Diabetes Type 1 and Paleo eating - anyone with experience?

[Isabella]

My daughter's boyfriend lives with us, and is T1 Diabetic.  We are embarking on a paleo way of eating, and wonder if anyone has had experience with this type of eating and T1D?

 

I'm thinking perhaps he should just have more carbs than us, but still not excessive, and of course reduced insulin dose.  Of course, we will be seeking advice of Dr, too, but I know most of those are weighted towards higher carbs, and will probably pooh-pooh lower carbs as unworkable for T1D's.

 

I know of Dr Bernstien's book, and that he consults with T1D's and recommends the low-carb WOE, but unfortunately we are in Australia, and he in the US, so a consult is probably out of the picture.

 

Anyway, any first or secondhand experiences - I'd love to hear them.

 

[Lawana]

Dd is Type 1 and has eaten a variety of styles, including Paleo for a while. Type 1 diabetics do not *need* carbs any more than any else does. And some, like Bernstein, would say they should have very few. As you already know, it is a matter of matching insulin dose to diet and activity. Is he on an insulin pump? Is he comfortable adjusting his own basal and bonus amounts? That would be key. He would likely need to reduce, perhaps greatly, his insulin doses. But it is certainly doable.

ETA At one point, dd was using only one third of the insulin she had been previously using. Just to give you an idea of how drastically it may affect him.

[Isabella]

He was diagnosed around age 16, and was given a basic run-down on what to eat (the usual diet pyramid of lots of grains, etc), and how much insulin to have etc. He wasn't really taught to alter it, and he has had no other 'training' since then.  He's a little stubborn about suggestions from others.  He would take it from a Dr, but not a lay person that just 'comes up with a bright idea!'.Over the year that he's been with us, he has had many 'lows', and actually rolled our car over while having a low.  He's not physically active, is out of work, and was not great about eating regular good meals (with adults in the house, it's not so easy to make them be home and eat at our meal times).  DD talked him into reducing his dose, and since then has not had bad lows.  She is now pushing him to eat Paleo along with her.  I've warned him that he will have to reduce his insulin intake, and he seems more amenable to suggestions right now.

 

Thanks heaps for your input, gives me lots of hope!

[An Unexpected Party]

I have eaten very low carb in the past. I no longer do so, but it is possible and I believe is generally recommended for diabetics, at least in the offices I've been in. If this is a drastic change in eating lifestyle the young man  will probably need to alter his dose based on how he is eating. I'm assuming he is not on a pump and is using some kind of multiple daily injections?  (I also have frequent lows (it is not uncommon for me to hit the 40s several times a month and I get into the 20s a couple times a year. I have never needed assistance, though, nor have I caused accidents as a result. Since this is already a pattern he should be prepared to test more often.) Protein from animal sources can cause a rise in blood sugar later than usual, but my suspicion is that someone going for true paleo eating won't be as affected by this as someone eating a 40 oz steak at a restaurant. As he switches eating styles, the best thing for him to do is to keep good data on what he's doing. I would be doing a lot of pre and post meal testing to figure out how my new way of eating was working for me to check and see if I needed to change my doses. 

 

If he has a smartphone he can keep that info right on it. There are many good apps out there to help.  

 

It sounds like he doesn't have access to healthcare at the moment. He really needs to see a diabetes educator who can help a young adult deal learn the skills necessary to manage his or her diabetes.  It's not impossible to manage, and it doesn't take long to learn, but he's missing some fairly important skills from what you've described.  

[Lawana]

First, your dd needs to understand that his safety depends on matching the appropriate insulin to carb intake. She should not push him to make changes in number of carbs before he can figure out how to change his insulin doses.

 

Here in the US, the teens are taught that they must check their bg before driving. Not negotiable. Is it the same over there?

 

Does he count carbs at all? If not, that would be a first step. Does he have access to a medical practitioner that can train him?

[sarah1615]

My son has type 1 diabetes too. I think a lower carb diet is fine for people with type 1 diabetes and likely preferable long-term over a higher carb diet. As others have already said, it is really about understanding how to match the insulin to the carbs consumed. I would also specifically ask the doctor about whether there is any concern for a very low carb diet and build up of ketones. I know in the past I had heard that people with type 1 diabetes have to be careful about very low carb diets that produce large amounts ketones in the body due to DKA (diabetic ketoacidosis), but I never saw anything scientific about the topic so that's why I suggest asking the doctor. Oh and by doctor do you mean an endocrinologist? If he's not going to an endo then I'd really recommend helping him find one. Usually regular MDs aren't as knowledgeable about the differences between type 1 and type 2 diabetes. An endo would be able to teach him how to fully manage his diabetes and how to adjust insulin for carbs, etc. Good luck!   

[RebeccaS]

My oldest dd is a T1, now pumping.  I agree with finding him an endo if he doesn't have one already.  When my dd was first diagnosed, we were told to have her eat 60 carbs a meal and inject x amount of insulin, plus correction.  That lasted just a few weeks, though, until we got comfortable with managing her diabetes (baby steps).  Then, we were taught how to calculate for carbs so she didn't have to eat a prescribed amount of carbs per meal.  Now, dd will sometimes eat very low carb meals, or if she wants something higher she can do that.  I agree with not making dietary changes until he can dose according to the carbs he's going to eat.  Dd's dietitian, though, does not want her to go below 45 carbs because she believes that dd needs to have at least 45 carbs per meal.  Dh and I aren't as convinced of that and so we allow dd to eat way less carbs if she wants to do that.  She also pushes cow's milk (which dd HATES), so I take what she says with a grain of salt.  :P

[tex-bex]

Here is a blog I follow for Paleo recipes. She is Type 1 and speaks about it at length. I hope you find something helpful in there!

 

http://www.delightedmomma.com/