To Carb or Not to Carb

I’m curious T1D community: do you eat carbs? Low carb diet? Keto? I’m constantly evaluating and re-evaluating what the best diet for me is. What works for you guys?

I’ve never been sure exactly what constitutes a low carb diet, but I myself average about 40 per meal. I started eating “Mediterranean style” the beginning of the year - it wasn’t conscious, but long story short I saw a plate a friend posted on FB, thought it looked delicious, and started looking up “Med style” recipes. I don’t have heart problems but due to my long-term diabetes I see a cardiologist periodically to make sure things are good. She was very pleased, especially when my cholesterol and other numbers improved a lot.
I will add that I started working out at the gym around the same time, which played a part, and between the gym and the Med I’ve lost about a pound a week so far, which is good for me. I started out with just breakfast, and liked it so much I often eat Med style at least twice a day.
Whatever eating style you choose, I would recommend talking with your dietitian to make sure you’re getting all the nutrients you need. Wishing you all the best!

Hello @Tosha and welcome to TypeOneNation. There is no straight answer to this. I like carbs, being Irish and Italian I like potatoes and pasta. If I am not trying to lose weight I’ll go 20-80-60 carbs breakfast lunch dinner but if I am at my computer it’ll be much less carbs and more like keto. If I am trying to lose weight same, more like keto. I am working out now and have upped my carbs and protein trying to gain muscle.

Oh yea I cooked my wife home made gnocchi and a tomato/ meat sauce I designed for Valentine’s Day. A small portion is an easy hundred grams carbs(fast carbs too). With the right red wine it’s to die for.

The law of small numbers means small carbs, small insulin, small mistakes and if I want near or even perfect blood sugar with no spikes even after a meal I have to eat low carbs probably 10-15 grams per meal.

So this is going to depend more on what you’re doing and what your goals are. If you spill, we can probably answer better. Cheers good luck :four_leaf_clover:

Hi @Tosha and welcome to typeonenation forum. As @joe said, there isn’t any one way and each of us needs to find what works best - individually.

Up until about sixty years ago I was on a “starvation diet”, the only way to live with diabetes. Now I eat, and enjoy carbs, about 225 grams average every day. I enjoy fruit and had lots today - I’ve eaten 250+ carbs so far and BG is 94; okay, I was volunteering on construction. I’m getting up in years and still healthy and active.

For you, eat what you need to fit your lifestyle and stay healthy - live a fulfilling life.


I do the keto diet, lately I have been cheating a lot. But I am doing better again. The keto diet works for me but being a teenager means I still need carbs to grow so I have to have some cheat days. hope this helps

While I certainly eat carbs, I find it easiest to control my blood sugar and keep my lines flatter when I’m eating low carb. Lower carbs, less insulin, less lows due to exercise with a lot of fast acting on board is easiest for me to control.

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How do you keep your blood sugar at 94 with 250+ carbs. I am just curious.

Hi Andrew @pheonixfirebear, a lot of luck. That day that I mentioned was NOT my normal - I had been working hard outside for 8+ hours and had taken almost 20 units of insulin. These days I use only one-fifth of the insulin I needed 60 years ago just to get my BS under 200.

For a person with diabetes, I have always eaten a relatively high carb diet - it has something to do with metabolism rate that my HbA1c has been between 5.7 and 6.4 for a couple of decades - I recall only a couple that have been outside that range. It requires trying to maintain the balance between food, activity, and insulin; since the late 1970’s when I was part of the team experimenting with the development of MDI I learned how to micro-manage insulin. Right now I’m letting Control IQ do the hard work for me.

Well, as a long time Type 1, the phrase Keto scares the bejebus out of me :slightly_smiling_face:

40 years w/ Type 1, I’ve lost about 40% of my kidney function. My Nephrologist is really on me to limit protein because it is very hard on the kidneys.

Just tossing it out there for consideration…

Hi Tosha
Unlike most T1Ds, I was diagnosed at age 38, when life patterns (eating) were pretty set. I ate what I wanted when I wanted, and often skipped meals etc. Of course some things had to change - no more sugar donuts for breakfast!, but some things couldn’t (I ate out a lot for my work, making it hard to to “standardize” meals, and meal times were unpredictable). But I was not willing to cut out my favourite type of food (carbs!) I did cut out/sharply reduced hi sugar foods, and I tried to take injections 20 to 30 mins. before eating, (though I learned the hard way that in restaurants something had to be on the table before I injected). And most important, I tested my blood up to 8 times a day. If I ate, exercised or felt ill, I would test as often as I needed to keep my BG in range. If it wasn’t, I would take as little as 1 unit to ‘correct’. I use a Dexcom 6 now (so no longer need to do finger pricks!) and my latest results show time in range at 90%. After 32 years I have very few side-effects (very mild neuropathy in my feet). I still eat lots of carbs, (complex carbs are better), but my rule is that if I eat it, I have to be willing to do blood tests (no longer an issue with a CGM) and take an injection when needed. Works for me, I still get to eat my carbs, but I test a lot and inject a lot.

The law of small numbers, as Joe put it, is what works best for me. That and always making sure I have some fat and/or protein with the carbs. A banana alone, even with the “right” amount of insulin, can send me into a spike that will take much more insulin than originally taken, to get back in range. The same banana with peanut butter is just fine. I do occasionally have a higher carb meal–meaning 45-60 grams for me–but I am scanning the freestyle libre pretty much nonstop and planning on those small corrections as needed. Higher carb meals aren’t worth it for me
. I am amazed at some of the high carb numbers I am reading; I wish that worked for me. It just doesn’t.

I’m with you @Bnootbaar. My kidneys are fine but the idea of high protein always scared me, even for non-diabetics. I do wonder about the kidney function of non-diabetics who follow high protein diets, and when people started jumping on the Atkins bandwagon I admit I wondered if it might cause damage to kidneys that might otherwise be used for transplant by those of us who needed one.

Hi @Tosha. I’m 17 and I honestly didn’t change much following being diagnosed. I cut out pretty much all candy and deserts but I was never a big fan of super sweet food anyways. I have always loved carbs and continue to eat a good number per day. While there is a fair bit of variability, I will usually have 60-90 for breakfast, 30-70 for lunch (although I do skip lunch a fair bit), and 80-120 for dinner. While this does mean I use a lot of insulin, I exercise a good deal (especially during sports seasons for me, where I have 2 hour practices 5-6 times a week), which does help to lower the amount I need. I am currently on MDI and try to inject at least a couple minutes before I start eating, especially if I am going to eat a high carb meal. I have been able to keep my A1c below 5.5 pretty easily (last one was at 5.1).

Hi will @20XC21, you certainly eat plenty of carbs, or should I say eat enough food to fuel a young, growing, healthy, and active body. And from reading your HbA1c, it appears that you have learned well how much insulin you need. You’ve got the food, activity, and insulin scale balanced.

Now a question, are you able to avoid hypoglycemia? Do your BGL often drop lower that you would like? A word of caution for when your life becomes more sedentary - cut back a little on your food intake and some insulin. Some people with TypeOne fail to do this, and with the help of insulin gain way to much weight and become “double diabetic” - our autoimmune type plus lifestyle obese diabetes.

Hi @Dennis, in general I find that I generally avoid hypoglycemia, as I am constantly adjusting my Lantus and Humalog doses based off of how much exercise I have done and how much I plan to do. Additionally, I am constantly monitoring my Dexcom and make sure to try to prevent any potential hypoglycemic events before they occur.

Because I tend to prefer to keep my BGL reasonably low (ideally at around 80mg/dL but I’m comfortable going down to appx. 65), I always have 40+ grams of fast acting carbs on me in case I need it. Generally my Dexcom gives me a time in range of 85% (70-150mg/dL) which I am pretty happy with.

I find that my insulin requirements in season are drastically lower than when out of season, so when I’m out of season (in the winter), I try cut back on carbs to keep the amount of insulin I need lower (I averaged about 35g of carbs per meal today). I will definitely continue this when I don’t exercise as much.

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@20XC21 Will, you are an inspiration!

Your story should be spread far and wide - especially to the teens and young adults who think living with diabetes is impossible. Thanks for sharing your story.


Tosha: I tend to eat high fiber products - - whole grains, brown rice and beans. These break down slowly so they don’t spike my BG as fast or as high as simple carbs do. I also keep my carb count down to 30-40gms per meal. Breakfast and lunch are usually 20-30 carbs and dinner is sometimes up to 40. For me, eating whole grains, etc, have been key - - they also help you feel full longer!

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@Tosha I do not “diet”, but depending on my BS and activity levels for the day, some times I am low carb, other times I am full on carbs. I have found that some foods or variations of foods just are not worth the blood sugar spike, so I tend to avoid those or only have them on special occasions. There are a lot of great low-carb alternatives out there that make the low carb days a lot less torturous and don’t make it like you are missing out on anything.

My best advice is to do what works best for you and your BS. What works for me, may not work for you, and what you do, may not work for the next person. There’s no “right” way to diet as a t1d.

I’ve been T1 for 48 years. I have no complications an A1c if 5.1 most all of these years or in earlier years a 5.3 before dexcom. I’m mystified why people have issues with carbs. I never spike after eating BECAUSE
I was trained by a licensed dietician to eat HIGH FIBER carbs( usually up to 3-5 grams fiber and mix it with 20 grams healthy fat ( besides fat in lean protein) and fiber like spring greens or spinach which are high in fiber- I never eat regular lettuce. I eat 4 carbs for breakfast , 3 for lunch and 4 for dinner. If I were to eat low fiber carbs I would be a mess. I have a great life and don’t have to starve the carbs out of me. I also ride 30 min treadmill every morning about 30 min yoga and we walk dogs about 45 min at night. I’m a yoga teacher but with covid pandemic not teaching so that’s why at night I’m walking a bit more than usual and doing a bit more strenuous yoga in the am. Also I can not eat high high fiber it takes too long to hit bloodstream . 3 gr fiber is good up to about 5 gr fiber. . I eat chicken, fish, turkey, cheese, Greek plain non fat yogurt-eggs 3 a week, tofu . For protein 3 oz in morning and 3 oz lunch and 4 oz at dinner. Fruit every meal and Greek plain non fat Greek plain yogurt, high fiber fruits like apples, blueberries, etc. I also weigh and measure food and read labels
Best wishes on enjoying a healthy lifestyle. It pays off. The complications aren’t worth me goofing off when I love what I eat and feel good with my exercise.

Hi @Pamshults. Wicks to the forum and thanks for sharing. I frequently get the :arrow_up::arrow_up: arrows on my CGM and your post served as a reminder that I should be conscious of the fibre in (or perhaps missing from) my foods. I’m about due for a nutrition consult anyway, but in the meantime will see about adding some fibre as you suggest. Thanks for sharing your success!