How Leonie successfully manages type 1 diabetes

Leonie had been following the dietary guidelines and her educator’s advice for type 1 diabetes for 25 years when an idea hit her. Her carb loading before exercise did no longer make sense to her, so why not try a low-carb diet? This is Leonie’s very inspiring journey:

I turn 65 this year and have had type 1 diabetes for 35 years. For the last 20 years, I’ve been playing competitive (pennant and social) racquetball. I was a conscientious, fit, healthy and well-managed diabetic who religiously followed the dietary guidelines and my educator’s advice, until about ten years ago (2009).

The dietary guidelines included carbohydrate loading before exercise but ten years ago, I started to question the logic of having to insulin load before exercise. Doing this meant I risked going hypoglycaemic (low sugar) when I started playing racquetball because I still had active insulin onboard. To avoid this scenario, I needed to eat at least three hours earlier than my matches, which meant an impractical 4pm-ish dinner. I spoke to my diabetes educator about seriously reducing my carb intake generally, and in particular before sport, (therefore reducing my insulin needs), but both she and the Diabetic Association of South Australia (now Diabetes SA) reinforced the recommended carbohydrate guidelines and discouraged the idea.

It didn’t make sense to me, so I started to read about the implications of low-carb eating for diabetics (particularly if it was going to be detrimental to brain function) and I became confident enough to totally drop bread, pasta, potatoes and rice from my diet. I closely monitored my blood-glucose levels and not only did my insulin needs decrease, but it also resulted in some appreciated weight loss (about 8 kilos, 18 pounds). I still aimed to eat about 100 g carbs per day because I’d read somewhere that our brain needed that amount to function properly (I’ve since found out that this is not the case).

My bio markers remained constant, I felt fine and had the energy to still play a good standard of racquetball so my doctors were happy enough with my decision. At this stage, I was eating healthy, real food, avoiding processed food and eliminating the high-starch carbs mentioned earlier.

I wasn’t a smoker and by then I’d also given up alcohol. I ate this way for seven years and maintained an acceptable HbA1c level (6.5 – 7.5 mmol/mol). Because this was a three-month average, it gave no indication of how many hypo or hyperglycaemic episodes I’d experienced during the testing period. I still had my fair share of both, even though I my diabetes was considered to be well managed.

I’m now on a pump and during Diabetic Week three years ago (2016), I heard a woman speaking on the radio (a listener who rang in, not a guest speaker) talking about Doctor Richard Bernstein’s book. She recommended that every person with diabetes (type 1 and type 2) should read it. This was great to hear because rarely is type 1 even mentioned these days because of the rising epidemic status of type 2 diabetes. Her enthusiasm motivated me enough to purchase the book, Dr. Bernstein’s Diabetes Solution: The complete guide to achieving normal blood sugars¹, which in turn led me to discover the ketogenic diet & become aware of the controversial issue of high cholesterol, heart disease & statin drug treatment (which I’d been on for years).

For the last three years, I’ve been eating low-carb, healthy-fat (LCHF), convinced by the many Youtube seminars and interviews I’ve listened to and watched, plus books I’ve read, that this is the way to go. Neither my GP nor endocrinologist, are happy with my high cholesterol readings but agree that it’s my decision to stop taking statin medication (after much research into the pros and cons). The decision to blatantly go against their “expert” advice hasn’t really sat easily with me although they are very pleased with my diabetes control, as illustrated by my annual (one week) continuous glucose monitoring (CGM) results. Of course, it’s very easy to be strict with yourself during the week of testing so those results don’t necessarily give a true indication of how well-managed I really was all of the time.

By chance, in May last year (2018), I heard Dr. Peter Brukner, an Australian, talking on the radio about his new book, A Fat Lot of Good², which summarised the history of the issues I’d been reading & worrying about for a few years. It also reinforced my decision to disregard the wayward dietary guidelines that ill-informed governments have burdened us all with for far too long. I purchased his book and couldn’t put it down — underlining many pertinent “YES!” facts and statements that related to my own health situation.

At the back section of the book, Dr. Brukner listed his recommendations for future resources: movies, videos, websites, books etc. The top website he recommended was Diet Doctor so I checked it out. It was like another world opening up to me so I registered, started exploring and haven’t looked back since. It’s amazing how long I can sit and listen, watch or read the vast amount of information on offer. What I’ve personally found to be the most beneficial are the stories of the doctors who also have type 1 diabetes (e.g. Dr. Ian Lake, Dr. Ali Al Lawati). Hearing them being interviewed or giving lectures about their diabetic stories have been fantastic & so reassuring. As I mentioned earlier, type 1 diabetes doesn’t receive a lot of attention these days and until recently I was unaware of websites specifically for type 1 e.g. “type 1 grit”.

Advice straight from the horse’s mouth, even if not in person, means a lot more to me than having someone (e.g. a diabetes educator) imparting information. Educators know the theory, but generally not the practicality of living with type 1 diabetes and also can’t really comprehend the unpredictability of it. We’re not like computers that you can feed a formula into, to make things work properly, because even if you do exactly the same thing, two days in a row, the results are seldom the same. Hearing how type 1 doctors manage their diabetes has given me the confidence to pretty much fly solo and take control of my health. I’ve been unable to track down a support person in South Australia, who knows more about the ketogenic diet for people with type 1 diabetes than I now do. It’s considered by many to be too risky to attempt, with an amazing number of (even medical) people still confusing the words and meanings of ketogenic and ketoacidosis.

For the last four months I’ve been in ketosis & eating (30-40 carbs/day) as well as doing 16:8 intermittent fasting (IF) every day and it has changed my life. The most amazing thing is that I find it quite easy and I’m never hungry. I’ve programmed my pump to aim for a lower HbA1c level and have adjusted my basal readings as needed. I’m still testing my blood five to six times daily and will discuss with my endocrinologist about getting full-time continuous glucose monitoring (CGM) within a few months. The reason: every now and then, my morning blood-glucose reading is unexpectedly lower than it should be (e.g. 3.5) but because my brain is protected by the fat I’m running on, I don’t have the normal symptoms of a hypo, like sweating profusely, black spots in the eyes, trouble verbalizing things or the feeling of being drunk and uncoordinated. This means I’m still able to function well, and even read, but it’s obviously not an ideal situation. Full-time CGM will give me an early warning that my blood sugar is dropping and needs some attention. This has been my only concern with the keto diet.

Since doing the keto/IF combo, my blood-glucose levels have almost totally flattened. I no longer get any readings above 10 mmol/L and very few below 4 mmol/L. These are not average readings, these are everyday readings, which I still find amazing. It’s such a shame I haven’t been doing this for thirty-five years!

Over the years, I’ve been most influenced by doctors who experienced their own health issues and, dissatisfied with information they’d received from their personal doctors, embarked on in-depth research to discover why the current health recommendations hadn’t worked for them. These doctors are:

• Dr. Richard Bernstein – Type 1 Diabetes
• Dr. David Diamond – Cholesterol – Heart Disease – Statins
• Dr. Peter Brukner – Carbs, not Fat cause Disease

The most outstanding thing about each of these gentlemen, and many others, I now realise, is that they are all endeavouring to spread the word, for the good of everyone’s health i.e. the current dietary guidelines are not based on scientific evidence.

Diet Doctor’s on-going information, research updates, recipes, videos etc has been the greatest support to me and given me the confidence to really take charge of my own health. These days I tell, rather than ask, my support team what I’m doing because I now have the knowledge and understanding of it all. It really disappoints me that Governments & Diabetic Associations have been so reluctant to embrace other options (e.g. LCHF) to treat diabetes. I’ve had contact with Diabetes SA about this but I have only received a political response that doesn’t say much at all. They’re basically sticking with what they know and have always done.

Whereas for years I thought my life expectancy would be significantly lower than my peers, I’m now quite confident that I’m going to age as gracefully and healthily (and in many cases probably more healthily) than my peers. I’m fit, healthy, alert, have maintained a steady weight for the last 10 years and have a very positive outlook on life.

It’s been a long and winding road but life is good and I’m extremely grateful to the Diet Doctor team and other dedicated workers who continue to strive endlessly to help those of us, living with diabetes, to live healthy and very fulfilling lives.

Leonie

Comment

Thank you, Leonie for sharing your story! Many, many people with type 1 diabetes indeed report better blood glucose control than ever, and fewer side effects, after going low carb. Science is starting to back this up, with multiple small but well-done studies showing the same thing.

However, there are a few things to consider, including adapting insulin doses in different situations. Getting support from a health care professional can be required, if there’s any uncertainty about this. Our new guide to type 1 diabetes and low carb may also be helpful for some:

Type 1 diabetes – how to control your blood sugar with fewer carbs

/ Andreas Eenfeldt, MD

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