In response to a reader’s recommendations, I determined it was time to explore what is a no-carb diet and learn whether or not it is beneficial for a type 1 diabetic.
This is part one of a two-part series exploring the best dietary options for type 1 diabetics.
Because we have a type 1 diabetic grandson we also want to learn what effect severely restricting or simply eliminating carbs from his diet would have on his blood sugars.
Since our grandson’s diagnosis in June of 2019, I have devoted much of my time to researching and learning as much as I can about diabetes in all its forms.
I have always believed that we need to be properly educated not only about how but also why it is important to make healthy lifestyle choices each day.
At the beginning of our type 1 journey, we were scared, confused and just a jumble of mixed-up emotions. These were normal responses and we had every right to be afraid.
I mean quite literally every time we give that child insulin we are literally putting his life in our hands. Talk about high stress, wow. Too much insulin and he goes too low risking severe hypoglycemia or even diabetic coma. Too little insulin and he could go into diabetic ketoacidosis, a very serious and life-threatening complication of type 1 diabetes.
Like many type 1 diabetics, Alex takes his long-acting insulin once a day. He also uses insulin to carbohydrate ratio (ICR) for his mealtime insulin.
I believe this is why a reader suggested a no-carb diet, believing that if he ate no carbs then his blood sugars would not rise thus eliminating the need for insulin.
This made a lot of sense to me so I went investigating to find the facts. Seriously though wouldn’t it be great if he could actually go off his insulin and not have to endure those four shots each and every day of his life?
Let’s check out what I learned and Hannie, this article will answer part of your question.
My next article “What Is The Difference Between Vegan And Vegetarian Diet?” will explore whether veganism or vegetarianism is safe for a type 1 diabetic and will answer the rest of your question so be sure to stay tuned.
What is a no-carb diet?
To put it as simply as I can, when you follow a no-carb diet, you eliminate all high-carb foods. This means you would completely eliminate all:
- whole and refined grains
- baked goods
- sugar-sweetened beverages
- and starchy vegetables like peas and corn.
To me, that seems like a pretty extreme diet for a 6-year-old and I’m not sure that is sustainable for such a young child.
I could not find any studies done on a no-carb diet, however, several studies on low-carb or keto diets suggest there may be many health benefits.
What is a low-carb or keto diet?
Generally speaking, a low-carb diet will focus mainly on proteins, healthy fats and non-starchy vegetables. You would limit grains, legumes, fruits, bread, sweets, pasta, starchy foods and sometimes nuts and seeds. There are some low-carb diet plans that do allow small amounts of fruits, vegetables and whole grains.
Macros for a low-carb diet plan:
Fat – 40% to 70%
Protein – 15% -30%
Net carbs – 15% – 30%
Macros for a keto diet plan:
Fat – 65% -75%
Protein – 20% – 25%
Net carbs – 5% -10%
As you can see there is quite a difference between the two diet plans.
The body breaks down and uses the carbs we eat for energy either immediately or stores them in the muscles and liver to use later. If we don’t use that energy then the body converts it to fat.
When you eat a low-carb diet you are restricting carbs so you have no excess carbs to be stored. On a keto diet, you are restricting carbs to the point that your body needs to burn fat for energy instead of carbs.
Who is low-carb eating good for?
A low-carb or keto diet is beneficial for almost everyone.
Because of possible rapid weight loss or dramatic changes in blood sugar, people with any of the following should seek extra support from their medical team:
- if you are taking medication or insulin for diabetes
- if you are taking medication for high blood pressure
- if you are breastfeeding
Disclaimer: While a low-carb diet has many proven benefits, it’s still controversial. Most importantly, you may need to adapt pre-existing medications. Discuss any changes in medication and relevant lifestyle changes with your doctor.
Any low-carb diet plan is for adults with health issues, including obesity, that could benefit from a low-carb diet.
It’s important to first note that studies suggest a strict low carb diet may have a negative impact on short term and long-term health of children and adolescents.
There is no dispute that healthy eating is good for kids. It helps grow strong healthy bodies. Teaching them healthy habits from a young age is a benefit they will carry with them throughout their life.
The possible problem lies in the fact that severely restricting carbohydrates in kids may not be sustainable in today’s world.
While indulging in treats occasionally is ok, the fear is that by severely restricting kids at home they will tend to over-indulge when out with friends and away from parental influence not to mention the psychological effects of not being allowed to have what their friends are having.
To me balance is key. Eat healthy, teach healthy choices and why they are important but allow treat occasionally.
Low-carb or keto with diabetes
First of all, if you have diabetes and are considering following either a low-carb or keto diet for weight loss, I want to commend you for your devotion and determination to improve your health.
Don’t try this on your own. It is imperative that you work closely with your health care team. I also stress how extremely important it is that your health care team includes someone very knowledgeable about the low-carb and keto diet plans and the effect they can have on the body.
Every person reacts differently and diabetics are no exception. It is highly likely that you will need to make significant adjustments to the dosages of your medications (insulin doses may need to be reduced). This is why it is so critical you work closely with your team.
Never make changes to your medications without consulting your diabetes care team.
By not eating the carbohydrates that raise your blood sugar level you will likely need to reduce your insulin dose in order to avoid hypoglycemia (low blood sugar) which is potentially dangerous. Be sure you increase how frequently you check your blood sugars in order to catch a low before it becomes dangerous.
Type 2 diabetes
If you are a type 2 diabetic and are not taking any medications and are treated with diet alone, it is highly unlikely you will experience low blood sugars as a result of reducing your carb intake.
Type 2 diabetics who are taking insulin must work closely with their doctor to find the right reduction in insulin that works for them.
You may need to reduce your long-lasting insulin by as much as 40% – 50%, again I stress don’t change your dose without first consulting with your primary physician.
There is no real way of predicting how much you will be able to lower your insulin dose. Many people are actually able to go off their insulin totally which is why eating low-carb is more of a lifestyle change than a diet.
It is generally safer to err on the side of caution and take less insulin because you can always take more if needed.
Whereas if you take too much insulin the resulting severe hypoglycemia is potentially more serious.
Type 1 diabetes
Yes, a low-carb, high-fat diet can be a great tool for empowering people with type 1 diabetes to maintain steady blood sugars. It can often result in significantly fewer and milder highs or hypos, as long as insulin doses are properly reduced. I stress the absolute importance of working closely with an experienced team member.
Eating low-carb with type 1 diabetes requires extreme diligence monitoring blood sugar levels and insulin adjustment, it also requires an even closer working relationship between you and your health care team.
Let’s discuss a few things you may want to discuss with your team.
It is common for type 1 diabetics to use insulin to carbohydrate ratio (ICR) for their mealtime insulin.
This is what we use for our grandson, Alex.
If this is what you use then it will work well for you to continue to give the same ratio of insulin to the carbohydrates you do eat. This works because as you eat fewer carbs you will automatically inject less insulin.
Be aware that in some cases a slightly higher ICR mat be required due to the fact that protein may increase insulin requirements.
In other cases, a lower ICT may be required because some people may become more insulin sensitive as they lose weight.
Not all type 1’s use an ICR, some use a relatively fixed dose of mealtime insulin or they may be on twice-daily insulin. In this case, they would follow the same guidelines as for type 2 diabetes as I discussed above. The main difference is that type 1 diabetics will always need some insulin, even on a very low carbohydrate diet.
Watch for dangers
Type 1 presents several things to watch out for and the risk of some of these dangers increases with a low-carb diet.
A diet that consists of less than 50 grams of carbs each day can lead to ketosis. This a normal and often sought-after physiological state in which the body burns fat for energy rather than carbs.
Because a very strict low-carb diet results in ketosis relatively safe amounts of ketones will be present (between 0.5 and d3.0 mmol/L) but could even be as high as 4 or 5 mmol/L. This should not be confused with diabetic ketoacidosis which is a dangerous complication of type 1 diabetes when there is insufficient insulin.
While ketosis is a normal response to using fat for energy, ketoacidosis is not. Ketoacidosis is a result of high blood sugar levels and dehydration as well as high ketones.
It is because of this that we recommend type 1 diabetics start slowly by reducing their carb intake to only 50 grams of carbs per day.
Then after several days, if you wish, you can reduce your carbs to 30-40 grams per day.
Naturally, you are working very closely with your healthcare professionals every step of the way. Always follow your doctor’s advice.
We do NOT recommend starting a ketogenic low-carb diet (below 20 grams a day) unless you are absolutely certain of how to handle this risk and are working very closely with an experienced healthcare practitioner.
You will need to test your ketones and blood sugars frequently and use extra care if you feel even slightly ill, practice intermittent fasting or have been exercising.
What are we doing with Alex?
Our family has always eaten relatively healthy. Oh sure we have the occasional sweets for birthdays or holidays but usually eat homemade healthy food.
When I do bake, I often bake gluten-free and sugar-free to accommodate both our Celiac son and our type 1 grandson.
But this is just on occasions.
Our daily meals consist of mainly fresh organic vegetables and fruits, lean meat, legumes and some dairy.
Our daughter typically feeds Alex the same foods we would serve him when he is here.
When Alex’s sugars are running high we tend to lower the carbs for the next meal or two, if he has been running low we increase his carbs slightly.
It is definitely a delicate balancing act and of course, we are still learning every day.
We are well aware that Alex’s needs change constantly. As he grows, his body will respond differently to a treatment. What works today may not work tomorrow so we need to be constantly evolving.
I believe we have learned what is a no-carb diet plan and determined that it would be a little too restrictive for a growing 6-year-old boy who struggles daily with type 1 diabetes.
We have learned that low-carb diets can be very beneficial for weight loss, managing type 2 diabetes (possibly even reversing it) and lowering blood pressure.
We have also learned that any diabetic(especially type 1) must work very closely with their health care team any time they are making significant dietary changes.
It may be necessary to lower your mealtime insulin dose, but please never make changes to your meds without first consulting with your doctor.
There you have it, Hannie, low carb may help Alex when he is older but severely restricting his carbs now may not be the best thing for him.
Next, we will explore the part of your question that I am most interested in learning about. I am so anxious to learn more about veganism and vegetarianism so stay tuned.
Always follow your doctor’s advice on what is best for you.
I am not in any way a medical practitioner, please do not rely on the information on our website as an alternative to medical advice from your doctor or another healthcare provider. We only share our experiences. We are affiliates, this means that if you purchase something from a link or ad on this site we may receive a small commission. This in no way affects the price you pay.
Do you follow a low-carb or keto diet?
How do you find it?
Share your experiences in the comment section below. Be sure to check out the second part of this series here.