Wednesday, 15 January 2014

Low carb and diabetes. A success?

Recently I had great news from my consultant... 

"Your HbA1c is 7.9%" 

"So you can send that data to the CCG then? Does that mean I can keep my pump? Will my trial be over from now? Do I need to do anything else?"

I'm sure I asked many more questions, just to be sure, but a letter came through my post box this week confirming that Iain the pump will be remaining firmly by my side (although according to the letter my a1c is 6.3% I think this is a typo). 

Success!! Or was it??

At the back of my mind is a nagging thought... When I was advised that my A1c needed to come down further I changed to a low carbohydrate diet. I was anxious that I would lose my pump and from hearing of other people's experiences I thought this would do the job. It did...

Sitting in my appointment my consultant leaned back in his chair and asked; "What's your secret? I've never seen your blood sugars like this before" and for the first time in 2 years he looked at his computer screen and said that he wasn't going to make any changes.

I told him that I'd changed to a low carbohydrate diet... I waited for his reaction... I didn't think this would go down particularly well. However he was supportive that I had made a choice and that, for now, it seemed to be working in my favour. The pump was clearly doing a great job as my blood sugars were always within my target of 5-10mmol/l. My basal rates were perfect throughout the day and night and I'd had no hypos at all... Good old Iain the pump. 

"Do you think you can keep this up? How is it making you feel?" My consultant probed a little further.

I knew what he was getting at. I'm sure from his side if the office I looked awful. I recall barely being able to stay awake during the appointment... and I knew I couldn't keep it up. 

"I'm so tired and I have no energy. I'm struggling to concentrate and my memory is terrible at the moment." I told him, feeling grateful that he'd asked.

Not only that but it was affecting people around me as well; I wouldn't eat the same food as my partner, my mum would offer to cook me dinner but I would turn it down, I cancelled nights out with friends if they were going out for meals, I avoided going to the pub because alcohol would play those wicked games on my levels, I even tried get out of going to my works Christmas party because we were having a three course meal that would be loaded with carbs. I knew that people were worrying and I didn't blame them... The big dark circles under my eyes were a give away. 

I agreed with my consultant that if I was to go back to eating carbs I would ease myself back in gently to save me from having those big bouncing high blood sugars. And that's what I did... I gradually introduced carbs back into my diet. Even on Christmas Day I was careful not to get too excited and eat everything in sight (though I wanted to).

Unfortunately since re-introducing carbs back into my diet my blood sugars have soared, my weight has increased and as a result of both, my mood has dropped. I carb count, I use the multiwave and extended bolus functions on my pump, I test before I eat, I take my insulin 20 minutes before eating, I test after I eat, I try injecting to see if that makes a difference, I have a range of insulin:carb ratios to use throughout the day that have been adjusted time and time again... I still can't seem to get my blood sugars under control when I eat. 

Occasionally I have a splattering of "good" days, but this is very occasional. When I look back over my data the highs are so glaringly obvious that my heart sinks a little as I know that it must be something I'm doing wrong, I just don't know what that something is. 

Now I'm toying with the idea of low carb again. I desperately don't want to, especially as I'm starting a 7 week placement from next week, but thinking about my next A1c and knowing that each day the result is creeping up is becoming incredibly frustrating. 


  1. I'm so sorry you're feeling this way. I guess I'd suggest maybe looking up some vegan meals if you feel low carb works for you? Vegans don't eat a lot of the carb filled meals that non-vegans do so have to find their protein and energy from other places. Maybe that might help? You haven't mentioned what you were eating on the low carb diet so I'm sorry if this was the route you were taking. Could you eat on a more little and often sort of thing? Maybe then your body would be exposed to a more of a constant energy fix that mimics carbs and would help you feel brighter? I don't know if this would fit into your schedule or not. Maybe you can look for more meals that are a X +Y thing. For example, pasta and a sauce with chicken but you could make your partner their pasta separate and portion up your own part with extra veg and theirs with the pasta and feel like you are eating together?

  2. I've only just found your blog and I've only skimmed a few posts, so I hope I'm not missing anything obvious. I'm a Diabetes Dietitian, and we're starting to find more and more evidence of the value of a low carb diet for some people - not for all, but as you've found, it does tend to have a beneficial effect on blood glucose levels. There are a couple of options: limiting to 120g carb per day (30g per meal plus 30g for any snacks), which doesn't change your metabolic status, or very low carb (30g per day) which switches your body into fat-burning mode. The changeover can have the effects you've described: headache, lethargy, fatigue, which usually last for about a week. You haven't written about what you did, but if it was very low carb we also suggest a standard multivitamin supplement as well.

    Hope you're doing OK now.