Hello Everyone, 

I just started something new at DrCarney.com that we are actually excited about which is the creation of groups for specific topics. The first one I created is for Type 1 Diabetes Support. I also just created one for Weight Control Support. The advantage of using a group over these discussions is that with a discussion every time we add a comment the document just gets longer and longer. And, if we want to change the topic somewhat it can be tricky to follow. 

With a group we can also create as many discussions, relevant to the subject matter of the group as we want. We can also submit videos of relevance in the videos section, podcasts in the podcast section, etc...  And the discussions that we create from within the group will be available as well from within the Discussion Forum. There will be a Groups link added to the Forum navigation bar if you are a member of any groups. 

I wish you would all check out the group and even consider jump starting a discussion there. There is also the ability to share documents which I have not tried out yet but want to try. 

Here is the URL for the access to the groups from the Club - Community Menu: 

https://www.drcarney.com/community/groups

Check it out and let me know what you think. Also, I am planning to add all of the people who have participated in this discussion into the Type 1 Diabetes Group. I hope that is ok. Otherwise, you can remove yourself from that group or ask me to remove you. 

Sean

Hi Tara,

I went WFPB/LF this past January 2018.  I was coming off of a low carb/keto diet that I had been doing for several years on the advice of several t1d groups online. My insulin resistance has improved quite a bit since going WFPB/LF. I am T1d, diagnosed in 2010 and I also use an Omnipod pump with Dexcom G5. Ken's info has been IMMENSELY helpful to me in transitioning to a WFPB/LF diet. I am experiencing more high BGs that I'd like, but am working on that! It's a process but I'm learning!

I received a question about over testing after meals and over correcting for a resulting high. I thought I would share my answer here:

I would not imagine testing too often being an issue. I never want to turn a blind eye to my blood-sugar. I want to know where I'm at, at any given minute. When I try a new food item, I will test every 15 minutes from consumption for about 2 or 3 hours, so I can plot its effect. That information is important for injection timing (how far to precede the meal), and the dose amount. If there is a dip then a rise, the dose precede time should be reduced. If it rises then falls (in less than an hour), the dose precede should be lengthened. When you get it right, it will stay flat then slowly taper down after 2 or 3 hours. My precede time averages around 10 minutes for a large potato, but sometimes it is as short as a minute or as long as 30 minutes (depending on state of insulin resistance). If I see that I'm going over 5.5 (100mg/dl), I will go ahead and add some correction and log it. Experience will tell how much correction is needed, but I no-longer worry about over correcting. If I think I might have over corrected, then I just keep testing and follow the rate of change. From that, I can predict when I will drop under 3.9 (70mg/dl) and can have a fruit snack that fits that timing to level it out. If the over-correction is huge, I will add some starch to the fruit. There have been occasions when I accidentally took insulin twice for a meal - a double dose. No problem, I always have snacks on hand and testing lets me know what's happening before I actually "crash". Testing after a fruit "boost" lets you learn how fast a particular fruit works and how much is needed for a particular fall rate.

 

Here is a link to an article Ken wrote about his logs and logging. He also provided links to download his logs although you may need to tweak the numbers for metric:

https://www.drcarney.com/blog/condition-related/ken-s-type-1-diabetes-journey-logs

 

Hi Rachel,

Thank you for the kind words.
Yes! I hear you about the stress. Getting a handle on diabetes, where you are actually in control is a major stress relief, even if it is hard.
It helps to keep a log of the meals, times, blood-sugars, insulin, activities, etc. A log helps for understanding the trends and is a guide for the next day. It is different each day, even if it is an exact repeat, so it is only a guide. It also helps get familiar with cause-and-effect making it easier to predict, which is a major element of control.
As his insulin resistance grows less, the meals and insulin become more in sync making control so much easier.
In the metric system, my blood-sugar window is 3.9 to 5.5. I figure that that is inside the non-diabetic normal range, so if I can keep it there, I will never suffer any diabetic complications. So far, so good! In fact, my optometrist informed me that my retina looks like that of a child or very young adult - I'm 65 years old.
I would say to your son, don't worry about being different! Be proud of it! No one has ever accomplished anything great by being normal! I get much of my inspiration from people who are like the Jonathan Livingston Seagull fable: http://csermelyblog.tehetsegpont.hu/sites/default/files/angol%20sir%C3%A1ly.pdf
Wishing you the best!
Ken

Hello everyone

My name is Rachel and I am the mother of a 12 year old diabetic boy. Matthew was diagnosed at age 4, and my health has suffered so badly because of the worry and stress I feel from the conflicting information from both medical staff and internet. I am a vegan myself and I follow the Starch Solution. My husband is French and continues to eat a high fat French diet, so my situation is complicated. It is harder to make changes to your child when both parents are not on the same page. After finding ken's story and reading for hours on end these past few days, Matthew and I have decided to give this a go. We will keep you updated because it is invaluable to read the stories of other people. I just wanted to say hi and a huge thank you to Ken for all the information he provides. You are an inspiration and a breath of fresh air in a world that demonises carbs.

Rachel

 

Hi Tara,

Welcome!! I am delighted that you have joined us. After adopting a whole-foods plant-based fat "free" lifestyle, I expect that you will achieve unimagined improvements. At least, I did.

When I discovered the benefits of this diet, I too noticed tremendous improvement in the first six months. However, it did not end there. Steady improvement has continued over the past three decades; improving still past the age of 60. I don't know where it will peak.

In my T1D adventure, animal products and fats have been the focus of "NO". But now, though, it is just fat. I no longer strive to avoid animal products. That is because it is so far removed - totally out of mind. I never even think about it, just as I don't think about eating sewage or poison ivy. Fat, however is unavoidable, yet it's effect is huge. So, I consider myself fat free. The plant-based community stresses that one must ensure getting enough "healthy" fats, but I have found that that effort is unnecessary because you literally cannot eat a whole-food-plant-based diet and not get enough fat. The difficulty is not getting too much. That's why I claim to be fat free - even though that is only true by effort. Even lettuce has more than enough fat. I've found that the lower the fat the higher the vitality. I've found that I don't have to rely on fat intake to maintain a healthy weight. In fact, gaining weight by increasing fats is not beneficial to health and vitality. Stored fat is non-contributing to energy, strength or endurance. It is just extra weight to lug around. It marbles muscle reducing its strength per volume. I have learned that 10% calories from fat is my limit. The 10%, however, is per any individual ingredient in a dish or meal, not 10% of the whole meal. Keeping it that low makes insulin response in sync with my biology, food and activity. I just use a cheap glucometer, Humalog and Lantus. No pump. With everything in sync, it's easy enough without pumps, etc.

Yep, I dumped glucose tablets years ago. I find their response to be too slow and shallow. I like fruits because you can select the right fruit for the right timing and magnitude. I like to keep a few medjool dates in my pocket just in case I miscalculate.

Blessing in disguise? I used to think that, but now I know it is a full-flat-out blessing - no disguise involved! T1D opens my metabolic control loop; putting me directly in the driver's seat. It opens a vision to nutrition and metabolism that is simply not available without being inside that loop. It's hard to imagine a greater blessing. Without it, I would be blind; groping about trying to figure out nutrition in the noise of society. That is one reason I avoid pumps and high-tech devices, because I want as much intimacy with that control loop as I can get. I am healthier with greater vitality now at 65 than I had in my 20's. I have no doubt that if not for the T1D, I would be stooped, decrepit, sick and tired long before the age of 65. It's hard to beat a blessing like that!

So happy you have joined us, Tara. Please keep us up with your adventures!

Ken

 

Welcome Tara,

I am looking forward to Ken seeing your reply here. I know he will be encouraged and be an encourager at the same time. 

Thanks for joining us. 

Sean

Hello Everyone,

I have had T1D since age 15 (I'm 33 now), and only recently discovered the benefits of transitioning to a whole-foods plant based lifestyle.  I wish I had known about this for much longer, but I'm pleased to see that Ken also discovered this in his 30's and is still in such good health (or better!) decades later.  I've been completely avoiding meats, dairy, fish, eggs, etc. for 6 months, and I've noticed a significant decrease (at least 50%) in the amount of insulin (Novolog) that I need to take.  I've also been very interested in limiting my fat intake, and the info you provide here excites me to continue on this path.  I use an Omnipod insulin pump and a Dexcom CGM, which I've found very useful for monitoring patterns and catching lows before they happen.  Just recently I began using fruit to do this, like you Ken, and moving away from glucose tabs.  I am so incredibly sick of glucose tabs.  They're the worst!  But I will never get sick of a Cara Cara orange, or a nice juicy Pink Lady apple!

I don't know if you feel this way, but I often think of my diabetes diagnosis as a blessing in disguise.  Who knows what my eating habits would have been if I had never been diagnosed?  Now I have a very powerful tool that encourages me to make the best decisions for my health.  If only I could have Ken's skills of logging and data analysis- that's where I seem to fall short!

Anyway, I am so grateful to find this website and a group of people with similar challenges (and successes).  The info that you all have provided is probably the most useful, concrete, and specific info I've been able to find online for T1D's and WFPB diet.  I look forward to reading more and keeping in touch!

Thank you, thank you, thank you. 

Tara

Thanks Ken for clarifying that. It is an important point you are making.  Sean

Hi All, Regarding my Type-1 diabetes "both-ends" control method (controlling both highs and lows), some have expressed that they could not use this method because they cannot feel when they go low. I have also recently read a science study where a method (product) is being developed to help Type-1's with that issue. This information prompts me to clarify that my method does not rely on anyone "feeling" when they are low - not even me. It is also important to note that I never wait until I'm low before correcting. That would be like pressing the brake petal on your car after the impact. Instead of "feeling", I use instrumentation to know what my rise or fall rate is, making it easy to know when I will go low and then to have a snack at the right time to stop the fall before it reaches 70 mg/dl. I don't use any fancy continuous monitoring gadgets; I only have a cheap glucose monitor, but it does just fine letting me know where I'm going and how fast I'm headed there. I "double-test" to determine the rate. "Double-testing" is where I test twice, fifteen minutes apart. The difference lets me know how far out the low is and how soon I need the snack. After years of experience doing this, however, I can generally predict it even if I happen to miss a double-test opportunity - but I never rely on feeling. Happy Tuesday! Ken

Sounds good, I just discovered Teff, which is an ancient whole grain and of Ethiopia. It cooks up like creamy hot cereal, is gluten free, and is 8.33% fat calories. It has 6 grams of protein and 5 grams of fiber. I mixed it with frozen mixed berries and it was quite tasty and filling! BTW, I, too am celiac. Thanks so much for the info!

Hey Norma, Thanks for the great tip! I'll have to check out some Tiff!

Sounds good, I just discovered Teff, which is an ancient whole grain and of Ethiopia. It cooks up like creamy hot cereal, is gluten free, and is 8.33% fat calories. It has 6 grams of protein and 5 grams of fiber. I mixed it with frozen mixed berries and it was quite tasty and filling! BTW, I, too am celiac. Thanks so much for the info!

Hi Ken, I was wondering if you eat pasta, and what whole grain cereals do you like? In addition what kind of BBQ sauce do you use?

Hi Norma, I do occasionally eat brown rice or quinoa pasta. I don't eat any wheat, barley or rye because I am celiac. I don't eat cereals very often, but I eat boiled brown rice every day. I eat steel cut oats very rarely (about 3 times per year) because its fat content is too high (~20%). The BBQ sauce most often used is Walden Farms Honey BBQ Sauce.

Hi Ken, I was wondering if you eat pasta, and what whole grain cereals do you like? In addition what kind of BBQ sauce do you use?

Hi Rien,

Thanks for the update! It's great to hear your experiences!

How do you take care of your omega-3 needs? I take flaxseed meal and chia seeds.

I don't worry about omega-3's or any of the fatty acids. Years ago, I was completely ignorant about them. Then, by the time I learned about them, I found that I was already getting plenty from the greens I eat. I never eat any seeds, nuts, etc. because the high fat concentration increases insulin resistance - which in turn increases insulin response delay - which in turn increases blood-sugar spikes and reduces energy.

I've modified my exercise routine in order to achieve a better A1c. I still walk 6km (one hour) before breakfast every morning. It is lovely to watch the new day break over the Coral Sea. I used to eat some bread before the walk, but that spikes much more than a banana. A banana is a mere pimple on my Freestyle Libre graph. 

The post breakfast bike ride I've had to halve. I used to ride about 2 hours at high intensity. Now I do just over half the distance at a more leisurely pace. Now that I inject rapid insulin to take care of the breakfast spike, I will go much too low mid-ride. In addition, after injecingt rapid to take care of the lunch spike, I get the mother of all hypos mid afternoon. This is well after the rapid action should be finished. I figure it is the so-called post exercise late onset hypoglycaemia phenomenon, where the liver scavenges all available glucose to replenish the stores that I so inconsiderately depleted during the ride.

Before starting the 'both ends' method I was injecting 6 units of slow acting Levemir once a day, no rapid at all. The bike ride would take care of the 500gm of carbs I eat every day, and give me an A1c of 5.8%. But, that requires high blood sugars after breakfast before the ride, and after lunch when the liver rebuilds its stores.

I have confidence that once you get the "both-ends" mastered, you won't have to limit or modify your exercise. You should be able to exert any level or duration without any blood-sugar high's or low's. I too experience mid-exercise lows, but I have learned to anticipate and take a snack during the exercise. I can pop one or more medjool dates, during the exercise, before the expected low, and more again if another low is expected in the duration of the exercise. If I go on any really long energy intensive endeavor requiring more snacks than will fit in my pocket, I take them in a back-pack; my "fuel tank". Keeping fueled during exercise seems to help prevent "post exercise late onset hypoglycemia phenomenon", because it keeps me fueled, thus not depleting the liver/muscle glycogen stores. The dates short duration works pretty well because after the exercise, I don't want blood-sugar to rise before the liver figures out that the exercise is over. If I happen to miss calculate and catch myself low, I fix it with a 6-8 oz. shot of apple juice. That fixes an in-progress low within 5 minutes. Anything eaten is too slow, prompting "panic eating".

Exercise may be beneficial, but it seems pointless that it requires high sugars for 8 hours of the day. So I'm reducing both the distance and intensity. 

I currently inject 12 units of Levemir and about 15 of Novorapid per day. I keep a detailed log and tweak insulin dosages. They seem to be trending up.

I have also found that as insulin sensitivity increases, insulin response and duration increases. My Humalog duration goes well beyond the published curves.

My diet is similar to yours, very much starch focused. I do eat more grains, oats, rye and barley. I really love the starch diet and am thriving on it. Is there a reason why you don't seem to eat much grains?

I do eat grains! Just happened to not be much during the particular week of my posted diet list. I do, however, not eat any wheat, barley or rye, because I am also celiac. While not banned, I do limit oat's because they are over my 10% fat limit. Every day, lunch is always 2-1/2 cups of brown and wild rice mix.

Every day I get a little better at following your method. My biggest issue is learning to catch the lows in time, and when I do have one (usually mid afternoon), to be calm about it and not eat the fridge empty.

My goal is; "Let there be no spike." Likewise, "Let there be no dip." This is accomplished by insulin sensitivity and snacks as opposed to limitations of carbohydrates or activity. And since insulin sensitivity is so diminished by fats, that is why I so adamantly avoid them. In that effort, however, I have found that I can't eliminate fats to a detrimental level, because they are in everything. That's a good thing since they are essential, but the good thing is that I don't have to worry about getting enough of any particular type no matter how fanatically I avoid them. Fats are so concentrated that I don't have to seek a prominent source. Just eating a whole food plant based diet with plenty of variety (and greens) has me covered.

Ken

Rien,

I hope it is OK for me to interject a comment from another discussion that Dr. Carney posted a couple days ago regarding Omega-3's:

I actually recommend that people consume the majority of their omega-3 fatty acid precursors from leafy greens at 2 different meals per day, rather than from walnuts, flax seeds, and chia seeds.  Most people will get all the omega-3s that they need from leafy greens twice per day, even if they never ate flax, chia, or walnuts (each of which is much higher in fat than leafy greens).

This came from a discussion located at https://www.drcarney.com/discussions/1418-how-about-hemp-seeds

Thank you for your responses to Ken. I believe that many others will be benfited as well from your interactions.

Sean

 

Hi Ken,

Thank you for describing in detail what you eat and why. The snacks information is also quite useful. 

How do you take care of your omega-3 needs? I take flaxseed meal and chia seeds.

I've modified my exercise routine in order to achieve a better A1c. I still walk 6km (one hour) before breakfast every morning. It is lovely to watch the new day break over the Coral Sea. I used to eat some bread before the walk, but that spikes much more than a banana. A banana is a mere pimple on my Freestyle Libre graph. 

The post breakfast bike ride I've had to halve. I used to ride about 2 hours at high intensity. Now I do just over half the distance at a more leisurely pace. Now that I inject rapid insulin to take care of the breakfast spike, I will go much too low mid-ride. In addition, after injecingt rapid to take care of the lunch spike, I get the mother of all hypos mid afternoon. This is well after the rapid action should be finished. I figure it is the so-called post exercise late onset hypoglycaemia phenomenon, where the liver scavenges all available glucose to replenish the stores that I so inconsiderately depleted during the ride.

Before starting the 'both ends' method I was injecting 6 units of slow acting Levemir once a day, no rapid at all. The bike ride would take care of the 500gm of carbs I eat every day, and give me an A1c of 5.8%. But, that requires high blood sugars after breakfast before the ride, and after lunch when the liver rebuilds its stores.

Exercise may be beneficial, but it seems pointless that it requires high sugars for 8 hours of the day. So I'm reducing both the distance and intensity. 

I currently inject 12 units of Levemir and about 15 of Novorapid per day. I keep a detailed log and tweak insulin dosages. They seem to be trending up.

My diet is similar to yours, very much starch focused. I do eat more grains, oats, rye and barley. I really love the starch diet and am thriving on it. Is there a reason why you don't seem to eat much grains?

Every day I get a little better at following your method. My biggest issue is learning to catch the lows in time, and when I do have one (usually mid afternoon), to be calm about it and not eat the fridge empty.

Thanks again for your information and enthusiasm. You inspire me.

Rien.

Ken - Thanks so much for all of your efforts. What you are doing is very intriguing and impressive. Would you mind (if you haven't done so already) sharing a sample meal plan for a week. I'm curious what you eat on a day to day basis.

Thanks again!

Trey

Hi Trey,

Here is a sample of my meals and snacks:

BREAKFAST is basically always the same.
sweet potatoes (largest portions)
greens (spinach, collard greens, broccoli, etc. Sometimes a mix.)
steamed fresh beets
mixed beans
an orange

LUNCH is basically always the same.
2-1/2 cups steamed brown and wild rice mix
Cup or two of berries, cherries, strawberries, melon, grapes, banana, etc.

DINNER is the variable of the day. It is always starch based. I take my Lantus insulin before bed time. I find the response curve of the Lantus is the flattest throughout the next day, however, there is a response spike (BS dip) between midnight and 2AM that a starchy dinner fills, keeping me flat through the night - and the next day.

My wife, Heidi, cycles through about 100 recipes that she has cataloged in a library style index box. These recipes are a collection from books, websites and friends. All have been edited to remove or substitute any ingredient that exceeds 10% fat calories. 
Each of these dishes are served with various greens and fresh fruit.
Here are what we had last week:
TWICE BAKES POTATO SKINS:
Large russet potatoes
Red bell peppers
Yellow onion
Chopped spinach
Yellow corn
Nutritional yeast
BBQ sauce
Smoked paprika
Black pepper

LIME-MANGO BEAN SALAD:
Cannellini beans
Fresh mango
Diced red onion
Fresh cilantro
Fresh lime juice

BARBECUE PINTO-PORTOBELLO OVER RICE:
Pinto beans
White rice
Minced onion
Minced garlic
Cubed Portobello mushrooms
Tomato sauce
Chopped green chilis
Yellow mustard
Molasses
Agave
Chili powder
Liquid smoke
Smoked paprika

BAKED VEGGIES OVER RICE:
Onion
Green pepper
Sweet potato
Broccoli
Mushrooms
Cherry tomatoes
Yellow squash
Red cabbage
Brown rice

Shepherd's Pot Pie:
LARGE russet potatoes
Black pepper
Yellow onions
Large carrots
Froze peas
Broccoli florets
Arrowroot powder
Suzie's unsweetened quinoa milk (fat calories <10% - no oil)
Nutritional yeast
Fresh chives
Mushrooms

SNACKS: (Snack, Onset, Ramp Rate, Amplitude, Duration)
Medjool dates, 20-30 min, Medium fast, high, short Grapes, 20-30 min, Medium fast, medium high, short ~ 2 hrs.
Oranges, 10-20 min, fast, high, short ~ 1 hour.
rice cakes, 25-35 min, medium fast, high, long >3 hrs.
air-fried potato wedges, 20-30 min, medium fast, low, long ~ 3 hrs.
raisins, 20-30 min, medium fast, high, medium, ~ 2 hrs.
cherries, 25-40 min, slow, low, < 2 hrs.
Apples, 25-40 min, slow, low, < 2hrs.
Banana, 25-35 min, medium fast, high, long ~ 3 hrs.
Apple Juice ~ 5 min, fast, high, short. Use only when caught low (Raw Carrot, NA, NA, NA, NA used for a munchie snack. Glucose effect too low to notate.
This is a general list. Snacks are not limited to the above.

I stopped logging snacks years ago. My current daily insulin dose is about the normal 40 units per day for the average T1 diabetic. Before I started the "both ends" method, it was almost half that. As typical, I would experience occasional lows, so I started carrying snacks with me to prevent any emergencies. I used to carry a small grocery bag with me at all times, then that evolved into small box raisins in my pockets, then that evolved to glucose tablets then, currently, I carry medjool dates. It did not start as a conscious plan, but carrying snacks on my person evolved into the "both-ends" method where I learned to purposefully increase insulin to force a constant downward blood-sugar trend and keep it pushed up with snacks. I then found I had even more energy due to the extra insulin pumping extra glucose from the snacks into the cells producing more energy. It also eliminated calorie counting requirements or any need for matching calories to insulin.

The above listing is and approximation, because the onset, rate, amplitude and duration varies by your current insulin sensitivity level and metabolic rate (activity) is never exactly the same.

YESTERDAY; Breakfast at 6:30 AM. Then, an apple plus 1/2 peach about 8:30 AM, 6 cherries and half a rice cake at 10:00 AM, lunch at 12:00 noon, a banana at 1:00 PM at the start of my 1-hour walk/jog, two medjool dates half way through the walk, 1 large carrot at 2 PM, 7 grapes plus a rice cake at 3:30 PM then dinner at 6:00 PM and 1/2 rice cake and pumpkin cookie at bed time (to help fill the midnight dip). This was yesterday's snacks, but it varies each day. Wakeup BS was 83 mg/dl.

Rien,

I am thrilled to read your response to Ken and his response to you.

Thank you for translating his log into the non-USA measurements.

I am not sure if you noticed below the editing window that there is the ability to add an attachment. I wonder if there are others out there that might like to download your translated version. You could put it in a .zip archive that somebody could download and unpack. :-)

Sean