Selling Paleo to a Type 1 Diabetic

by (2512) Updated April 22, 2011 at 1:35 AM Created September 17, 2010 at 1:35 AM

It's easy to convince someone with Type 2 Diabetes that low-carb paleo is the way to go, since the Internet is flooded with material supporting this move and anecdotes of successful folks who have cured the disease, even whilst eating frankenfoods.

My Type 1 diabetic colleague, who confidently espouses the importance of her following a low-fat-low-GI-low-sugar-low-salt diet, coupled with a tonne of exercise to avoid hypoglycaemia, will not consider any possible diet except that laid out by her by-the-book doctor. I can give her the whole run-down of why grains etc are poison, but she feels that her disease makes her far too special and that those unhealthy foods are fine for her.

Is there anyone here with Type 1 who could give me a pithy anecdote of their own to explain why living on rice crackers and whole grain foods is perhaps not the smartest idea for a diabetic?

I've found a couple of resources online, but they tend to confuse Type 1 with Type 2 - can anyone point me towards some more targeted texts?

Right now, that colleague is giving "health advice" to some other colleagues who have just enrolled in Weight Watchers, now run at my school! ARGH!

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8 Replies

20469 · September 17, 2010 at 3:43 AM

This one is tricky. Hypoglycemia in a type one is not caused by the same thing as hypo in a type 2. A hypo in a type 2 is often caused when the body overshoots on its insulin production. But a type one does not produce insulin. A type one has to shoot insulin via a syringe. A hypo in a type 1 is when the human does not balance insulin shots with glucose intake and the insulin is too strong and too much glucose is taken out of the blood stream. That is why type ones must carry sugar with them, in case their blood sugar starts to go too low. Even believing in paleo, if I were a type one, I would always carry sugar. In a type one, if the blood glucose goes to low, sugar is the best fastest way to save your life. Protein/fat digest too slowly. In the event of an oncoming hypo, you must ingest glucose asap or you could quickly have convulsions and die. In order to properly argue for a low sugar diet, you MUST understand these basic issues that face a type 1.

Now for other complications. There are many kinds of insulins, fast acting insulins, slow acting insulins, and a variety of intermediate acting insulins. Type ones will often use a variety like a slow acting one for all day plus a faster acting one to shoot up around meal time when glucose load is high. How fast each individual responds to each type of insulin is unique and required experimentation, planning, and experience. How much insulin is needed at meal time depends on how much food is eaten and what type of food is eaten.

For a person who processes/responds to insulin quickly, that person damn well better have a lot of glucose entering the blood stream quickly. Or he/she could die. Or that person can try to find a slower acting insulin and then perhaps coudl eat more protein fat and less glucose. But the two must be balanced, both insulin action and glucose entering the blood stream from food. The diabetic must try to match not only intensity but also duration. It's tricky.

To make matters worse, the body doesn't always respond in the same way to the same dose of insulin. Morning insulin may act different than night insuline. And exercise can strongly inhance the activity of insulin. That is why exercising diabetics can easily risk going hypo. Cuz now the same amount of insulin is going to be stronger than it was before and the diabetic will need to be very very careful of not going hypo. Best keep some sugar around for emergencies. Also, for unknown reason, some diabetics are just 'brittle' as well, which means their bodies react particularly erratically and unpredicably to glucose intake and insulin intake. These people have special difficult balancing their blood sugars.

So. What you are probably trying to do is convince a diabetic that has figured out a succesful balance of specific insulins to specific glucose intake, to try a different type of food, which would probably mean she would have to work with a whole different insulin regimen in order to properly balance it. She could not continue to shoot the same levels of insulin if she cut her glucose intake. If she did, her current insulin intake could kill her. To change her diet to low carb, high fat/protein, she would need to find an insulin regimen that would mean a less strong insulin that would last a longer time in order to match the digestoin rates and glucose load of the new diet. This could throw off her whole system and it could take months or longer to come up with a new system that is safe for her. Doing this would mean more blood testing, higher risk of going either hypo or having too high blood sugars, and lots of experimentation. This is probably why she doesn't want to do it. I'd say over the long haul, the improved health that comes with eating healthy food is worth it. But you have to realize that simply changing diet is not a simple process for a type 1 diabetic.

1267 · September 17, 2010 at 2:07 AM

Oh you have to give her Dr. Richard K. Bernstein's book - Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars Its a wonderful book and although he does not refer to the diet as Paleo its pretty much the same thing. It really is an amazing read

848 · September 17, 2010 at 9:49 PM

I've been type 1 for awhile, but I could never really get my sugars under control. I always wound up over 200 every day, and was constantly fighting high blood sugars, even though I took such care with carb counting! I've been primal for 2 full days, but my sugars are already staying between 85 and 135 -- literally non-diabetic. My insulin usage has been cut in half. I'm down 2.8 pounds. I went partly primal several weeks ago, and in that time I've eliminated my morning dose of Metformin -- I hope to be off my evening dose eventually as well.

I only worry about lows because my basal needs are changing along with my diet. Because I no longer take excessive amounts of insulin at meals, I no longer have to worry about having misjudged my carbs and crash horribly later.

And if she ends up hypo easily its because her basal usage is too high.

3035 · September 17, 2010 at 3:23 AM

I am Type 3, meaning I burned out my betas as a type 2 from chronically high blood glucose. I shoot like any Type 1 only straighter and from the hip...into the hip. The answer is that High Insulin is more dangerous than high blood sugar. The more carbs you eat the more insulin you have to shoot. The down side of high blood sugars are diabetic complications. The down side of high insulin is cancer, endothelial disrution and blockage ie. heart disease, auto immune disease, excelerated ageing and all the horrible consequences that come too soon to diabetics who shoot too much insulin or produce it. INSULIN IS A GROWTH FACTOR. And lastly, Doc Bernstein's Rule #1 "The Law of Small Numbers"...the smaller the number the smaller the mistake...the bigger the number the bigger the mistake. Big carbs means Big insulin means Big mistakes means Big cell overgrowth means Big health problems means Big money for Big Pharma.

1658 · September 17, 2010 at 2:10 AM

Dr Bernstein has been Type 1 for over 60 years. Head on over to Youtube to check out what he has to say. He has a practice -STILL- in norther California, and has a monthly teleseminar.

The teleseminar starts with a topic of the month (5-10 minutes) then the rest of the hour is devoted to listener submitted questions.

He is THE best testimonial for Type 1s and his patients are a close second.

2297 · September 19, 2010 at 3:53 PM

Many T1's acquire additional autoimmune disorders over time. One of the most prevalent is celiac and another is autoimmune thyroid disease. Eliminating grains and other inflammatory substances may help prevent that.

link text

20 · April 22, 2011 at 1:35 AM

I know this thread is on the outs, but here are some more thoughts to consider.

I've been type 1 for 15 years, on a pump for 13. During my undergraduate career I managed to gain quite a bit of weight. I was using 60-70 units of insulin per day. I found sparkpeople and as I started losing weight (still on SAD) I made it down to 30-40 units per day.

Since going primal/paleo, I use about 20 per day. I feel better and my blood sugars are under MUCH better control.

I also HIGHLY recommend Dr. Bernstein's Diabetes Solution - his main point is with small inputs (aka low amounts of carbs and insulin), there is less room for error. It's so true. His diet is practically paleo. I learned quite a bit from this book even though I've been diabetic so long. (Think Like a Pancreas by Gary Scheiner is also good, but SAD.)

Hope this helps someone out there!

80 · September 17, 2010 at 11:25 AM

I have a client with Type 1 and he used to require 13 units of Insulin before each meal. After converting to Paleo he is now down to between 3-5 units prior to each meal. It just works!!

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