Need help with low carb diet

Hi All,

My sister have been type1 D for 10 years. She switched to low carb diet recently so that she can maintain the blood glucose in range, and limit risk hypos by not dealing with high doses and getting it wrong.

She had Kashi Pesto ChickPea quinoa bowl once( and ended up with high insulin resistance and sustained high for almost 2 days. We were not clear if this is because of the 14g fat (most of them are unsaturated) in it. But after this experience, she is bit scared of having fat too.

This fear of fat and low carb is leading to low carb, low fat, high fiber and medium protein diet. We are not sure if this a healthy meal plan as she is losing weight.

I have few questions that I am hoping someone will be able to help me understand

  1. What is the healthy way to do low carb diet, is avoiding fat sustainable in low carb diet?

  2. How much of fat will trigger sustained insulin resistance ?, since there is fear of hypo, when ever there is sustained high, it usually takes long time to correct since she is bit apprehensive about dosing high or increasing the basal.

  3. Off late, it takes a long time and lot of gluco tabs to recover from the low, could it be possible because liver’s glycogen store is very less because of the low carb diet? If yes, how do ppl following low carb diet work around depletion of glycogen store in liver due to limited carb intake?


Hi, I’d like to help you with some of your questions. I have had T1D for 42 years and I have a MS in Nutrition Science. I am a LDN RD. 1) I get the low carb thing, make sure the carbs that are eaten are high in fiber. That is: whole fresh fruits and vegetables. Personally, I never eat rice, white or brown, it makes my blood sugar very high. I eat a very high fiber bread that I get at Aldi called Seedtastic. I only use whole wheat pasta and I weigh all carbs on a Salter brand scale and get the exact amounts of carbs - especially cereal and high fiber snacks like popcorn. I do not avoid fat. Having fat at a meal will actually help you to digest food more slowly, thus avoiding a rapid high blood sugar. I also use an insulin pump which allows me to divide my boluses and give them over a longer period of time. The best way to increase muscle glycogen is to exercise regularly. When you deplete your glycogen stores exercising, your body will want to fill them back up. You do this with good carbs, like whole grains and fresh fruits and vegetables. And remember, fat is not the enemy, as long as it is good fat, like avocado, olive or canola oil, peanut butter. Lean meat, like chicken, and fish, lean beef and pork tenderloin, are great for also slowing down blood sugar rise after meals. I hope this was helpful.

Thank you Lisa @lisabw26 for your wonderful “refresher”. Your diet tips are what I’ve been attempting to do for many years. But like many other aspects of living with T1D [I was diagnosed in 1957] I have let slip. I hope everyone will read what you wrote.

I’ve never practiced a “low carb diet” scheme having decided in the 1950’s that I want to live a real life and not let diabetes govern what I do, but rather make or manage diabetes to fit my active, full lifestyle - there isn’t a thing that I’ve wanted to do [other than a Naval Officer Commission] that I’ve let diabetes rule out.

I am also searching for low carb diet.


I’m not sure about the specific diet causing a sustained high. But I do find that exercise is the best treatment for a refractory high. The combo of accurate carb counting, using a scale for carbs, exercise, insulin with proper ratios and corrections and timing of delivery, and smart low carb diet. I don’t think avoiding fats is necessary, it can slow carb absorption and perhaps you need to do a combo bolus delivery where 50% of dose is delivered over 2-3 hrs if your pump can do that. Hope it helps.

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One thing to watch out for with an extremely low carb diet is ketosis. A non-diabetic will have no problems with ketones in the bloodstream. But if you have T1D and ketones, going high for whatever reason can lead to ketoacidosis. Then it will be very hard to get your blood sugar back to normal. Ketoacidosis requires immediate medical attention.

I recommend speaking with your doctor and a dietitian about a minimum level of carbs per day so you can avoid the production of ketones.

I totally agree with a low carb diet, but make sure to treat yourself once in a while so you don’t feel tortured.

I too eat a very very low carb diet; I can maintain blood sugars so much better. Straying off once in a while does help with the sanity tho. Mediterranean diet works for me

:smiley: excellent summary - thanks for your input.

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