Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
25 Oct

What About Type 1 Diabetes?

You hear a lot about type 2 diabetes on this and other sites in the community. It’s easy to see why: type 2 diabetes is the “lifestyle” diabetes, the preventable one, the one that “doesn’t have to happen” and that you can “fix if you just dial in the food.” All true, for the most part. Whether you’re in the camp that thinks it’s red meat or egg yolks causing it, or fatty liver from excess PUFAs and fructose, the point is that people commonly accept the idea that T2D is preventable and manageable with the right diet and lifestyle. But what about type 1 diabetes? Why don’t we hear so much about it?

First of all, it’s rarer than T2D. For better or for worse, there simply isn’t as large an audience for stuff about type 1 diabetes. Second, type 1 diabetes (T1D) is an autoimmune disease. In T1D, the pancreatic beta cells that produce insulin in the body are destroyed by an autoimmune attack. Left untreated without exogenous infusions of insulin, T1D results in severely elevated blood sugar and, eventually, death. Autoimmune diseases are confusing, tricky, and hard to manage. I mean, your body is attacking itself and preventing a completely necessary physiological function – insulin release! It’s not something you want to mess around with. It’s not a subject you can tackle lightly.

And I think that’s why people have steered clear of making any absolute recommendations regarding T1D and Primal or paleo. That said, we can make some general recommendations, I think, that won’t cause many problems and can even help solve some of them (with a doctor’s approval and assistance, of course).

I find the standard issue protocol a little odd: let people eat all the carbs they want and supplement with, as Dr. Kurt Harris once put it, “massive doses of insulin required to compensate for 6 times a day tsunamis of glucose arriving from the gut to keep the glucose from putting you in a coma.” Sure, it “works” in that it doesn’t kill you outright, but it’s an imperfect solution. It’s trying to replace an innate, finely-tuned physiological function (insulin release in response to glucose) with the blundering inexactitude of exogenous insulin administration by human hand.

Are there any other options?

Low carb diets certainly work. Richard Bernstein, an MD with T1D himself, wrote The Diabetes Solution, a popular book that prescribes an essentially ketogenic diet for diabetics. It’s the diet he used to manage his own condition, and it’s apparently helped a huge number of people (the latest 2011 edition of the book has 45 5-star reviews on Amazon).

Indeed, several studies support the use of low carb diets in the treatment or management of T1D:

A low carbohydrate diet in type 1 diabetes: clinical experience–a brief report. – After three months on an isocaloric low-carb diet (70-90 grams per day, with extra fat and protein to make up the missing calories), the weekly rate of hypoglycemic incidents in T1D patients dropped from 2.9 to 0.2 and requirements for insulin after meals dropped from 21.1 IUs to 12.7 IUs. After a full year, insulin requirements were even lower at 12.4 IUs per day. Total and HDL cholesterol remained the same, while triglycerides dropped.

Low carbohydrate diet in type 1 diabetes, long-term improvement and adherence: A clinical audit. – Researchers tracked long-term diet compliance and HbA1c levels in T1D attendees of an educational course recommending lowered carbohydrate consumption. Those who complied with the recommendations saw their HbA1c drop from 7.7 to 6.4 after four years, while those who did not comply saw their HbA1c move from 7.5 to 7.4 (no change) after four years.

Effects of carbohydrate counting on glucose control and quality of life over 24 weeks in adult patients with type 1 diabetes on continuous subcutaneous insulin infusion: a randomized, prospective clinical trial (GIOCAR). – Among adult patients with T1D, carb-counting improved quality of life, reduced waist circumference and BMI, and reduced HbA1c levels.

Does low carb “cure” T1D? No. The pancreatic beta cells remain damaged and unable to produce insulin, but the amount of exogenous insulin required for proper physiological function is lower when you’re not eating so many carbs. This improves quality of life (not so many needles), it improves metabolic risk factors, and it improves body weight (not so many needles full of insulin). By all accounts, low carb seems to help T1D, and it definitely doesn’t hurt it. So that’s something.

What about going Primal? And not just the food recommendations – can the kind of lifestyle changes I encourage have any affect on T1D?

Well, as I always like to do, let’s talk about epigenetics and gene expression. Most people think of T1D as a “genetic disease,” as in you “just get it” if you have the genes associated with T1D. But, as my astute readers undoubtedly know, genes do not represent our destiny. Genes – particularly the ones associated with disease – require an epigenetic trigger before they’re expressed and become active. For genotype to give rise to phenotype, you need an environmental stimulus. This is true of numerous diseases, and type 1 diabetes is no different. And sure enough, among monozygotic twins (same genotype) with the genes for T1D, there is just a 30-50% concordance rate for the trait. That means though they have the same genes, if one of the twins has T1D the probability that the other twin will have T1D is only 30-50%. In other words, there’s something more at work than genes (otherwise there would be a 100% concordance rate). And, it’s shown that when people move from a low-T1D incidence area to a high-T1D incidence area, T1D goes up. The genetics aren’t changing; the environment is changing.

If I know my readers, you’re now wondering about these epigenetic triggers. Right? Let’s take a look at several candidates (you may be familiar with them):

Vitamin D – The further away you are from the equator and the less UV rays you’re exposed to, the greater the incidence of T1D.

Breastfeeding – There is a strong association between protection from type 1 diabetes and having been breastfed as a baby.

Gluten – 7% of type 1 diabetics also have celiac disease, which by some measures affects just 0.7% of the general population in the United States. Babies with early exposure to gluten often display evidence of T1D-related antibodies.

Omega-3s – In one study of children at (genetic) risk for developing T1D, omega-3 intake was inversely associated with the disease.

Sound familiar to anyone?

Interesting, but what about once you already have T1D? Well, if you catch it early enough, there’s a chance you can restore or halt the destruction of beta cell function, just like the 6-year old Danish boy who enjoyed total remission of type 1 diabetes (complete with cessation of insulin therapy) upon adopting a gluten-free diet. Most people don’t catch it early enough, though. For them, the folks with full-blown type 1 diabetes, the same Primal prescriptions are going to be helpful.

Avoid gluten. Studies suggest that avoiding gluten can improve type 1 diabetes, particularly in those with celiac disease. It can also reduce type 1 diabetes-related antibodies and reduce intestinal inflammation in type 1 diabetics. I suspect it’s helpful for diabetics with “mere” gluten sensitivity, too (which is probably a ton of them!).

Get sun or take vitamin D. Although you can’t go back in time to prevent the development of T1D, you can make sure your vitamin D levels are adequate. Plus, folks with T1D are at a higher risk for having low bone mineral density, with which vitamin D can assist.

Get your sleep. Sleep isn’t just helpful, it’s especially helpful in T1D. Altered sleep patterns disrupts circadian rhythms, which disrupts insulin sensitivity in type 1 diabetic youths. Same goes for adults with T1D, who suffer impaired peripheral insulin sensitivity after just a single night of bad sleep.

Exercise intelligently. “Vigorous” exercise can exacerbate blood glucose levels, with some researchers even proposing an intense 10 second sprint as an effective way to boost blood glucose levels in type 1 diabetics experiencing a hypoglycemic episode. Lift weights, walk a lot, and sprint occasionally – but be careful about how often and how intensely you do it.

Keep the carbs low. The fewer carbs you eat, the less insulin you’ll need to administer.

Overall, I don’t think going Primal is just helpful for type 1 diabetics who want to reduce their reliance on exogenous insulin; it looks almost essential. At any rate, I see nothing inherent to the Primal Blueprint that would preclude a type 1 diabetic from adopting it.

When you do approach your doctor, you don’t even have to mention the grains, legumes, sugar, and vegetable oils you won’t be eating, the sun you’ll be getting, the sprints you’ll be occasionally sprinting, the quality and quantity of sleep you’ll be focusing on. Just say you’re thinking of trying “low-carb,” which your doctor will no doubt be familiar with and (hopefully) open to trying.

Tomorrow, I will feature a success story from someone who’s using a Primal approach to effectively manage his type 1 diabetes, so stay tuned for that!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. I am T1D and went primal on May 1st with my wife. I grew up in a spanish family with all meal consisting of wither rice or pasta. I thought I would never be able to give them up but I was wrong. A friend turned me on to the site and when reading about some of the lifestyle choices people make it was all the stuff I did.I was 282 lbs and eating between 325-400 grams of carbs a day, using 125-130 units of insulin a day and just out of shape and always tired. I’ve now lost 23 lbs, avarage about 150 grams of carbs a day and I’m only using 75-80 units of insulin on average per day now! I’m about to get my first A1C taken next week since starting and I’m sure it will be better than the last 9.6. All I can say is Primal works great and I’m still not where I want to be on weight or amount of carbs but i’m getting there. I still get tired in the afternoons but nothing like before and I’m testing different things to try and get that under control. My wife and I are going to PrimalCon in April and can’t wait to get even more insight’s on the best thing to happen to our healt n a long time. I need to also be more diligent about exercise which is something that is still missing. Overall it’s been great and there have been some big changes but still working on being more primal!

    James Nolan wrote on October 25th, 2012
    • With excercise James i personally do nothing but body weight work and some sprinting. I dont need (or want) to go to a gym, when its good weather (about 1 week of the year in UK) i work out outside. Im talking working at 1 arm push ups, 50 consectuive 1 leg/pistol squats, handstand push ups. I could barely do 5 stanrard push ups last August and prior to didnt excercise. O got into a routine and now i love to workout. I’d recommend ‘you are your own gym’ and ‘convict conditioning’. The excercise will make real diference to your a1c. My last a1c was 6.5, i’m aiming, and will acheive, 4.6 within a year. I keep recommending on here but Dr Bernsteins the diabetes soltuion is a must read for diabetics, combined with primal it’s made amassive difference to my blood sugar within the last 4 weeks. I wish it hadnt take me 23 years of diabetes before i read it.

      greg wrote on October 26th, 2012
  2. Fantastic, information, Can any one tell me how precise the blood test is that determines, the Beta Islet destruction?? etc

    Sue wrote on October 26th, 2012
  3. Thanks for sharing this great article! That is very interesting I love reading and I am always searching for informative information like this.

    Dan Clay wrote on October 26th, 2012
  4. I also would like to chime in as a T1D and say switching to primal/paleo/eating REAL food has changed the way I manage my diabetes for the better and after 16 years with this disease feel better and look better than I ever have!

    Mark wrote on October 26th, 2012
    • Oh yeah and – my doctor and dietician think I’m crazy eating this way, but I’ve decided it’s because they have been taught according to the SAD protocol and cannot legally recommend any other way!

      Mark wrote on October 26th, 2012
      • Yep i think from a legal perspective even if they are open minded they get stuck. Epecially in the US where health is insurance based.
        In the UK i get 20 mins with my Dr (although rarely the same one) every 6 months, ”you’re not dead, thats good, see you in 6 months.”

        greg wrote on October 26th, 2012
      • Yeah, I’m a dietetics student and I’m interested in studying diets like paleo for diabetes management, and how that might work, but it’s not really ever brought up in class. If I hypothetically recommended paleo IRL and the person wasn’t super compliant and got sick I would be in SO MUCH trouble! I’m looking forward to more research on this topic as time goes on.

        K. Schuette wrote on October 26th, 2012
  5. It’s nice that a post dedicated to type 1 has been written as those type 2 hog the diabetes lime light! 😉 . I’ve been type 1 for 23 years (35yo) and started the primal journey about august 2011 and I can say that type 1 is pain in arse, literal and figurative.

    Last month i read Dr Bernsteins book and realised i was (still) consuming too many carbs and the reality is i shouldn’t be eating sweet potatoes, potatoes, canned tomatoes and several other foods that primal peeps take for granted. Within a week i saw my bloodsugars start to normalise, and I mean normal, like non diabetic range. They improved greatly on primal but this berstein/sisson hybrid has taken them to a new level. Bernstein advocates the use of sweeteners and whole load of processed foods but i’m doing the diabetes solution with a primal lead, so no processed, just meat veg fat, the good shizzle. It helps that I’m a rather good cook, blow my own trumpet. But if wasn’t for Mark and this website my diabetes wouldn’t have improved so much and my knowledge wouldn’t have improved and I wouldn’t have got to know about Bernstein through my process of going from link to link, researching, not understanding, understanding, experimenting. BTW my GF had no choice but to follow primal, she loves it now, she lost 30 lbs in the last year, looks amazing. Now she near enough preaches it to anyone who’ll listen.
    One thing i’d disagree with in the article (i’m nit picking here) is ”but the amount of exogenous insulin required for proper physiological function is lower when you’re not eating so many carbs. This improves quality of life (not so many needles)”. I still have the same amount of injections (needles) each day, i just don’t inject as much insulin with each injection.
    One thing that i’ve noticed over recent years that’s converse to the widely reported kids getting type 2 is adults getting type 1 (aka juvenile diabetes) without them first having type 2. For me that definitely points to environmental factors. But there’s still a big role gene’s play when it comes to autoimmune. My mums side of the family have 3 celiacs, 1 of who is also type1 (that sucks), there’s 3 or 4 type 1’s, there’s a lupus, then my mum and some of her sisters have rheumatoid arthritis. Our immune systems are cold blooded killers. I also recently introduced my sister to primal and shortly after (couple of months ago) Mark did an article on gluten intolerance, almost like celiac but much less severe and she realised she had that. Obviously primal sorted that out within a couple of weeks. Voila!

    For any type 1 diabetic out there i would endorse the primal approach coupled with the bernstein approach (I personally find all out sprinting has no effect on raising my blood sugar). I would agree with Bernstein in that diabetes (1 and 2) is probably the largest cause of death in the USA, it’s just not reported as diabetes on the death certificate because it the symptom that kills you. Got diabetes then had a heart attack? Guess whats on the death certificate? Heart attack. Guess what caused the cause of the heart attack, diabetes. Cancer? Yep. Caused by the diabetes. The list goes on. The advice handed out by the ADA and BritishDA (I’m from the UK) is criminal, it’s killing millions. Eat a shit load of carbs, pasta, bread, cereal. In fact why don’t you base 60% of your calorie intake on this crap and then inject insulin. Ah, the food pyramid, you’ll be mummified and entombed if you go anywhere near that particular pyramid ( Mark, that should be quote of week!). Injected insulin doesn’t work anything like your non-diabetic insulin. Your insulin is chauffeured Bentley, give it instruction it’ll carry it out as instructed, even when you abuse it. injected insulin is the old ass bus that has no heating, should have turned up 60 minutes ago when it’s zero degrees outside and you need to pee for the 3rd time in the last hour. It sucks at it’s job. Call me a conspiracy theorist but big pharma is quite happy for more insulin to be injected to cover huge carb intake thats promoted by the ADA, BDA etc. Unfortunately these ‘ charities’ are in bed (to what degree you can argue) with the big pharma. Think there will ever be a cure for diabetes, no chance. Cures don’t make profit. Blood testing strips, insulin, insurance does.

    Anyhoo I’m writing this whilst at work and my big ass sald is staring at me and I’m hungry so rant over.

    greg wrote on October 26th, 2012
    • Just to add to the above, as if it wasnt long enough, is that i also do Intermittent Fasting. I eat my first meal between midday and 1pm and my 3rd and last meal between 8pm and 9pm. Every day. If you’ve read IF aint for diabetics, tell them i sent ya, and they’re wrong.
      This approach isnt advocated by Bernstein but it works for me at least.

      greg wrote on October 26th, 2012
      • I’m on day 5 of IF now and going well, sometimes just struggling to get it all in! :) What method are you following?

        Mark wrote on October 26th, 2012
        • Hi. Cool, stick with it. It’s a great tool.
          I’m going with the Martin Berkhan Lean gains style, just 16 off 8 hours on. I’ll occasionally do a 4 or 5 hour eating window, first meal about 4-5pm, but I’ve never done a 24 hour one although I’d give it a go. IF gets easier with time. My girlfriend thought she’d never be able to go without eating breakfast (pre primal days she was pathetic if she didn’t eat every 3 hours!!) but now finds IF easy and regularly doesn’t eat til 2pm, plus she eats less and says she feels less hungry since she started it. She had weight loss plateau and this really kick started the weight loss again. I think once a non diabetic can happily do IF without complaining of low blood sugar (they should try diabetic hypoglycaemia!!) they are fat adapted.
          Personally I like it for several reasons. Helps burn fat, gives my digestive system a rest and it also means that for 14 hours out of 24 my blood sugar can stay pretty much untouched as long as I get my long acting insulin dose on the money.

          greg wrote on October 26th, 2012
    • That pyramid quote is a good quip.
      I think it might be a good idea to have quotes of the week. Maybe 3 or so.
      It’s a good medium for entertainment and sharing ideas and encourages more care to be put into comment writing so why not expand it?

      Animanarchy wrote on October 26th, 2012
    • Hey Greg. I’m also type 1 in UK. Novice with Primal. Struggling abit. Bernstein on my book shelf but not got round to reading it yet. Shame there is not more interest in UK with primal. Wrote to Diabetes Uk and Balance mag suggesting they do a feature on it but they wouldnt contemplate it

      gillyd wrote on October 26th, 2012
  6. Thanks so much for addressing T1. While I’m somewhere in between T1 and T2 (gestational diabetes that didn’t go away after giving birth at age 27 and needed insulin immediately), I’ve always considered myself more T1. Most people don’t understand it at all because it’s T1. My husband is mostly Paleo and I’m certain our whole family will be shortly after reading this. Thanks Mark!

    Laura wrote on October 26th, 2012
  7. I’m a 60 year old who was diagnosed type 1 20 years ago. A year ago, I had my sleep apnea diagnosed, went on a CPAP machine, learned how to count carbs and tailor my insulin dose to my intake and bg level. I cut out all wheat and grains. I learned about primal diet here, and with the help of the New Atkins Diet book, have greatly improved.

    My daily insulin dose has gone from 140 units to 0, I use Metformin now. My endo has said each blood test has indicated that I making more insulin. I”ve lost over 60lbs and feel in control of my health for the first time in many years. My allergies have disappeared, no more chronic sinus infections, athma is totally gone.

    I’d say this is a very beneficial program for Type 1’s.

    marcsfl wrote on October 26th, 2012
    • Thats totally amazing! Thats a success story right there.
      I would highly, highly recommend you read the diabetes solution by Dr Bernstein, lots of good info in there.

      greg wrote on October 26th, 2012
      • Thanks Greg, I have read the Bernstein book and found it immensely useful. I only wish I had found it sooner.

        marcsfl wrote on October 27th, 2012
    • I have to say, you story sounds like T2 not T1. A daily intake of 140 units is huge for typical T1. Being able to reduce to zero injected insulin and get by on metformin only is another indicator that your are T2. A T1’s body produces no insulin.

      David wrote on July 31st, 2013
  8. I have had t1D for 44 years- was diagnosed just before my 7th bday. I was stubborn for a very long time and stupid in college to the point of ketoacidosis and near death and a coma for 3 days- I straightened up for awhile after that, got married and pregnant snd behaved pretty well through pregnancy and had a healthy baby. :-) started working out (crossfit) and went paleo 2 years ago and I have NEVER felt better! My A1C’s were always in the 11-13 range and after going paleo for 3 months , my A1C was 8.5- my doctor did cartwheels. I rarely ask permission to do something so she didn’t have a chance to approve or disapprove but she loved the results! I also lost 30 pounds over the first year and a half. I have no food allergies or intestinal probe so that is not a factor I just know that I feel great- so I am sticking with this. :-)

    Lisa wrote on October 26th, 2012
  9. I am also an adult-onset Type I, with ZERO family history of the disease. My diabetes was discovered during my pregnancy with my son @ age 28. In hindsight, I can see symptoms originating all the way back to age 18. I have been 70/30 or 80/20 (more recently) Primal since May. My A1c is down from 6.9 at diagnosis to 5.4 at my last checkup in August. Based on my meter readings and overall health, I feel that it will be even lower at my next appointment. I have lowered my basal insulin from 18 units to 15 so far, but am still tweaking because I have been experiencing minor lows. My bolus ratio has been reduced from 1:15 to now 1:20, and also still tweaking. I have gone from a size 16 to a size 8, and I feel like a different person.

    My endo says this is just my “honeymoon phase” and not to get excited. I guess we will see. But in the meantime, I will keep going Primal, and am considering full on Paleo if I can sacrifice the cream in my coffee and occasional cheese/cream based dips for my veggies. I realize dairy has been implicated in T1D almost as much as gluten, so I know I need to add this into my experiment.

    As for other carbs in my diet, I am certain gluten is the main cause of my problems. When I venture into safe starches or even cheat with a little brown rice or white potato, my blood sugar recovers quickly with proper insulin dosage. Early on, when I would have a gluten cheat, my blood sugar stayed out of whack for days. I have never been tested for celiac, or even gluten sensitivity. As a Type 1, I just take it for granted that I have gluten issues and now avoid it like the plague. I would definitely advise other Type 1s to do the same.

    Juniper wrote on October 26th, 2012
  10. Eating a low carb paleo/primal diet can be great for a diabetic!
    I’ve been eating paleo for 3 years. Its made managing my diabetes so much easier. I have amazing blood sugar control. Look at a reading on my continuous glucose monitor for 24 hours–

    Pretty cool, yeah?

    Ryan wrote on October 26th, 2012
  11. I’m type 1 (for 35 years, since age 3) and I do believe that eating fewer and healthier carbs helps with bloodsugar control. But please don’t offer people the hope that they can reverse type 1 diabetes. 24 hours without insulin and I’m in the ICU … probably dead within a week.

    zip wrote on October 26th, 2012
  12. This is all well and good. I have been diabetic for over 45 years. I have been told that I am diabetic because of a virus. I want to be healthy, I want to eat healthy, but almost every day I have cravings or just plain don’t want to eat what is good for me. Does this go away once you start on any of these alternate diets?

    Tina wrote on October 26th, 2012
    • I would definitely say those cravings start to go away after 2-3 weeks of Paleo/Primal, and it only gets easier from there. People ask me all the time if it’s hard, if I have cravings, or “how can you just sit there drinking water and eating nuts while we all eat cake?” And I honestly just tell them that I have no desire for it. And it’s TRUE. If you read “Wheat Belly”, he theorizes that gluten acts on opiate receptors in the brain. I have heard likewise that sugar acts like cocaine in the brain. Those two together pack a powerful punch. But like a drug addict who goes through the initial detox (not too fun, mind you), those cravings DO go away, get manageable, and you become healthier.

      Juniper wrote on October 29th, 2012
  13. I work in healthcare. I spoke to a dietician I used to work with about my patients out-of-control blood sugars and the amount of carbs (mostly refined garbage) on their meal trays. She informed me that they could actually receive MORE carbs than that, according to ADA guidelines; they could have up to 4 exchanges per meal (60 grams!) Add snacks to this, and most patients were consuming over 200 grams a day (and certainly not in the form of “safe starches.”) I know she is required to follow certain guidelines if she wants to hold onto her job, however, in the mean time, her patients with diabetes (both type 1 and 2) were regularly enjoying pre-prandial blood sugars in the 200-300s!

    Finally, she admitted that it came down to cost. And there, I think is the crux of the whole thing–carbs are cheap, and the ADA is not going to make recommendations that don’t jive with the typical hospitals food budget. I know this sounds cynical, but they certainly aren’t basing their recommendations on sound science.

    The ADA should be ashamed of themselves. They recommend that patients with diabetes NEVER go below 130 grams of carbohydrate/day, as this is “unhealthy.” Last I heard, they almost insisted you HAVE to eat whole grains as a significant part of these carbs. 130 is admittedly better than the typical SAD, however, for some diabetics, 130 really is still too high. I wont even get into their view on the evils of fat.

    Fritzy wrote on October 27th, 2012
  14. As a T1, I really appreciate this article. When I decided to try (still getting there) primal eating I had immediate success but didn’t really know how to manage my changed insulin requirements at first.

    So I started by halving all my insulin. This became my new measure. I eventually had to slowly increase my doses to find the right amount. It’s better to run slightly higher and increase insulin, than to have too much insulin, and stuff yourself on carbs because of a hypo.

    The hardest thing about the primal diet is getting access to clean meat and vegetables. Organic meat is great but costs a fortune. It’s incredibly frustrating, knowing you need to change for your health, but you cannot afford to eat like your grandparents did.

    So as much success as I’ve enjoyed on primal, I am often forced to eat more carbs than I want to (more fruit) simply because it’s what I can afford.

    Chris wrote on October 28th, 2012
  15. Thank you so much, Mark for writing this article. Type 1’s always feel so left out, being lumped in with type 2’s, which is a completely different disease. I was diagnosed at age 16, which is 41 years ago! I followed Dr. Bernstein’s diet for 7 years 1996-2003, which saved my life. But went on Raw food vegen diet to try and cure type 1 . IT DIDN’T Work. I started paleo Jan 1 2010. Then after researching ketogenic diets, I went even lower carb. I eat about 20 gm carbs a day. My diet is now 80% fat, 15% protein and 5% carbs. I am doing very well on these percentages. I believe the only reason some people have trouble with very low carb is because they are afraid to eat enough fat. I really have to eat enough fat to keep me satisfied throughout the day. I actually eat very low amounts of protein, because protein will turn to glucose if you eat too much. 2-3 eggs abd bacon for breakfast, 4 oz grassfed meat and sauteed vegies at lunch and grassfed raw butter, colostrum and a few Brazil nuts for supper. This works very well for me, keeps me satsified, so I can stay on the diet. My last A1c was 5.1, I was very happy with that. It is so wonderful to communicate with so many T1D who are taking charge of their health and lives. I recommend staying far away from regular allopathic doctors, I check in with an alternative nurse practitioner if I need to. (for syringe prescriptions) I take regular insulin and NPH because I don’t need prescriptions for those! I still think there is a way to regenerate our beta cells and heal.

    Aimee wrote on October 31st, 2012
  16. Very nice post also getting good responses. My mother in low is also having diabetes and I will follow this for her.

    Thank you very much.

    Aidan Bertie wrote on November 3rd, 2012
  17. I’m a Type 1 Diabetic and have been for 12 years. I have struggled with my BG readings and A1C readings for years. I just couldn’t understand other T1’s that had good control. (and I’m on a pump).

    I have always taken my Diabetes seriously but have never figured out why my BG spike even with say a very low gi cereal (last A1C was in the 9’s). I am now on my 5th day of Paleo and all I can say is WOW! So far my BG have normalized and I am within range for the first time in years. The biggest plus is that I am not worried about big swings to the low BG side so I have good control (will live longer) and have more confidence not having to worry so much about lows. Yes it’s early days but the principal will remain the same on my BG, I have no doubt.

    Thought I would share here.

    I can see how it will take time for the medical community to look at a simple change like this due to mostly out-dated info on Cholesterol / Fats etc but hey I’m treating myself and taking control.

    Can’t wait for my next A1C :-)

    Tim wrote on January 10th, 2013
  18. Tim, Funny you should post. Last night I watched a series of youtube vids with Richard Bernstein, the author and Type 1 diabetic, of The Diabetes Solution, mentioned here at MDA. Dr. Bernstein is awesome. Anyway my son has Type 1 and, at age 29, he has been struggling. I sent along Dr. Bernstein’s book and for the first time in fourteen years, he (my son) has gotten his head around what he needs to do, no thanks to his doctor who just keeps upping insulin levels. Continued to success to you and thanks to Mark and Richard for lighting the way.

    Linda A. Lavid wrote on January 10th, 2013
    • I also just found Dr Bernstein only last month, and as a result of his book and trying out Paleo am now managing my blood sugars well for the first time. Great book!

      Andy wrote on March 6th, 2013
  19. Interesting Blog. I thought i would share my experience as a Type 1 Diabetic.

    Having been a Type 1 Diabetic for 6 years. I have dabbled in this before without much planning and after 4 weeks found I didn’t need half the size of my regular insulin. I lost about 7 pounds and felt great. The only problem was working away and lack of available ingredients forced me to go astray.

    That was a year ago and my weight came back and insulin getting out of control. I am now back on the paleo lifestyle (not diet as i don’t want to think of it as short-term) and I am better prepared this time with lots of paleo ingredients in the kitchen, loads more recipes available since last year.
    I am four weeks in and 10 pounds lighter, insulin jabs are down to virtually nothing, I am monitoring levels all the time and finding the opposite, the sugar levels too low without having insulin. The food cravings have disappeared, no stomach rumbles as I have paleo granola bars, at the ready.
    Hoping it continues, I think i may reintroduce some dairy once I get to my ideal weight as it seems i could be missing a few essential nutrients. the almond milk takes a little getting used to.

    Bottom line is thumbs up for Paleo from me.

    Hope this helps any other T1D thinking of trying the lifestyle.

    Alan Wright wrote on January 20th, 2013
  20. Searching for Paleo eating for my friend who was just diagnosed with gestational diabetes…I happen to have type 1, so I am looking to support her. Here’s another bravo for this article & fab conversation. I have lived 36 of my 40 years with iddm and can’t wait for my cells to heal themselves (one way or another!?) – but in the meantime, I am re-amping my vlc Paleo/primal lifestyle, as it’s served me well in the past. Also, I have a healthy 3 year old dd and would love another, even at my “advanced maternal age”!!

    Davis wrote on January 25th, 2013
  21. Thank you *so much* for addressing type 1 diabetes and paleo!

    Katie wrote on February 2nd, 2013
  22. I am a type 1 diabetic, and I know I am late to the party but wanted to say that having recently discovered paleo through a friend, and cut carbs out of my diet, I am now experiencing the first phase of my life when I feel like I actually have control over my blood sugar.

    The results for me have been incredible. Before cutting them out I diligently followed the advice I was given about matching insulin to carbs, but was always chasing my tail. Now my blood sugar has stabilised and HbA1C is right down. I couldn’t recommend it enough!

    Andy wrote on March 6th, 2013
  23. Thanks for this article. I knew about the evils of gluten in other auto-immune disorders, but not with Type 1 Diabetes.
    I am a nurse, and thanks to my anatomy courses and even my nutrition courses, I have always known the food pyramid didn’t match up with reality.
    My daughter, my mother, and myself have been low-carb (around 100g a day) and gluten free for a year now, with only my father refusing to come along. I have had asthma since I was 8 and Hashimoto’s Thyroiditis since 13. My mother has Hashimoto’s and celiacs, and was diagnosed as T2D with Fatty Liver Disease last year. This was when she finally gave in to my years of begging her to change her diet. (Her brother has T1D, as does her father, who also has Hashimoto’s, so I knew she was a diabetes candidate) I can’t help but think that if we had known about Primal Lifestyle years ago, none of us would have the health problems we have now.
    I had not even heard of Paleo until a year or so ago, and didn’t start doing any research until recently, when a friend of mine went Paleo. I wish I had found this page sooner! I’m going to direct my uncle and grandparents toward the book, and try to sell my father, just this week diagnosed as T2D, on Primal. My current A1c is 4.0, and I’d like to keep it this way. The evidence speaks for itself. This is not just a fad diet, this is a lifestyle change based on sound medical/scientific evidence.
    I’d also like to add for the record that not all doctors are bad. Our dr encourages his diabetic patients to go low carb, and try to get off meds. He also encourages low carb and discourages lap band and gastric bypass to those who want to lose weight.

    Serena S. wrote on March 12th, 2013
  24. Serena, better late than never. Also the body can have amazing recuperative powers. Continued success for your entire family.

    Linda A. Lavid wrote on March 12th, 2013
  25. Hi, I just had a read over your article, and the attached study, just a note, in your article you speak of “equirements for insulin after meals dropped from 21.1 IUs to 12.7 IUs.” which is correct however insulin is administered prior to meals, based almost entirely on the amount of carbohydrate you are about to ingest – the only time you would really need to dose after a meal is if you miscalculated – which happens quite often as pre prepared meals often have hidden carbs – like corn syrup or thickeners.

    Other than that, this article is why I am giving the’ 21 day total body transformation’ a try.


    Everhardt wrote on April 30th, 2013
    • “requirement” apologies.

      Everhardt wrote on April 30th, 2013
  26. I have been Primal for three months and am also a T1 Diabetic. This diet has helped control the disease greatly, by making my BS easier to control. There have been two challenges though: One, I at times eat too low carb of a diet and feel Hypoglycemia slowly over coming me and on a primal diet it is hard to deal with that as there are few foods that hit the bloodstream quickly and don’t spike. Second: even when I keep the carbs very low, strangely after periods of intense exercise or work I have sudden sharp increases in my BS once spiking to 35 mm/ol (healthy is 4-8). In this instance I had not eaten any carbs for 24 hours and even then it was just a veggie stirfry. Why would I have such spikes? is the fat I’m losing releasing some dormant stored sugar?

    Matthew Gates wrote on June 19th, 2013
  27. Hi, I’ve been a T1 for 19 yrs now (I was 11 when first diagnosed) and recently became aware of the Paleo diet. My a1cs are very high and I need to take control of my diabetes. The regular system and diet are not working. And for a little while there I kinda given up. I even had a pump for 4 years and did better but not as good as the result many have obtained with Paleo.

    As I read about the Paleo, I like the idea; however, I have one concern: how hard is it on kidney health? Thanks to the heavens, I have no complications yet; however, as I’ve been researching diet options like Atkins and Paleo have raised the concern of increased protein and kidney disease with long term applications. Has any of you that have been on Paleo for couple years or more had any renal changes/tests? What has been your experience? Please advise me, thanks.

    Tito M wrote on September 9th, 2013
  28. My son has type 1 diabetes, and I use the paleo diet for the whole family. I recommend this lifestyle and eating plan for diabetics. If he strictly adheres to low carb eating, his blood glucose levels remain in the non diabetic range. As soon as he eats any processed foods, rice, potatoes, ice cream, his blood shoots up high. I believe that wheat gluten is responsible for initiating the autoimmune response, and so wheat and all grains are forbidden in our house. In addition to the food choices, I encourage exercise and sun exposure.

    High carb and low fat is promoted as the correct way of eating for diabetics in my country. But, I did my own research and this website definitely saved my son’s life. His HbA1c blood tests are around 5.5, which apparently is rare amongst diabetics. And yes, Dr Bernstein is the guru of diabetes management and his books should be read by all diabetics. The dietary requirement for carbohydrate is zero, but nobody in diabetes healthcare seems to know this.

    Amy wrote on October 22nd, 2013
  29. I am mom of a T1D 3 year old who was dx when he was 2. He was also breastfed for 2 years and weaned right before he was dx. The important thing to note is that while a LC or VLC diet works wonders for adult T1Ds it is not healthy for growing children. Children are using carbs to grow and are much more active than adults. They need the carbs!

    T1DMommy wrote on October 22nd, 2013

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