# Does low carbing cause Insulin resistance?



## Pattidevans (May 18, 2021)

So Inka and I were having a discussion in another thread, but I felt we were in danger of hijacking the OPs subject, so I suggested we discuss it elsewhere.

I was rather surprised when Inka said that low carbing caused insulin resistance as it goes against everything I have read.  So I decided to do some research and I have to apologise to Inka as there is indeed evidence for that theory.  However, it would appear that it is a physiological change that is triggered by a very low carb diet where the body has gone into ketosis.

The following quote comes from Marks Daily Apple - https://www.marksdailyapple.com/does-eating-low-carb-cause-insulin-resistance/


> *However, going very low carb – to around or below 10% of calories, or full-blown ketogenic – can induce “physiological” insulin resistance. Physiological insulin resistance is an adaptation, a normal biological reaction to a lack of dietary glucose.* As I’ve said in the past, the brain must have glucose. It can use ketones and lactate quite effectively, thus _reducing_ the glucose requirement, but at the end of the day it still requires a portion of glucose. Now, in a low-glucose state, where the body senses that dietary glucose might not be coming anytime soon, _peripheral_ insulin resistance is triggered. This prevents the muscles from taking up “precious” glucose that the brain requires. The brain’s sensitivity to insulin is preserved, allowing it to grab what glucose it needs from the paltry – but sufficient – levels available to it.


So what do we mean by "low carb" when talking to T1?  Do we mean a very low carb diet as advocated by Bernstein?  Or the TypeOneGrit group on FB (incidentally I did mention that I am a member, but it doesn't mean I follow it for anything other than the odd low carb recipe for a sweet treat).  The article here https://www.diabetes.co.uk/news/201...ptional-type-1-diabetes-control-91241367.html discusses a study showing the exceptional control experienced by the type ones who adhere to this type of diet.

Or do we mean just moderating carbs and avoiding high carb meals?  What is a high carb meal and what is a "normal" amount of carbs?  To me, growing up in the 50s and 60s, we ate meat, fish, bread, potatoes and vegetables.  Our diets did not consist of lots of pasta nor rice.  Rice was for rice puddings, usually only after Sunday dinner.  I well remember working with an Italian girl in the late 60s who gave me her recipe for Spaghetti Bolognaise.  I decided to cook it for my parents.  I had to scour the shops for spaghetti, eventually finding it in a specialist shop in a long long purple paper packet.  The general public were largely unaware what a pizza or a curry was (except for Vesta curries which were dehydrated) In the 70s the majority of people were slim and an obese person stood out.  It was in the 70s and 80s that carb creep crept in, takeaways became more available and between then and now people started to feel that if you don't have a huge pile of carbs on your plate it's not a meal.  In part I do feel that the "Eatwell plate" which started to be touted in the 70s as "heart healthy" has a lot to blame with it's insistence that grains should be a large part of people's diets.  That all goes back to a very flawed 7 countries study that Ancel Keys thrust upon the world and that the American grain industry latched on to.  He omitted to mention that the study had started with 22 countries and that he had thrown out the results from the countries that contradicted his theory.

Sorry to hark back to DSF, but there we advised T2s to "eat to your meter" and frankly I do not think that's bad advice for T1s either.  I know that if I have a couple of days where I overdo the carbs that I am going to suffer for several days afterwards,  struggling to get back to over 70% Time in Target on the Libre.  So  where do I stand?  I prefer to stick to 70g(ish) carb per day with the relevant insulin boluses.  I would not consider 70g as normal carb in one meal.  I'm more insulin resistant in the mornings, so I usually don't bother with breakfast.  This week though I have a series of appointments in the late morning which means my lunch is later than usual and so I have been having a small breakfast, a single piece of Burgen (12g carb) with butter and marmite spikes me up into the 10s and 12s.  This morning instead I had 100g greek yoghurt with strawberries.  It was quite filling and I bolussed for 10g.  I had barely a blip in BG.  Anyway I digress, the thing is if a T1 eats something, pre-bolusses and counts carbs correctly then it spikes them, then I am likely to mention it might be better avoided in future.  Just because we have insulin doesn't mean we can eat everything with impunity.

As we so frequently say, we are all different.


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## travellor (May 18, 2021)

We have eaten carbs throughout time.
High carb was a staple diet.
Rarely was meat the predominant part.
Bread was always used to finish off a meal, semolina puddings, potatoes were a bulk of the meal.
We evolved to process carbs.

It is true that cutting carbs out of your diet causes high blood glucose, but only until the body readjusts. (for a normal, healthy person).
Whether it's insulin resistance, or the pancreas becoming slow to respond for a type 2, or both, we adapt to the diet we are on.

For a type 2, taking an oral glucose tolerance test, it is recommended to eat a normal carby diet for at least three days before to let the body re-adjust.


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## Pumper_Sue (May 18, 2021)

I have always found it's the amount of fat in the diet that causes the problems.


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## Inka (May 18, 2021)

Apology accepted @Pattidevans  I explained what I was referring to in that thread - a biological response. I used to like Mark Sissons because he was pretty balanced about carbs but now he’s jumped on the keto wagon so his explanation downplays it a bit IMO. It’s not something I’d want to encourage longterm. I have excellent insulin sensitivity and I’d like to keep it that way.

There are Type 2s I know who have been very low carb for ages and I don’t think it’s done them any favours, and it does Type 1s no favours either. The keto forums are full of cult-like rubbish and women (mainly) with eating disorders. The ones inflicting keto on their children are...well, I can’t think of a polite description.

You said that we should start a thread and I purposely didn’t - because I’m *so* sick of the obsessives going on and on about keto and I’ve said what I think a thousand times over. I have no desire to go over it all again, It’s not a secret way to better control for Type 1s. It’s a haven for people with disturbed eating, and hypo unawareness. Obviously that’s not you or others here, but the amount of utter garbage out there is shocking. You mention Bernstein. He has zero hypo awareness. That’s dangerous.

No, you’re not “over-doing the carbs” - you’ve messed up your sensitivity. That’s what happens. A T1 friend used to bolus 4 units for a sandwich. They then decided keto was the answer and now if they want to eat a sandwich they have to bolus 12 or more units. That’s solely because they effed up their sensitivity. It’s stupid.

No, I don’t expect people in the U.K. ate much rice and pasta in the 60s but that’s because we tended to eat British traditional foods like your meat, potatoes and veg example. We still ate plenty of carbs though. I’m significantly younger than you but as a child I ate cereal and toast for lunch, crisps or an apple for snack, a sandwich, choc wafer fruit and yoghurt for lunch, and roast potatoes, meat, veg and fruit crumble and custard.

I am SO sick of carbs being blamed the whole time. It’s not carbs per se - it’s crap, processed nothing foods and too many takeaways and snack options. It’s also lifestyle like watching TV and playing inside rather than outside. Look at that BBC programme a while back where they fed teens on a 1940s or 50s diet. They were all astounded at having bread and butter with their meals, and stodgy puddings, etc yet they all lost weight because they weren’t surrounded by rubbishy foods.

Obesity was also far less decades ago. Even when I was at school, you rarely saw a fat child. There was literally one of each sex in my school of approx 150 children, and they were seen as unusual. Now walk down any high street and look around you. That’s not because people are eating rice and pasta but because they’re eating too much rubbish and not exercising enough.

My HbA1C is (and has always been) lower than yours. I achieve that by using my insulin. I don’t sit and eat vast amounts of carbs each day. I eat normally - ie what I’d have eaten without Type 1. I don’t keep a tally. I count for my bolus then forget them. My insulin sensitivity is good but I know it could be improved if I lowered my fat. That’s how Barbaro and others did it - ate very low fat. It’s fat that’s associated with IR.

Sorry if this sounds rude and abrupt. That’s not aimed at you. I left one forum because it was ruined by very low carb cultists and my tone is informed by that not by my feelings about you @Pattidevans I won’t be writing any more in this thread. I would just add that I tried very low carb myself twice. It doesn’t work. It just swapped one set of problems for another. I also don’t believe it’s healthy.

I wish you well.


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## travellor (May 18, 2021)

I was curious, so I read the other thread

"then how do you explain that a low carb diet works well for Type 2s in reducing their insulin resistance? In fact if the body perceives a lack of carbs it will easily switch to making energy from protein and fat."

It is actually the opposite. 
Low carb doesn't reduce insulin resistance, the same as non diabetics, the body tries to conserve BG, and also the pancreas needs kick-starting later. BG is simply kept low, as there is nothing apart from the liver to increase it. Many end up with "dawn phenomenon" and find workarounds, like a snack before they get up, or ways to measure before the liver kicks in, such as measuring in bed.
The body doesn't often switch easily, many suffer from "low carb flu" as the body tries to switch to burning fat and protein. It has quite a lengthy list of symptoms, and is often mentioned on here.
It is a process the body normally rarely uses, there is a price to pay for making it work differently.

Interestingly, as an aside, as fat has been mentioned, it does seem low carb, high protein is now becoming an alternative, low carb, high fat may have had it's day, and a change is coming?


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## trophywench (May 18, 2021)

I'm not ever likely to give myself insulin resistance since I certainly don't eat very low carb much at all but OTOH I've never ever eaten actually high carb..  Gobsmacked at the amount that people eat - average 250g of carb a day? How on earth do their bellies cope with that!


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## trophywench (May 18, 2021)

It never should have been termed HIGH fat - it was only ever intended to be normal fat - not 'fat with absolutely everything'.


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## Stuvart (May 18, 2021)

trophywench said:


> I'm not ever likely to give myself insulin resistance since I certainly don't eat very low carb much at all but OTOH I've never ever eaten actually high carb..  Gobsmacked at the amount that people eat - average 250g of carb a day? How on earth do their bellies cope with that!


I did a Google on something today and 250g-350g a day of carbs is recommended for a 2k calorie intake seems wierd now, but half of that could come from 4 medium spuds (roughly 36g per spud) then add a bowl of cereal for breakfast plus the carbs in everything else it seems entirely possible.


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## travellor (May 18, 2021)

trophywench said:


> It never should have been termed HIGH fat - it was only ever intended to be normal fat - not 'fat with absolutely everything'.



It does seem many feel the need to add saturated fat to every meal though.

250g of carbs is 1000 calories.
Around half the average food intake.
By the time you include the carbs in all food types, like veg, fruit, milk, it's quite easy to hit 50% of energy from carbs.
If memory serves, that's about the target advised for most people.


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## trophywench (May 18, 2021)

Yes - I don't know how it would be possible to consume 2000 calories a day though.  I'd still be there tomorrow if I had to eat that much.  Plus I'd be like a barrel.  I do not wish to look like that.  So I try not to.


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## SB2015 (May 18, 2021)

An interesting article @Pattidevans.  As you say we are all different.

I am of a similar age and remember the newness of pasta when I when to uni.  Food was what was available and in season.  Many years later when  I was diagnosed with T1 (or LADA if you want to be picky) I  took the message from my DSN of eat what you want and match the insulin.

A few years later and I then have the Libre output.  Now I saw the spikes I was getting, and started to time my bolus, modify my diet and portion sizes to get flatter lines.  I chose to stick to about 30g of carbs per meal and that seems to work for me for what I want to achieve.

like others have said it is the access to processed pre-prepared meals that seems to be an issue around carb loading.  I do not think of myself as being ‘on a diet’ I simply eat what I choose to in order to manage my levels in a way that I am happy with, and to avoid developing hypo unawareness.

so much that we now know through the use of tech.


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## pm133 (May 19, 2021)

@Inka,

I said on another thread that the food and diet world is choc-full of snake-oil salesmen with their latest fad complete with evangelical disciples out there spreading the word.
Sadly diabetes is no different.

I ended up just switching off from all of it and going with what worked for me.

I only hope that newly diagnosed people don't get side-tracked into dangerous and inappropriate fads which can lead to serious consequences or avoidable eating disorders but the snake-oil salesmen know that desperate people will take desperate measures and are quick to cash in on that. The worst type of disciple is the one for whom an approach worked personally and maybe for a few mates and now they are out there saying it'll work for everyone. Low Carb is absolutely rife with those people but it's not alone in that regard. Like I said, eventually I just switched off from all of them. I have an approach which works for me and am happy with that.

It doesn't matter whether your approach is blunt or not. I think it needed said and it'll need said again and again.


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## travellor (May 19, 2021)

I just read the article in the link above.

The findings of the survey showed that the group, of over 300 patients......The data was taken from an online survey of a social media group for young people with type 1 diabetes...Those that took part in the survey were generally children or young adults, with parents completing the survey for their children.

Now, I may be cynical, but as a parent, I know full well what my kids eat, and what they tell me are two completely different things. And I know full well, that as a parent, I tend to present my parenting in the best light, so I wonder how reliable I'd be filling in an on line survey on behalf of my kids? Particularly on a forum where poor results would be a "failure", considering the website the survey was on. I may just scroll by, and think I'd fill it in next time around, when we'd got the hang of it properly.
A sample of 300 seems very small. But maybe not in that context.

I wonder what results he got from the controlled study, or if indeed it's been done in the three years since the online survey was published?


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## pm133 (May 19, 2021)

travellor said:


> I just read the article in the link above.
> 
> The findings of the survey showed that the group, of over 300 patients......The data was taken from an online survey of a social media group for young people with type 1 diabetes...Those that took part in the survey were generally children or young adults, with parents completing the survey for their children.
> 
> ...



At an HBA1c of just 39 in a Type 1, I'd be very worried about the disappearance of hypo awareness.


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## AndBreathe (May 19, 2021)

Pattidevans said:


> So Inka and I were having a discussion in another thread, but I felt we were in danger of hijacking the OPs subject, so I suggested we discuss it elsewhere.
> 
> I was rather surprised when Inka said that low carbing caused insulin resistance as it goes against everything I have read.  So I decided to do some research and I have to apologise to Inka as there is indeed evidence for that theory.  However, it would appear that it is a physiological change that is triggered by a very low carb diet where the body has gone into ketosis.
> 
> ...



Patti - As I understand things, one way to manage physiological insulin resistance is to periodically eat a few extra carbs, which appears to almost rest the clock.  Allegedly, it doesn't usually have to be much of a carb "booster".

Not being T1 or an insulin user I have no experienced this myself.

As a a T2 in remission (or other word of your choice) for over 6 years now, I can't say I have noticed any increase in insulin resistance, but then I rarely eat keto for any prolonged period, which I believe is where physiological insulin resistance is most likely to rear its head.


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## Ljc (May 19, 2021)

As an insulin user I find that that the less carbs I eat the less rapid insulin I need to inject


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## Pattidevans (May 19, 2021)

@Inka


> No, you’re not “over-doing the carbs” - you’ve messed up your sensitivity. That’s what happens. A T1 friend used to bolus 4 units for a sandwich. They then decided keto was the answer and now if they want to eat a sandwich they have to bolus 12 or more units. That’s solely because they effed up their sensitivity. It’s stupid.



I haven't messed up my sensitivity - I have always had a higher ratio of insulin to carb in the mornings.  It hasn't changed.  Just to set the record straight, I don't champion the very low carb or keto diet.  Never have and never will.  I just wanted to hear from others what carb level they consider "normal".  Some people have responded to that and I am happy with those replies.  So you learn something new every day.


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## Pattidevans (May 19, 2021)

@SB2015


> I am of a similar age and remember the newness of pasta when I when to uni.  Food was what was available and in season.  Many years later when I was diagnosed with T1 (or LADA if you want to be picky) I  took the message from my DSN of eat what you want and match the insulin.
> 
> A few years later and I then have the Libre output.  Now I saw the spikes I was getting, and started to time my bolus, modify my diet and portion sizes to get flatter lines.  I chose to stick to about 30g of carbs per meal and that seems to work for me for what I want to achieve.


That's exactly what happened when I first started to use the Libre (self funded) shortly after it came out so, like you, I modified my diet and portion sizes.  Yes, it works for me too.

It's a normal diet to me as it's more or less the sort of thing I ate before diagnosis and that visit to the dietitian where she told me to base my diet around carbs and that made me gain 3 stone, most of which is now gone.  We never eat processed food.  I cook everything from scratch and always have.  I've been shocked in the past at what some of my colleagues considered "normal eating".

For example yesterday I had:
100g greek yoghurt with strawberries.  OK I don't normally bother with breakfast.
Lunch: 2 poached eggs on one slice of Morrison's Spelt, wheat and rye bread with 2 rashers of bacon.
Dinner: Roast fillet of Pork with a sauce made with apple, thyme and garlic, minted new potatoes, braised fennel topped with Parmesan, some leftover roasted butternut squash and roast beetroot.  Fruit platter with raspberries, strawberries,  blueberries and a couple of small slices of Mango.

I would say that was moderate low carb.  Only 20g carb at lunch but nearly 50 for dinner.  This diet hasn't caused any insulin resistance as far as I know, as my ratios have stayed the same for years.


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## SB2015 (May 19, 2021)

Pattidevans said:


> Dinner: Roast fillet of Pork with a sauce made with apple, thyme and garlic, minted new potatoes, braised fennel topped with Parmesan, some leftover roasted butternut squash and roast beetroot. Fruit platter with raspberries, strawberries, blueberries and a couple of small slices of Mango


I like the sound of your menu.  It is my week to cook so I am feeling inspired.

We didn’t change much, as we cooked from scratch, but with the Libre we just dropped the portions and did a few swaps for spikes foods.


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## rebrascora (May 19, 2021)

I am 2 years down the line with my low carbing. I probably have 50-70g carbs a day. 
I have openly spoken about my poor relationship with food, comfort eating and sugar addiction prediagnosis and for me cutting the carbs has given me back a lot of control because I no longer crave the carbs/sugar anymore and I feel so much fitter and healthier eating this way. I have no interest in going keto. It is too restrictive for me and I am not organized enough, but avoiding high carb foods or keeping portion size of them to a minimum is simple enough that I don't have to do much planning or thinking for it. I would only very rarely have a meal containing as much as 50g carbs but I am pretty good at timing my bolus to prevent spikes now that I have Libre. Protein tends to be the complication for me as my levels drift upwards 2 hours after a meal so I have to remember to jab for that later. 

I have not noticed any increase in insulin resistance during that time and nothing else so far which would discourage me from continuing to eat this way because it feels right for me and has given me back control over my eating disorder, even if others might consider that my low carb diet may itself be an eating disorder. I guess I am an all or nothing girl!


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## nonethewiser (May 19, 2021)

Spent just 3 months following LCD diet, basal didn't go up in so unsure about insulin resistance, will add thou that bolus doses & amount of times to inject it went lot higher considering only eating 1/4 of carbs I eat now, so that was main reason why it got big heave ho, that & dont like limiting foods as enjoy food to much.

Even now have to bolus for extra protein in meals, mentioned this last week on forum when someone asked about difference between eating 1 or 2 chicken breasts in meal where carbs are included.

Nowt is straight forward with type 1 is it.


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## Pattidevans (May 19, 2021)

SB2015 said:


> I like the sound of your menu.  It is my week to cook so I am feeling inspired.
> 
> We didn’t change much, as we cooked from scratch, but with the Libre we just dropped the portions and did a few swaps for spikes foods.


Yes, a few swaps will help.  Tonight it's sausages with a mash made from half potato and half cauliflower, which lowers the carb but still gives a satisfying mash.  I'm using the sauce from last night, let down into a gravy and serving some green beans.


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## Pattidevans (May 19, 2021)

nonethewiser said:


> Spent just 3 months following LCD diet, basal didn't go up in so unsure about insulin resistance, will add thou that bolus doses & amount of times to inject it went lot higher considering only eating 1/4 of carbs I eat now, so that was main reason why it got big heave ho, that & dont like limiting foods as enjoy food to much.
> 
> Even now have to bolus for extra protein in meals, mentioned this last week on forum when someone asked about difference between eating 1 or 2 chicken breasts in meal where carbs are included.
> 
> Nowt is straight forward with type 1 is it.


Could the bolus going up be as a result of the physiological insulin resistance discussed earlier in this thread?

It never is straightforward!  LOL!  I had half a spanish omelette at lunchtime using up leftover cooked new potatoes, some chorizo, half an onion and some cheddar.  The carb content was less than 20g but I bolussed for 25g to cover some for the protein.  BG has been more or less level all afternoon, despite running round doing supermarket shop in 2 different supermarkets.


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## Robin (May 19, 2021)

I think there is confusion between insulin resistance and an overactive liver first thing in the morning. Whatever I have for breakfast, I need 2 units extra novorapid to cope with my liver waking up and swinging into action. Some people might say that they need extra bolus because they’re insulin resistant, but I don’t need an increased ratio, I just need two extra units. So if I have eggs, I just take the 2 units, but because I will therefore process some protein into glucose in the absence of carbs, I will need a unit at around 11am. So, I could look at my rising levels, and think, I need more basal in the morning, I must be insulin resistant, but no, I don’t need extra basal. If I have a small bowl of muesli, carb value 30g, and bolus 3 units, plus the extra 2, I will be nicely in range all morning.


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## rebrascora (May 19, 2021)

@Robin I find it amazing how similar our systems work. That is exactly my experience with breakfast.


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## TinaD (May 19, 2021)

Prof Roy Taylor (Newcastle Uni) according to his recent book takes the view that Type 2 simply means you are too fat for your particular metabolism. He has no objection to any form of diet (low carb/keto/low fat) as long as you eat real food not processed stuff, avoid dodgy oils, and slim down enough to get the fat out of your pancreas. If you are a TOFI (thin outside fat inside) the dropping 10lbs may be enough to reverse your Type 2 as long as you maintain the loss. The advantage of keto, it seems to me, is that it gets your BG down quickly whilst you are waiting for the weight to come off and that it does prevent you feeling quite as hungry as other diets.


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## AndBreathe (May 20, 2021)

I think it's worth differentiating between pathological and physiological insulin resistance.


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## Pattidevans (May 20, 2021)

AndBreathe said:


> I think it's worth differentiating between pathological and physiological insulin resistance.


I see where you are coming from there.  Surely physiological insulin resistance only kicks in when the body enters ketosis for a period of time.


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## rebrascora (May 20, 2021)

TinaD said:


> Prof Roy Taylor (Newcastle Uni) according to his recent book takes the view that Type 2 simply means you are too fat for your particular metabolism.* He has no objection to any form of diet (low carb/keto/low fat) as long as you eat real food not processed stuff, avoid dodgy oils,* and slim down enough to get the fat out of your pancreas. If you are a TOFI (thin outside fat inside) the dropping 10lbs may be enough to reverse your Type 2 as long as you maintain the loss. The advantage of keto, it seems to me, is that it gets your BG down quickly whilst you are waiting for the weight to come off and that it does prevent you feeling quite as hungry as other diets.


I find that quite surprising considering the original study used meal replacement shakes which are clearly not REAL FOOD. I guess it was a trade off of to ensure that the 800 cals could easily be quantified for people taking part in the study.


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## TinaD (May 20, 2021)

rebrascora said:


> I find that quite surprising considering the original study used meal replacement shakes which are clearly not REAL FOOD. I guess it was a trade off of to ensure that the 800 cals could easily be quantified for people taking part in the study.


Yes, I was quite surprised too. 
It was,in the original study apparently, a diet of shakes and green leafy veggies. The objective was not only to demonstrate that fat loss would solve the problem but to do so at speed and, I believe,  in a manner which would allow for ease of monitoring. 
The study did achieve very fast weight loss but a) not all people could tolerate such a diet (yuk from me), b) he accepts that slower weight loss should achieve the same end result c) it is the end result and the maintainance of weight loss rather than the mechanism which he seems to regard as important. 
I have to say doing 800 cals and 20gms or less of carbs on real food is a b****rd of a job  and in my experience needs supplements  of minerals and vitamins which are much less likely to be needed on a slightly higher calorie intake. So, I suspect,  it comes down to how fast you want to shed the fat. 
May I say, smugly, that my recent abdominal scan showed a very healthy liver which suggests my pancreas is also fat cleared? According to the Prof the pancreas can recover over time - I await personal proof of this as my FBG and post-prandial figures hop up depressingly still  if I cheat to the extent of indulging in an apple or 150gms of strawberries + 100gms of Greek yoghurt. Oh well, could be worse, I could have an ethical bar to steak and salad...it must be Hell on wheels for vegans.


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## travellor (May 20, 2021)

rebrascora said:


> I find that quite surprising considering the original study used meal replacement shakes which are clearly not REAL FOOD. I guess it was a trade off of to ensure that the 800 cals could easily be quantified for people taking part in the study.


Real food. (no need to shout)
That's quite subjective.
To some, it's what they personally grow, or rear, and gather, or kill and butcher themselves.
To some, it's organic, at Tesco's.
To some, it's under clingfilm on the chill counter
To some, it's in the freezer at a wholesalers
To some, it's a little vitamin or mineral tablet from Holland and Barretts, or the internet.
If you are with NASA, it's freeze dried, and in a plastic bag, and rehydrated with processed urine.
If you are in a third world, it's whatever you can find to live on.


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## travellor (May 20, 2021)

TinaD said:


> Yes, I was quite surprised too.
> It was,in the original study apparently, a diet of shakes and green leafy veggies. The objective was not only to demonstrate that fat loss would solve the problem but to do so at speed and, I believe,  in a manner which would allow for ease of monitoring.
> The study did achieve very fast weight loss but a) not all people could tolerate such a diet (yuk from me), b) he accepts that slower weight loss should achieve the same end result c) it is the end result and the maintainance of weight loss rather than the mechanism which he seems to regard as important.
> I have to say doing 800 cals and 20gms or less of carbs on real food is a b****rd of a job  and in my experience needs supplements  of minerals and vitamins which are much less likely to be needed on a slightly higher calorie intake. So, I suspect,  it comes down to how fast you want to shed the fat.
> May I say, smugly, that my recent abdominal scan showed a very healthy liver which suggests my pancreas is also fat cleared? According to the Prof the pancreas can recover over time - I await personal proof of this as my FBG and post-prandial figures hop up depressingly still  if I cheat to the extent of indulging in an apple or 150gms of strawberries + 100gms of Greek yoghurt. Oh well, could be worse, I could have an ethical bar to steak and salad...it must be Hell on wheels for vegans.


If you had to kill and butcher your steak, could you?
That would be more ethical from the animals point of view.
Especially if you and the bull were both bare handed?

Me, I could have the lettuce part of the steak and salad any day.


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## TinaD (May 20, 2021)

travellor said:


> Real food. (no need to shout)
> That's quite subjective.
> To some, it's what they personally grow, or rear, and gather, or kill and butcher themselves.
> To some, it's organic, at Tesco's.
> ...


True enough - availabily to the consumer has to be taken into account. However avoiding heavily processed food should be relatively easy for the bulk of the UK population.


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## TinaD (May 20, 2021)

travellor said:


> If you had to kill and butcher your steak, could you?
> That would be more ethical from the animals point of view.
> Especially if you and the bull were both bare handed?
> 
> Me, I could have the lettuce part of the steak and salad any day.


At 74 I shall not be taking on any bulls but I do kill and prepare poultry. You would be very short of nutrients if you lived solely on lettuce.


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## travellor (May 20, 2021)

TinaD said:


> True enough - availabily to the consumer has to be taken into account. However avoiding heavily processed food should be relatively easy for the bulk of the UK population.


Oh no, I realise how privileged I am.
What is your definition of the bulk of the population?
Class, income, number of kids, etc ?


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## Pattidevans (May 20, 2021)

Sorry to go back to the original purpose of the thread (I have no issues with thread hijacking) it's how normal face to face conversations go.  Anyway, it was suggested that my carb level of 70ish grams per day could give me insulin resistance.  So today I was having a sunbed treatment and as my thoughts wandered to pass the time, I started to think about this (logically I hope).  Gary Scheiner and John Walsh (Using insulin) both seem to intimate that people use between 0.5 and 1.0 units per kg in weight.  I worked mine out and checked my mental arithmetic on the calculator when I got home.  I am actually using 0.3u per kilo, which doesn't suggest IR.  Of course people do use less on pumps than on MDI as a general rule of thumb.


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## travellor (May 20, 2021)

TinaD said:


> At 74 I shall not be taking on any bulls but I do kill and prepare poultry. You would be very short of nutrients if you lived solely on lettuce.


Exactly.
Ethically, the bull has the upper hand, we are just privileged enough to be able to let the process sort it out for us to have it as a steak.
It's all about were we draw our lines on what processed food is.


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## travellor (May 20, 2021)

Pattidevans said:


> Sorry to go back to the original purpose of the thread (I have no issues with thread hijacking) it's how normal face to face conversations go.  Anyway, it was suggested that my carb level of 70ish grams per day could give me insulin resistance.  So today I was having a sunbed treatment and as my thoughts wandered to pass the time, I started to think about this (logically I hope).  Gary Scheiner and John Walsh (Using insulin) both seem to intimate that people use between 0.5 and 1.0 units per kg in weight.  I worked mine out and checked my mental arithmetic on the calculator when I got home.  I am actually using 0.3u per kilo, which doesn't suggest IR.  Of course people do use less on pumps than on MDI as a general rule of thumb.


Yes, sorry about that.
Meetings need a chairperson.


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## Pattidevans (May 20, 2021)

travellor said:


> Yes, sorry about that.
> Meetings need a chairperson.


LOL!  Don't worry!  As I said, it's normal.

If I were to rely on anything I personally produced I'd be starving now... tomato plants are still tiny as are the runner bean plants... and anyway, I do like a bit more variety than just those veg!


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## TinaD (May 20, 2021)

Pattidevans said:


> Sorry to go back to the original purpose of the thread (I have no issues with thread hijacking) it's how normal face to face conversations go.  Anyway, it was suggested that my carb level of 70ish grams per day could give me insulin resistance.  So today I was having a sunbed treatment and as my thoughts wandered to pass the time, I started to think about this (logically I hope).  Gary Scheiner and John Walsh (Using insulin) both seem to intimate that people use between 0.5 and 1.0 units per kg in weight.  I worked mine out and checked my mental arithmetic on the calculator when I got home.  I am actually using 0.3u per kilo, which doesn't suggest IR.  Of course people do use less on pumps than on MDI as a general rule of thumb.


Quite right - sorry to wander so far from the topic. However I found no suggestion that insulation resistance was identified by Taylor (altho', of course, he was working on Type 2 not Type 1 diabetics). There was some dicussion as far as I vaguely recall (sorry posted book off to newly diagnosed friend yesterday) of a natural mechanism kicking in to, effectively, differentiate between providing glucose to muscles when the levels were very low so that the brain would have an adequate supply.


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## travellor (May 20, 2021)

Pattidevans said:


> LOL!  Don't worry!  As I said, it's normal.
> 
> If I were to rely on anything I personally produced I'd be starving now... tomato plants are still tiny as are the runner bean plants... and anyway, I do like a bit more variety than just those veg!



Very true.
I liked to let meetings I chaired run, (after we sorted out business) there were sometimes that giant leap from an odd comment.
I hear you on the tomatoes!
Beans, they are still underground as well.


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## Leadinglights (May 20, 2021)

Pattidevans said:


> LOL!  Don't worry!  As I said, it's normal.
> 
> If I were to rely on anything I personally produced I'd be starving now... tomato plants are still tiny as are the runner bean plants... and anyway, I do like a bit more variety than just those veg!


Excited to pick my first 3 strawberries from my polytunnel. Everything is at least 3 weeks behind where it should be.


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## AndBreathe (May 20, 2021)

Pattidevans said:


> I see where you are coming from there.  Surely physiological insulin resistance only kicks in when the body enters ketosis for a period of time.



I wonder if this video might be helpful for some.


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## Deleted member 25429 (May 20, 2021)

rebrascora said:


> I am 2 years down the line with my low carbing. I probably have 50-70g carbs a day.
> I have openly spoken about my poor relationship with food, comfort eating and sugar addiction prediagnosis and for me cutting the carbs has given me back a lot of control because I no longer crave the carbs/sugar anymore and I feel so much fitter and healthier eating this way. I have no interest in going keto. It is too restrictive for me and I am not organized enough, but avoiding high carb foods or keeping portion size of them to a minimum is simple enough that I don't have to do much planning or thinking for it. I would only very rarely have a meal containing as much as 50g carbs but I am pretty good at timing my bolus to prevent spikes now that I have Libre. Protein tends to be the complication for me as my levels drift upwards 2 hours after a meal so I have to remember to jab for that later.
> 
> I have not noticed any increase in insulin resistance during that time and nothing else so far which would discourage me from continuing to eat this way because it feels right for me and has given me back control over my eating disorder, even if others might consider that my low carb diet may itself be an eating disorder. I guess I am an all or nothing girl!


This is exactly what I do low carb and protein cuts in about five hours later . I’ve lost all the weight I want to and maintained that . Diabetes has made me look at food in a much more healthy way


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## Bloden (May 20, 2021)

Does anyone remember @DeusXM (I think that was his forum name)? He’s a type 1 whose diet / philosophy is extremely low carb (almost no carb, I think). He once reported that he was quite markedly insulin resistant as a result of low low carbing.

Just thought I’d mention him...haven’t seen him on here for a long time.


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## grovesy (May 20, 2021)

Bloden said:


> Does anyone remember @DeusXM (I think that was his forum name)? He’s a type 1 whose diet / philosophy is extremely low carb (almost no carb, I think). He once reported that he was quite markedly insulin resistant as a result of low low carbing.
> 
> Just thought I’d mention him...haven’t seen him on here for a long time.


I have not him seen post in a long time.


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## helli (May 21, 2021)

I've seen this thread for a few days and avoided it but today my curiosity got the better of me.

I don't eat low carb but as with most people with Type 1 I am more conscious of my carbs than most people and basically, it varies hugely. 
Like some others, I have chosen to learn to eat what I want and how to dose insulin for it. I make mistakes sometimes but I know how to correct them and they have never been huge mistakes and when there are so many things which can affect my blood sugar levels which I am not willing/able to compromise on (stress, exercise, vaccinations, ...) I have chosen not to obsess by the food part because I know I will be disappointed. 
Bernstein was mentioned - one of his techniques for women to manage their blood sugars is that we should all go on the pill because our hormones make it too difficult. 

The other thing that has been touched on is the impact of protein. I can only comment from a Type 1 perspective. I find Low carb, high protein meals very difficult to bolus for. I tried but found, in the absence of carbs, protein increases my blood sugars. But in a different way to carbs and in a different way to each other. Protein blood sugar rises are later than (most carb) ones and the affect of 100g of salmon is different to the affect of 100g of prawns which is different to 100g of nuts and different to a 3 egg omelette (I never weighed the eggs). So I would need to remember the different insulin to protein ratio for every different type of protein. 

Finally, I can have days when I eat over 200g of carbs and almost certainly have days when I eat over 2000 calories (although I never measure that) but i have days when I eat a lot less and most days burn off most of what I consume.


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## Pattidevans (May 21, 2021)

@helli you clearly know what you are doing and what suits you.  TBH I have never really read Bernstein but the idea of women being constantly on the pill, despite the health risks is insane!  Fortunately, at 75 my hormones are long gone.

I'm usually very good at knowing how much to add on for protein if I am having a low carb meal... I would find it difficult to eat 200g carb though.  I have such a small appetite. Yesterday we were invited to some friends for lunch.  The starter was a chicken caesar salad with a few croutons. I didn't eat the croutons.  The size of it was as much as I would eat for a main course usually!  Then we had new potatoes, asparagus and poached salmon.  I couldn't manage all the salmon.  The dessert I had about 2 mouthfuls and hubby ate my portion up, but it was followed by a cheese board.  I did have some cheese with a piece of french bread.... I felt awful that I couldn't finish a single course in it's entirety.  Nor did I eat anything else for the rest of the day!  I'm sure if 70ish grams of carb left me hungry I'd soon deal with the resultant insulin requirements.


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