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June 27, 2004

Insulin, Meal Planning, Food and Diet

Question from Ashby de la Zouch, England:

I was diagnosed as a type 1 diabetic in February 2003. Since then, I have kept my sugar levels under control. I have read a lot about low carbohydrate diets which have helped a number of people control their blood sugar levels. So, I decided to experiment. First of all, I reduced my carbohydrate intake and also cut my insulin intake by 50 percent. Normally, I took 10 units of insulatard twice daily. My blood sugars remained very good. I have then took it a stage further and reduced my carbohydrate intake still further and stopped taking insulin. I am still able to control my sugar levels to between 4.5 to 7 mmol/L [81 to 126 mg/dl] and I am asking myself if I need to take insulin? Obviously, where I cannot control my intake of carbohydrates, when eating out for meals, I do have a shot of insulin to control my sugar levels. Is there any danger in what I am doing since I am on a high protein diet and I am concerned about my cholesterol?

Answer:

There are some concerns for the changes you have made. First, it is very important you do this with the knowledge and guidance of your physician. If you truly have type 1 diabetes, it can be dangerous for you to stop your insulin altogether. The reason for this is that patients with type 1 diabetes do not make insulin. Even if your carbohydrate intake is low, you still need some insulin to prevent you from going into diabetic ketoacidosis. Because diabetic ketoacidosis can be a serious condition, it is important that you discuss this with your physician. If it turns out you do not need insulin, make sure and discuss the diagnosis with your physician to determine whether it could really be type 2 diabetes. It is clear that if you cut the carbohydrate intake of your diet, you will need less insulin. However, I am not optimistic that people can continue to eat such a drastically low carbohydrate intake and remain healthy.

JTL