When I was diagnosed with type 1 diabetes in 1979, the dietary rules (yes they were RULES) had a “forbidden foods” list of all the things that contained sugar – (all the best stuff for a 12 year old) and then there was a “free list” ALL the meat and cheese and fat, oh and vegetable sticks, and a list of carbohydrates that I had to eat 6 times a day. Heaps of it. Heaps and heaps……There was a focus on the fact that carbohydrates were the building blocks of a “diabetic diet” as it was called. Did I mention we weighed all the foods at first as well? Because it was a “portion” diet, later changed to exchanges, to model the US version. A portion was 10 grams of carbohydrates, and an exchange 15 grams. This meant I got very good at counting food. That is not very good for your mental health.
Each meal had a set amount of carbohydrates, so for example – 6 portions for breakfast, 2 portions for morning tea, 6 portions for lunch, 2 for afternoon tea and 6 for dinner, 2 for supper – SO MANY CARBS! Sometimes it was more or less, but always set. In stone.
You basically had to feed the insulin back then, and I guess as bacon is one of my favourite foods, it was apt that I was also using pork insulin – literally insulin direct from the pancreas of a pig, or pigs to be precise.
I was on 2 set injections per day, and they had to be given at set times and then you had to chase your tail all day to prevent hypos (low blood glucose) and deal with the highs with….well…nothing really, because back then we would not take additional short acting to deal with a high. And so, after becoming sooooo thin prior to diagnosis, I put the weight back on and then some. I carried too much weight in late high school, but by then I had given up the idea of 2 injections a day and was taking just the one, and was not really that interested in caring for diabetes, or myself.
It was not until after I had my second son in 1999, that I had my first dietitian consult since diagnosis, and she explained that we now looked at the glycemic index (GI) of foods, and that it was no longer necessary to use the forbidden list, as long as I looked at the GI. This opened a lot of food doors for me! I was able to eat things like honey, cereals and other products that contained sugar. It was not really a positive change in some ways, but it did make me feel better.
Over the years my weight went up, and down, and up and down. After my first son, in 1993, I suffered with postnatal depression and a terrible relationship, they kinda went together like bacon and eggs (bacon again!). And this did not bode well for my weight. I ended up around 110 kilos and was miserable. After leaving the relationship with a 9 month old baby, I set about making changes to my life. By this time we had fast acting analogue insulins (pigs were no longer, other than bacon!). We also had a more flexible approach, with a dose to what you eat regime for the fast acting insulin, still with 2x day long acting insulin. I saw a dietitian and worked very hard across a year, to lose the weight and get back to 70-75 kilos.
Things were going along ok, but my diabetes was never fabulous and then I developed gastroparesis. I will blog more about that in particular soon but it is basically delayed emptying of the stomach, leading to all sorts of pain and problems, as well as really messy diabetes control. I ended up needing to split my meal time doses to pre and post meal and was on around 10 injections a day. I went on an insulin pump in 2001 which was also life changing (and other post!).
Following my second son’s birth in 1999, I also put on lots of weight and was once again up in the high 90 kilo range. I undertook to lose the weight with calorie controlled eating once again, and got back into the 70’s again. Carbs however, still featured in my daily eating plan. The idea of low carb eating for diabetes was creeping in, but I was firmly in the Carbs Camp and not a fan, in fact I was scared of life without carbs and the impact on hypos.
In reality, low carb is not new. Years and years ago, the diabetic diet was based around dropping carbs and eating meat and cheese. It makes sense. However the Australian dietary guidelines are heavily tied to carbs and as a diabetes health care professional, I was schooled in this idea, of course on top of all those years of having carbs drummed into my head for my own diabetes.
The third time my weight crept up was after my 3rd baby (bloody kids!). And after seeing a photo of myself and realising I was again in the high 90 kilo range, I set about the weight loss pathway yet again. I successfully got back into the 75-78 kilo range. You see, I could lose the weight with a tonne of hard work and calorie controlled eating and exercise, but my diabetes was ever increasingly hard to manage. I would be doing up to 20 blood glucose checks a day, dealing with multiple stomach issues, hypos and hypers, troubles controlling my levels during exercise, sitting up late at night waiting for stability…..
Then, at the end of 2015, I got very sick with asthma that would not go away and ended up on prednisolone in early 2016, which stacked on more weight. I was so miserable. My weight crept up and slowly up, until I hit 90 kilos again. My diabetes was hell. I knew something had to give. One day, a weight loss programme flew by my Facebook feed. It was basically a low carb, high fat eating plan. I just jumped. Never having been a fan. Something just said jump. It can’t be worse than where I am.
Where I landed was life changing. I have lost 12 kilos from November 2016 until now, but even better than that, my HbA1c last week had gone from 7.8% to 6.5% which is the lowest it has been ever, except in pregnancy. I can now exercise with a level of 8 mmol and end up between 5 – 7 mmol. I no longer have to manipulate my levels pre exercise to be in the teens, or eat additional carbs. I have far less hypos and when I have one it is easier to recover from. I rarely see numbers over 10 mmol unless my insulin pump site is failing or I am sick or stressed. It has truly been life changing.
I will share what I did and what I eat soon, as well as some recipes. But for today that is long enough. I will say I am not zero carbs, I probably range around 50 grams per day, give or take a little. I have given up bread (NOT easy), and all other grain based foods, sugar – so all commercial sauces, jams, ice cream, any flavoured yoghurts etc.
My diet is based around a lot of fresh vegies (no starchy ones), some fruits – bananas, apples, oranges, all the berries, pears (but in measures, so maybe half at a time, or just one here and there, but at least a piece each day), some seeds (I discovered some upset my gut like linseed and chia sadly), nuts and nut butters, cheeses, bacon, all the eggs, dark chocolate (I was thrilled to discover a little of this does not impact my blood glucose much or my weight), coconut yoghurt, lots of healthy fats, lean chicken, fish, turkey (I can not eat red meat with my gastroparesis). I am never hungry. I am very happy.
The early weeks were hard and I did have runs of crashing hypos, but as my body adjusted they became less and less. My understanding is that the higher fat is important for your body to gain energy instead of via carbs and over time my body has changed.
I would love to know if you have gone low carb and how you have found it? Stay tuned for the next part of this story!
(please bear in mind this is a personal story and if you are looking to change your eating plan you should seek advice from your health care professional).