very diligent in my carbohydrate counting, insulin timing, making frequent changes, and attempting to maintain a constant train routine.
I learn many books about diabetes administration to attempt to acquire tighter management. I joined many diabetes boards and browse the blogs of seasoned diabetics to collect as many methods as doable. One day, I got here throughout a web site that contained free chapters from the e book “Diabetes Solution” by Dr. Richard Bernstein.
As a scientist, one concept that I examine notably struck a chord with me: “the law of small numbers.” Essentially, by minimizing carbohydrate consumption and insulin use, any errors in carbohydrate counting or insulin dosing might be significantly minimized.
Many variables can have an effect on insulin absorption and its exercise profile: the time of day, the location of injection, the integrity of the insulin, and insulin sensitivity on the given second, simply to call a few. In addition, it’s tough to pinpoint the precise variety of carbohydrates in fruit, and the allowable error on vitamin labels and blood glucose meter accuracy might be as much as 20 p.c.
Altogether, these variables could make it extremely tough to good insulin dosing for meals which might be excessive in carbohydrates. Injecting a bigger quantity of insulin to cowl a bigger quantity of carbohydrates is extra prone to lead to suboptimal insulin dosing, and thus extra variance in blood glucose. In distinction, small quantities of carbohydrates and the corresponding doses of insulin yield smaller, extra manageable errors.
At first, I puzzled if the weight loss plan proposed by Dr. Bernstein could be too restrictive for me. After all, eliminating all grains and sugar appeared like a very huge bounce from the “typical” American weight loss plan. However, after seeing so many success tales on-line, I determined to attempt it for myself.
After simply a week of consuming this manner, my blood glucose common dropped by about 60 mg/dL. During this time, I additionally discovered that I wanted to be taught to calculate insulin doses to cowl protein consumption, as a result of whereas protein digestion at all times leads to a rise in blood glucose, the speed of this course of is greater when one consumes fewer carbohydrates.
Amazingly, I didn’t really feel disadvantaged. I discovered that though I was now not consuming sugar and grains, I may eat all the things else. I additionally discovered that there’s a low-carb various for actually all the things.
What was much more wonderful was the distinction in the best way I felt. I had extra vitality. Seeing my efforts replicate so shortly and dramatically on my blood glucose common and stability was one thing I was extremely pleased with.
In addition, I now felt hopeful that a extra “normal” life was doable with diabetes. I by no means had large quantities of insulin on board anymore. As a outcome, no matter lows I had have been delicate and simple to deal with exactly. I was additionally capable of obtain extra predictable blood glucose with much less effort throughout train.
Perhaps what made me the happiest, since switching to a low-carbohydrate life-style, was having a straightforward and wholesome full-term being pregnant. Throughout, I maintained regular A1C ranges (between 5 – 5.7 p.c), and in response to my Dexcom report, was capable of keep regular blood glucose (60 – 120 mg/dL) about 90 p.c of the time, one thing I by no means thought I would be capable of obtain.
My recommendation to anybody seeking to make enhancements in blood glucose administration is to attempt new issues earlier than making any assumptions about whether or not or not they’ll work. I was skeptical that this manner of consuming wouldn’t work for me for one purpose or one other. However, it turned out to be extremely constructive and really life-changing in serving to me to optimize my diabetes administration.
Read extra about A1c, blood glucose/sugar administration, Dexcom, Dr. Richard Okay. Bernstein, train, insulin, Intensive administration, low-carb weight loss plan.