Dietary strategies

I need help!!! What dietary strategies do you use?
Low carb?
High carb?
Time restricted feeding?
Same food everyday ?
Certain diet philosophy?
Steve T.

Hi @spt2 . What is it you need help with - weight loss, improved control, preparing for an extreme challenge? Certain strategies may be better than others depending on your specific goals.
While I could stand to lose a few pounds I’m not doing anything in particular: usually I just try to bolus appropriately fit my carbs, in my case about 15 minutes before eating. That works out pretty well for me unless I’m having something high in fat.
I was trying to follow the Mediterranean eating plan (I prefer not to call it a diet as its more of a lifestyle change) but it does involve a commitment to using fresh foods and that became difficult for me. Still, it is one of the healthiest options out there.

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Steve @spt2, I do not eat any particular diet, especially avoiding “diabetes diets”. Somehow, I’ve been able to enjoy a full, active, and enjoyable lifestyle while living with diabetes - insulin - for more than six and a half decades.

That said, I’ve always enjoyed a healthy-food regimen that tends toward the Mediterranean Style diet that includes pasta, fish, many vegetables, and plenty of fruit. What I have learned to do, is gain a fairly good grasp of the reality small amount of insulin, plus exercise, I need to balance the 230+ carbs I eat per day.

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Wow Dennis you eat a lot more carbs everyday than I do! Im usually in the 150-180 range. I just think that there would be something out there diet wise or framework that would:

  1. Help maximize insulin sensitivity
  2. Help mitigate potential T1D side effects.
  3. Help decrease total amount of insulin needed
  4. Help reduce spikes in BG
  5. Stimulate the Incretins and Adiponectin
  6. Help improve aging and longevity
    The only “diabetic” diet that i am aware of is the mastering diabetes diet, but that seems like eating mostly fruit and some, grains and vegtables. Seems pretty restrictive and vegitarian.

I guess im trying figure whether or not a T1D should be on a certain diet or just learn to “cover” whatever your diet is with accurate calculation of insulin needs.
And is there specific diatary needs of the T!D that should be addressed?

well there is also the Dr. Bernstein group that are basically the polar opposite of the mastering diabetes group. I do what works for me which is a lower carb lifestyle but not as low as Bernstein’s diet. I discovered it by accident about 10 years ago and was reinforced by wearing a cgm. If my job allowed more exercise though, maybe it would be different.

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Steve @spt2 , you may have seen posted here many, many times that no two bodies are the same, and that there isn’t any textbook method for managing diabetes. We each must find a “management plan” that fits our own body and lifestyle. I’ll attempt addressing your itemized thoughts/concerns.

  1. Maximize sensitivity: I don’t know specific way; it is something dependent on lifestyle and body absorption, insulin helps food nutrients including carbs to pass-through to do their work and some people need “more assistance”. There is evidence that body weight, specifically BMI, affects insulin requirements, for instance, a BMI near 20 requires less insulin than a BMI near [or above] 24.
  2. Side Effects: The DCCT Study found that avoiding prolonged high level BGL and avoiding wide BGL swings can reduce some diabetes related complications.
  3. Decrease NEEDED Insulin" WHY? There is no question that anyone with autoimmune diabetes NEEDS insulin from an outside source. You need all the insulin required to manage BGL in an acceptable range. Insulin does much more than just “cover” food eaten; for example, try going a day without eating and insulin and see how you feel, and where your BGL flies.
  4. Reduce Spikes: Spikes, at least for me, happen following a meal for which I have bolused sufficient insulin for the carb count of food eaten and related to my activity because of the glycemic value of the food-carbs. I accept reasonable spikes as long as my post-meal BGL returns to where it should be within an allotted time. An example, today my breakfast was a bowl of oatmeal with plenty of milk accompanied by a glass of orange juice - within an hour I spiked 115 mg/dl - acceptable and three hours later my BGL was back below 110 mg/dl. Perfect.
  5. Incretins and Adiponectin: If you truly have autoimmune diabetes, you don’t have these hormones. T1D is caused by the body autoimmune system misidentifying and destroying beta-cells in the pancreas; Beta-cells produce two principal hormones - insulin and Amylin; insulin you know about, Amylin is the one you are referring to here.
  6. Longevity: Good question, I’ve had diabetes since age 15 and I’m an octogenarian now.

A diet? figure out, maybe with the accistance of a good dietitian, what you need to live the lifestyle you desire; foods you enjoy eating that provide necessary and proper nutrition - and eat those foods. Eat moderately, vary meals from day-to-day and watch quantity.

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I’m 60+ years old, and not that I think my life will be over soon, but my philosophy is more “enjoy life” than anything else. So I eat what I want and try to cover the carbs. Had I known in my teens and twenties what I do now, and had our tools been available back then, I might have done what you are now - studied the different options to see which would deliver the best outcome - but we’ll never know.
That said, it may not be a question of “one size fits all.” Just as we know that all of our bodies need insulin, two people of the same height, weight and activity level may have very different daily doses and carb ratios; or the bp medication that works for one of them may not work for the other. So consider that the plan you should choose should be the one that works best for you: that helps you feel good overall; that doesn’t make you feel deprived; and perhaps most important, that you will stick with. And don’t forget to enjoy life*. A merry heart is good, like medicine* - happiness is healthy.


In my opinion, a strategy that satisfies these is: low fat and daily (if not 3x daily) exercise. Hits all your points. Good luck. :four_leaf_clover:

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Thanks Kevin, That seems like a reasonable approach!

Dorie, I like your “enjoy life” approach! What is your stress, activity level and TIR?

You are a true diabetic warrior! And also I think you are an exception to the typical.
It seems like what i am seeing here is that many people choose diet of choice, lifestyle of choice and then learn to manage BG accordingly. Im wondering if this is the norm or is there a large group of people that choose a specific way of eating and lifestyle to manage their BG? Like opposite of what you do?

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Steve, as you point out, there are many varied “diets” people follow to help manage diabetes and, there are many people who successfully manage by eating low-carb, high-carb, moderate-carb. My thought is that each of the three I mentioned can be “good” as long as it fits the chosen lifestyle and provides necessary nutrition and insulin is added thoughtfully - neither too much nor too little.

Upon leaving the hospital in 1957 following two weeks recovering from my 1700+ BS and extreme acidosis poisoning, I was, told to take 18 units of NPH before breakfast and given a “starvation diet” to follow even though my weight had dropped to the point where I looked emaciated. A few hours after arriving home, I was at the family dining table for our usual supper with the entire family - my parents had 8 kids; I ate everything, except the pie, that everyone else had but I had to use measuring cups. The next day I was out hoeing rows of corn practically dying of starvation - I don’t remember how many carrots I pulled and ate after wiping off the dirt on my pants - so much for sticking to a diet. That is one example of “diabetes diet” and another was shared with me last week at a JDRF meeting. The woman sitting next to me, also living with T1D for 60+ years told me about her keto diet where she eats no more than 40-50 carbs per day. We both use the Control IQ algorithm to assist our management and we each have had favorable results measured by TIR.

With care and thought, I believe most food types can be acceptable - think quanty and don’t over eat.

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I’m in my 60s and diagnosed 11 months ago. It’s been trial and error for me. I don’t use a specific diet. I do carb count the best I can. I’m learning as I go and when I repeat food (especially restaurants) now I just know how much insulin I need for that dish.
I do avoid high sugar/carb meals because the quick spikes are unpredictable for me and take a long time to correct. I’ve found some lower carb items (often called Keto or no sugar added) that allow me breads, ice cream, “treats” without the crazy spike.
I love to eat and want to enjoy life so I’m finding compromises on various foods. When I want to be part of the birthday party I eat a very small piece of cake, for example.
Good luck! It’s crazy and unpredictable but with time it makes a little more sense.
Celebrate the good days!


The only strategy you need has really nothing to do with diabetes if you are a type 1 with a pump. Eat what you want and put the carbs in the pump. You are just about a regular person. You just have a pre-meal step. Type 1s in my mind are free as a bird!! Celebrate that. We are not a thesis project full of analytics. Sure there are hassles and adjustments needed but live your life like you want to. Don’t let it be a job.

Over 50 years T1D - I avoid fast carbs like sugar, hard candy, pop, sweet tea, unless it’s an emergency low blood sugar cure. I eat a normal diet and consistently cound carbs for meals and snacks. “Hey Google, how many carbs in a McDonald’s cheeseburger?”… Or a cup of milk or a banana…a fantastic resource. I have dropped over 30lbs since I went on the Tandem Pump & G6. My weight is currently high school level and I am healthy. A1C: 6.48.

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Love your straight forward point of view Larry!

Thanks Jim,
56 yr old, Ditto on weight, MDI, G6 and A1C 5.4

It’s my life. I live in and am not shy. Well technically I am shy but have a big mouth! Hehe

My Endo would say your a1c is WAY too low