Imagine putting your child with type one diabetes (T1D) to bed with less fear of a dangerously low blood sugar. If you have T1D, imagine doing a triathlon or a belly dancing class your friend keeps bugging you about with confidence your blood sugar will remain stable along with your energy levels. The process I used to achieve near normal blood sugar took some time, commitment, experimentation, and sacrifice. All people with T1D have unique physiologies and my experience may not extrapolate to anyone else. However, the process I used is inexpensive and has no side effects, but the benefits could be priceless.
My daughter does not have T1D, but she has watched me check my blood sugar thousands of times. Every now and again she asks me to check hers. Day or night, her blood sugar is always between 70 and 100 mg/dL. This is a sign of a healthy and robust metabolism that allows her to eat a variety of foods without de-stabilizing her blood sugar or energy levels. This is my target range for my own blood sugar. I now spend roughly 90% of each day in this range and my last HbA1C was 5.1. I have come to believe that stability is probably more important than absolute blood sugar numbers. If your target range is 70-100 mg/dL or 90-120 mg/dL’ it probably doesn’t make a huge difference.
In an effort to keep my daughter free of diabetes, I’ve read zillions of medical journals, articles on diabetes, and listened to lots of great podcasts. The cause of T1D is unclear, but some patterns have emerged. If you have T1D, or any autoimmune disorder, there is a good chance that your intestinal lining as well as your intestinal bacterial ecology have been compromised. As a result, your immune system may overreact to certain trigger foods. Considering the link that has emerged between celiac disease and T1D, it’s not surprising these trigger foods are often gluten and dairy (Dairy is a common cross reactor with gluten).
My journey began with a gradual elimination of gluten, dairy, added sugar, seed oils, and anything else that made my blood sugar unstable. I now eat a wide variety of the most nutritionally dense whole foods I can get my hands on. My palate seems to have adapted to eating real food so intense cravings for sugary junk food are all but gone. Blood tests have revealed significant improvement in my previously inflamed intestinal lining as well as improvements in my bacterial ecology. The autoimmune protocol (AIP) is pretty restrictive, but I think it’s a good starting point for anyone interested in initiating the healing process. Dr. Terry Wahls is a great inspiration (here’s a link to her book!) and has done a lot of research in the field of nutrition and autoimmunity.
Once the healing process had started, my immune system calmed significantly making stable blood sugars possible. At this point, I started experimenting with macronutrient ratios, timing of carbohydrates, basal insulin levels, and some lifestyle modifications like sleep and meditation. Since competitive swimming has always been a big part of my life, I use multiple daily injections with Lantus as my basal insulin instead of a pump. I know it’s obvious, but it’s worth noting that large boluses of fast acting insulin are typically the cause of high or low blood sugar. Therefore, I set my basal level carefully so I can get through a day with as little fast acting bolus insulin as possible. The law of small numbers, a concept I first encountered through Dr. Bernstein’s work, goes like this: small carb counts and small insulin boluses result in small errors and small blood sugar swings. I am not suggesting a low carb diet. When I removed processed carbohydrates and switched to real, whole foods, my insulin requirements came way down and my blood sugar swings narrowed dramatically. At the time of my diagnosis in 2002, my team of healthcare professionals kept pushing “healthy whole grains”. I have nothing against grains, but I could not control their impact on my blood sugar. I finally had to eliminate most grains all together.
Like many people with T1D, I utilize many tricks and strategies in the daily grind of balancing blood sugar. However, once the healing of my gut began and my immune system no longer had a twitchy finger on the trigger of my stress response, the biggest factor was to simply eat nutritionally dense real food and abandon convenience foods. Most food like substances with health claims on their packages have been engineered by really smart people to make you hungry for more and typically contain very little nutrition.
A note on kids with diabetes. It’s no secret that kids prefer junk food. Controlling what kids eat outside of the home is difficult. I’ve noticed, however, when parents clear the fridge and pantry of junk food and replace it with real food, the kids will start eating real food. Better yet is when parents ask their kids what kind of real food they would prefer to have in the house thus opening a dialog about nutrition with their kids. Raising kids in our modern food culture is a nightmare. Creating a nutritious real food environment at home helps establish eating patterns outside the home and into adulthood.