The Great Carb Debate
Having diabetes means you automatically have food issues. I don’t mean that everyone with diabetes has a problem or a disorder with food (although many of us do), but I mean that because food is a central factor in controlling diabetes, it creates issues that people without diabetes never have to consider.
We know carbohydrates cause our blood sugar to rise. Carbs have to be accounted for with another great controlling factor of diabetes: insulin. Therefore, people with diabetes have a lot of choices around food, and particularly with carbohydrates in order to control their disease. Our food choices are often what set off a series of diabetes management decisions, so it makes sense that it would be one factor that we put a lot of thought into. And I have to say, after 18 years with this disease, I’m not sure I have any solid answers about what the perfect “diabetes diet” is.
I’ve had a lot of confusing food thoughts lately. Here’s what I know: Carbs require insulin. When I eat a lot of carbs and I have to take large amounts of insulin, I make “larger mistakes”. I have more BG swings, more lows, more highs, and more “domino effects,” than when I take small amounts of insulin. To prevent this, I often subscribe to what many would consider a low-carb diet – lots of meat, cheese, cruciferous veggies, and almost no bread, pasta, rice, potatoes, whole grains or starches. This diet does two things for me: it allows me to have more even, predictable blood sugars in the normal range, and it also prevents me from gaining weight. That’s another thing I know for sure: taking more insulin = weight gain for me. Every single time, without fail. When my total daily units go up for a few days in a row, I see weight creep on right away.
So if I know that eating low carb controls my blood sugar and keeps the weight off, what’s not to like? Well for one thing, I’m cutting out an entire food group (the starch department). And for another thing, I’m eating a lot of foods high in fat and saturated fat (cheeses and dressings). I tend to allow myself higher calorie fare as long as it’s low carb. I don’t have a cholesterol problem yet, but it’s likely tempered by my active lifestyle. I guess what I’m saying is that although I know my diet works for diabetes control, I don’t think it’s particularly balanced. I’ve also noticed some consistent stomach aches lately, especially after breakfast which for me is almost always eggs or egg whites with chicken sausage and cheese (holy protein stack!). I can’t help but wonder if the tummy trouble is from all that protein and dairy. At this juncture though, I know I feel the best when I don’t have wide fluctuations in my numbers, and I don’t feel confident in adding in carbs – even the “good kind,” because dosing the insulin to cover it seems to create problems.
Don’t get me wrong – I do allow myself carb indulgences every once in awhile. But that’s just it – they’re indulgences and not part of my daily routine. Part of me wonders if I just need to ditch the “low-carb” thing and start concentrating on the basics of healthy eating like whole grains, lean protein, and more veggies. But the other part of me doesn’t want to sacrifice any diabetes control by dosing for more carbs. I’m seriously considering making an appointment with a registered dietician, just to get a fresh perspective on what’s considered “healthy” these days. I feel like I’m living in extremes right now, where I either go no-carb, high fat, or I’m “cheating” and allowing myself some carbs.
See what I mean about issues? They’re there even when I’m striving for health. One thing’s for sure, I’m feeling the need for more balance with my diet. Let me know if you have any food guidelines you follow when it comes to balancing health with good diabetes control. I’m thinking it’s time for me to back up, do a little research, and maybe a diet overhaul. Talk about food for thought!
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Comments
Though I don’t always eat as low-carb as I’d like (I just like bread and beer too much!), I think it’s a very healthy diet. High cholesterol runs in my family, and I’ve had borderline high cholesterol forever. But… when diagnosed with Diabetes I went through a 6 month period before they figured out just what kind of D I had, and for several months was controlling it mostly through diet. Meaning, I ate very, very few carbs, never more than 10 or 15 at a time, and less than 40-50 a day. That meant LOTS of fatty cheeses, cream, meat, eggs, etc.
At the end of that six months, I got bloodwork done, and it was the best I’ve ever had in my life. My high cholesterol was gone. All the other numbers were great. I wish I had the willpower do eat like that all the time!
I highly, highly suggest you read Good Calories, Bad Calories by Gary Taubes. The cholesterol in our bodies is related to cholesterol in our food is bogus, and based on on crazy, bunk science. Sorry to sound like an extremist, but i am just completing my master’s in nutrition, and i work as a personal trainer, and i have had type I for 19 years 
BTW- i lurk here daily- awesome blog- i relate to you so often!!! Thanks for writing.
Everyone - thank you so much for all the information! I’m glad to know that others have the same concerns about cholesterol, but can also speak with experience about it still being a healthy diet. YOu guys have convinced me I’m still on the right path!!
Robin - I’ve been dying to read that book! Thanks for reminding me, and I’m so glad you like the blog. Thanks for lurkin’ And for commenting!!
When I was a young fatty over 250 lbs., my ex-wife’s mother was dating Bob Atkins. I went on his diet and lost nearly 100 lbs. in 6 months in 1972 in non-acidotic ketosis. Gained it back later, but in the past 5 years the low-carb high-fat diets have been scientifically validated. As Robin said, almost all the blood cholesterol is courtesy of your body, not diet. People, including T1 and T2 diabetics on Atkins-type diets have lower LDL, higher HDL, lower overall cholesterol and stupendous A1C. Even the ADA has recently said their old ideas of 40 - 60 gms carb a meal (!!!) may be passe. Your diet of low carb with the occasional carbotreat (I’m gonna haveta try your mom’s pasta at the restaurant someday) sounds great, and your exercise and insulin regimens should continue to balance the weight. You looking good girl
I read your blog because I have a daughter who is 3 yrs old and Type 1 and you give me hope that she can have a happy, healthy fun life while living with T1 (and celiac disease). I may be unpopular here, but carbs are just fine in your diet. I think if you try to add certain carbs that you like you can figure out how to treat them. When my daughter was diagnosed, her endocrinologist told us about an older woman from a study who ate the same thing every day, including apple juice for breakfast. Her A1C was great, like 5.5 or something crazy. It was not because she didn’t eat carbs, it was more because her diet was so predictable. Did you read about the 90 year old guy who has had diabetes for 85 years? He just received the Joslin award for living the longest with diabetes. He eats 5 prunes for breakfast. Every morning. Seriously? Dried fruit? Talk about crazy high blood sugar. I’m not saying you should eat the same thing every day, but you can figure out ways to regularly eat the carbs you really enjoy. And just so you don’t think I’m a big old carb pusher, we also remind ourselves almost daily - little numbers little problems, big numbers big problems (that’s from Dr. Bernstein’s book).
I found that gluten was causing me major BG swings throughout the month, hair loss, unpredictable periods, back and knee pain … so after removing gluten, I now eat rice and potatoes and corn but try not to do more than 30g carbs at one time … this has helped me a lot! Bolusing 20 mins. ahead helps too, and medtronic pumps have an extended bolus feature as well as a dual wave (take % now and stretch the other % out over a designated amt. of time) … really helps with “grazing” … long meals/parties/weddings, etc … and fatty meals where a spike could happen later. Good luck to all!
Stay the path! I’m a big fan of low carb and the MSM is coming around now. Yesterday read an article about the new food pyramid and the writer was also showcasing a study about the positive effects of a high fat, moderate protein low carb diet on artery walls. I was on low carb for years, did the same as you are thinking, ended up with more weight to lose and more insulin to take and more health problems because I was told my diet was not healthy. Now that I’ve detoxed myself from the carbs I’m beginning to feel better, take less insulin and fight the battle of the bulge. Your diet is healthy IMHO!