Diabetes

Type 1 Diabetes

insulin_stomachType 1 diabetes – previously called “juvenile onset diabetes” – results when the body is no longer able to produce enough of the blood sugar-lowering hormone insulin that it needs. Fore some reason (usually autoimmunity) the majority of the insulin-producing beta cells in the pancreas has died.

Type 1 diabetes is treated with injections of the insulin that the body lacks.

The more carbohydrates you eat the greater doses of insulin are needed. This usually makes the blood sugar more difficult to regulate, with higher average blood sugar levels. Many people therefore experience that a reduced amount of carbohydrates in the diet makes it easier to keep blood sugar stable and at normal levels.

The Effect of Fewer Carbohydrates

Blood sugar before and after starting a low-carbohydrate diet

Blood sugar before and after starting a low-carbohydrate diet

Figure above showing blood sugar readings during ten days before and after starting a low-carbohydrate diet. Data from this study.

Note especially how much more stable blood sugar becomes. Before the change there are large spikes from carbohydrate-rich food, and large drops in blood sugar from corresponding amounts of insulin. Eating instead fewer carbohydrates and taking less insulin will logically enough produce much smaller fluctuations. It thereby becomes easier to maintain a more normal blood sugar level without risking hypoglycemia (low blood sugar).

Weight

Overweight diabetics (both type 1 and type 2) will as a rule lose weight on a low-carbohydrate diet.

Studies

Cholesterol

But what happens to blood lipids when you eat fewer carbohydrates, and a higher proportion of fat? The fact is that recent studies (contrary to what was previously believed) show clearly improved cholesterol numbers.

Blood Pressure

Blood pressure also often improves on a low-carbohydrate diet, which is partly, but probably not completely, explained by the weight loss.

I have heard of many people who have had to reduce or stop using blood pressure medications, when their blood pressure had dropped too low. A common symptom is then dizziness and a feeling of weakness.

Studies

NOTE

With insulin-treated diabetes it’s important to monitor your blood sugar closely initially when starting an LCHF diet! A diet including few carbohydrates usually causes a greatly reduced need for insulin. It’s then important to adjust (lower) the doses sufficiently to prevent blood sugar from dropping too low. This should, if possible, be done with the support of your physician or diabetes nurse, especially if you have limited experience of insulin adjustment yourself. 

You also need to be diligent about closely checking your blood sugar in the event of an acute illness, please see below. 

Insulin for Type 1 Diabetics

bloodsugarmeasuring

The doses of insulin need to be reduced significantly on a low-carbohydrate diet. As a starting point, a reduction of 50% may be appropriate when on a strict LCHF diet (compared to eating plenty of carbohydrates). However, this varies with the individual and it’s not possible to predict how large a reduction is needed. There’s only one reliable way: check your blood sugar often when changing your diet and adjust doses accordingly.

If you feel uncertain, make a gradual transition with a gradually reduced amount of carbohydrates in the diet over a few days or more.

The result (after adjusted dosing) will usually be significantly more stable blood sugar, with a decreased risk of hypoglycemia, in addition to other potential benefits on weight and health from lower insulin doses.

To be able to manage entirely without insulin injections in the long run will, in principle, not be possible regardless of how few carbohydrates you eat. However, some people may in the best case maintain well-regulated blood sugar with only basal insulin when on a strict LCHF diet. Mealtime insulin will then be something that’s only used if one makes an exception and eats more carbohydrates.

If Blood Sugar Drops Too Low

Immediately eat something carbohydrate-rich, such as a fruit or a sandwich. A glass of juice or glucose tablets may also work well. They raise blood sugar. If your blood sugar drops too low you should strongly consider reducing your medication. If you need help doing this contact your doctor.

Acute Illness and Ketoacidosis

Note also that the need for insulin – regardless of which foods you eat – increases with acute illness. It’s not uncommon with dangerous ketoacidosis (life threatening condition caused by severe insulin deficiency) in connection with, for example, stomach illness during which you don’t eat and therefore may forget to take your insulin.

The same applies if you eat an LCHF diet. The insulin-requirement may increase with illness. If you normally take low doses it is of course extra important not to miss this increased need. Don’t forget this. Missing the increased need for insulin when ill, is likely the greatest risk with low-carbohydrate diets and adjusted low insulin doses.

 

More on Type 1 Diabetes

Another Diabetic Epidemic – Type 1

Common Questions and Answers

I HAVE TO eat carbohydrates regularly or I’ll suffer a blood sugar drop.

Yes, IF you take the same doses of insulin you take today, then you probably have to consume plenty of carbohydrates. But if you adjust the insulin doses according to your needs you don’t have to do this.

The question is: should you allow insulin to control your life, or would you be willing to adjust insulin doses to fit the life you lead? In the latter case an LCHF diet may work great, as it has for many type 1 diabetics who have tried it.

As noted above the insulin doses usually need to be lowered significantly. It’s not uncommon that doses need to be halved.

Don’t fat-laden sauces, lots of cheese and butter mean death for me as a type 1 diabetic? For diabetics, the risk of getting cardiovascular disease is increased, and a diet based on large amounts of fat would be like signing up for a future heart attack?

This is an old theory, that has been proven incorrect. Natural fats in food don’t cause heart disease, whether you are a type 1 diabetic, or not.

The problem with type 1 diabetes is exclusively a deficiency in insulin production, which makes it difficult to control blood sugar. High blood glucose levels over a long period of time is what then causes dreadful complications in the long run: heart disease, blindness, dialysis due to failing kidneys, amputations.

If you, with the help of a low-carbohydrate diet and adjusted insulin doses, normalize your blood sugar your body will work just as well as any healthy person’s. If you are able to maintain this the risk of long-term complications will likely be zero.

More on Diabetes

Diabetes – Normalize Your Blood Sugar

LCHF for Beginners

All blog posts on diabetes

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62 Comments

  1. Sorry, I didn't understand that you were underweight. Please talk with your doctor about your problem. I'm not a doctor so I avoid giving medical recommendations but if you are a member you can direct questions to our experts here:
    http://www.dietdoctor.com/member/ask-the-experts

    but doctor i am in under weight i am looking very skinny and sum time i go so many time for urine my urine at morning its coming dark yellow please suggest me i have can i manage my weight i cant stop lose the weight please suggest me

  2. Yaseer
    I lose my body weight. my sugar level is 300 around 1 year. my diabetic is type 1 or 2?
  3. Arnaud
    Thanks for all these advices. I've got T1 diabete since 2015,may. I'm eating LCHF since March,1st. I have reduced my daily intake of insulin to 0!. I've put the insulin pump in the box and now I'm free. It's completely magic. My doctor wants to see how it will evolve. Thanks again.
    Reply: #55
  4. Chetan Daware
    I found with t1 diabetes before last 3 months n my age is 28 at present, one of my family doctor medicate me with proper medicines so that I don't have to take insulin dose, but my weight is not gaining at present it is 46 kg around, and I am drinking cows milk daily also.
    So is it OK to drink cows milk daily? And suggest also to gain weight.
  5. Jay

    Thanks for all these advices. I've got T1 diabete since 2015,may. I'm eating LCHF since March,1st. I have reduced my daily intake of insulin to 0!. I've put the insulin pump in the box and now I'm free. It's completely magic. My doctor wants to see how it will evolve. Thanks again.

    Hi Arnaud. I've also got T1 diabetes since May-2015. I have my medicine doses. Can you help me out with LCHF food?

  6. Bitterlaw
    I guess some people find these articles helpful. I do not. I have been a type 1 diabetic for 33 years. Given a choice I at 15, I would have preferred cancer to this curse. At least you have a fighting chance with cancer. Diabetes is a long, slow death sentence that shatters one dream at a time.
  7. glen
    If a type 1 diabetic didnt take there insulin and ended up in Ketoacidosis, will they lose fat im guessing its the same as the keto diet
  8. Rebecca
    I've been a T 1 for 30 years. I also have other autoimmune diseases. I also suffer from many diabetic complications. I have almost lost my life and my only pregnancy. I battle conflicting hormone imbalaces. Insulin is a hormone. I have never been told by any specialist to eat high carb. You need to be in charge of your disease. We have so much info. Don't be lazy and rely on others to keep you well. For stomach neuropathy get pancreatic enzymes until your stomach regulates. Pick a doctor who is willing to be invested in you. A couple years ago I decided to only eat food that are high in nutrients. Nutrition calculater.org. our bodies work better with proper nutrition. When I figured out a diet for me it consisted of no junk or processed food. 66 percent was fats from seeds and nuts and eggs vegetables varied fruit, because the nutrients were higher in veg. Needed only small of whole grain. I was getting all needed nutrients. I felt great. Lost 50 pounds. Eating 2500 c a day. Neuropathy felt way better. Best advice don't eat crap and walk. I walk all the time. Walking takes away pain and so does a nutritious diet. No excuses people. I've gone from 45u long term to 15. I only take what I eat short term. If you go hypo try taking it after you eat and see what you need. Don't keep up with a shot. I test 10 times a day on my meter. Could care less for pee sticks. I just started doing this. I was eating around 70 carbs a day. I've dropped to about 40. Obviously I adjust my short term to compliment my needs. I cannot stop long term. If I go to bed at 100 my waking would be 400. I can go for a 7 mile walk and get kicked up to 500. We're all different. I have infections that ill never be rid . I am a difficult case. But I found nutritious eating is also high in oils. I started by walking around my little block. Now I walk 35 miles a week. Whether you live or die by type one or type two (and I've been both through a pregnancy, not fun). The chose is yours. Oh and eating rice , seriously, you'd be better of mainlining corn syrup, never eat by the way. In my 50s not over too overweight, but I just watched most my family lose their stomach fat. I'm in. PS the only person keeping you from being a healthy diabetic is you. Be informed. Don't eat crap. Try to walk. Eat nutritious, you can do that on this diet. Anyone that tells you it's okay to alot of carbs is smoking crack. I don't want to hear your neuropathy keeps you from moving. Not true. Weather you live or die is up to you.
  9. Kole
    None of you non- diabetics know what you're talking about. Go live a diabetics life for a week, then come post comments.
  10. rebecca sullivan
    Yes, some of these comments are nonsensical. I have been on the Lchf diet for over a month, I have had to increase my long term insulin. I am guessing I have not used the glycogen stores during the day since I'm burning ketones, so I am spiking more at night. My short range is less due to less carbs. I hike two hours a day. My blood sugars are alot more stable and I rarely go low. I am type one. A type two can get rid of their condition,but a type 1 never will. They can make the best of it though and keep from getting worse. Again my moto is don't eat crap and walk. I am actually disappointed in many of the ketogenic views. Nutrition is key. You can eat keto and eat very healthy foods. I don't agree with just sit on your ass and eat pork rinds dipped in mayonnaise. And if you want live of off fat bombs filled with chemicals it's all good. I don't give a rot how many degrees you have that's bull. I am hiking two fast hours a day. My macros are 10c15p75f. I have to get some extra carbs sometimes because I feel sick. I believe athletic people need to carb up sometimes. I often smell like ammonia an hour in to my hike. I know the difference, been type one for over 30 years. Oh and I get at least 100% of every nutrient I can get plus alot extra. This diet needs to be done with wisdom as with everything. You need to listen to your own body. Don't be a flippin sheep.
  11. sfslavin
    I'v been T1 diabetic for nearly 40 years. I'm well educated in nutrition and healthy eating and have had good control over my disease. I recently took a "leap of faith", two weeks ago, I changed to a very strict low carb diet with help of this site. As a side note, my diet never included heavy carbs, we eat organic whole foods. I'm guessing 100 to 150g per day of previous carb intake. Currently I'm 10-20. My decision was based on inflammation problems I suffer from mostly, but tighter blood sugar control would be a bonus. I have been a contractor and avid martial artist for 35 years, that takes a toll on anyone.
    Within two weeks my insulin intake has decreased 50% and blood sugar barley moves from 85-90. My energy level has increased significantly. Also, my inflammation problems have improved. For instance, most mornings for a number of years I have to hold a frozen rock in my hands because they get "stuck" due to arthritis. The past 11/2 weeks I have not had this issue. I am very excited about these results and look forward to the coming months.
    Thank you diet doctor team! Good luck to everyone, use common sense and adjust to your own body and situation. It does work, even with somebody like me who ate very well and was not too far off in diet.
  12. Jay
    Diet Doctor is a great resource. But the one thing that ought to change here is the notion that Type 1 diabetes is in any way "juvenile diabetes." Referring to it as such, or even saying it was "previously called" that term, is like saying "AIDS" was "(previously called 'Gay Related Imunnodeficiencey Syndrome')." That may be true, but it's such antiquated terminology that was inaccurate then, and is even more inaccurate now; because we know that a significant number of autoimmune diabetics are diagnosed after the age of 30. I was nearly 50 at diagnosis, and my in-law relative was over 60. So, Type 1 / autoimmune diabetes can happen to anyone at any age -- the adult version is often called LADA (Latent Autoimmune Diabetes in Adults), but it is an autoimmune disease with little or no difference between it and Type 1 in children. The result is destruction of beta cells in the pancreas, insulin dependence for life, and a need to control diet to maintain normalized blood glucose levels. Thank you for fixing these two pages in advance! Enjoy your videos and articles a lot. You're helping many people.
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