Does & Low Carbohdydrate Diet Cause Insulin Resistance In Type 1 Diabetes & Does It Matter?

Insulin Resistance In Type 1 Diabetes

In recent decades researchers have become increasingly concerned about insulin resistance in those of us living with Type 1 Diabetes.

Carbohydrate Restriction

Most of us with Type 1 Diabetes have at some point been encouraged to reduce our carbohydrate intake, this means that as we reduce the amount of energy we get from carbohydrates we are forced to increase the amount of fat that we eat, sadly even high protein diets are high in fat.

Small doses of insulin does not equal insulin sensitivity

You could be forgiven for thinking that if you are following a low carbohydrate or ketogenic diet that you are insulin sensitive because you are using small doses of insulin; but this is a bit like saying I did not drive my car during the COVID lockdown so it was really fuel efficient. Yet, all you really achieved was not using your car very much.

The same is true if you limit your of carbohydrates, you may use less insulin but that is not a sign of increased insulin sensitivity, instead it is simply a sign that you have eaten less carbohydrates.

Low carbohydrate diets are high in fat

Now research is demonstrating that “Higher fat, but not carbohydrate, intake is associated with increased Insulin Resistance and an adverse vascular profile in patients with T1D”

This brings us to a really important question, why does your insulin sensitivity matter?

 The traditional model of Diabetes management that dates back to 1993 describes HbA1c, your blood pressure and your lipid levels (cholesterol) as the most important markers to indicate your risk of developing complications of Diabetes

Sadly the evidence and clinical experience show us that many individuals that achieve great results in all of these still go on to develop complications of Diabetes.

In 2017 a team of researchers recruited 17.050 people living with Type 1 Diabetes in Sweden set out to determine if insulin resistance was the ‘missing link’ that might explain these complications and they found that “a strong association between eGDR (insulin resistance) and all-cause mortality, as well as cardiovascular mortality, in individuals with T1D”. In other words, as insulin resistance increased so did the risk of heart attack, stroke and death by any cause.

OK, but if your HbA1c is great then does your insulin sensitivity matter?

 In 2021 a team of researchers in the UK put this question to the test and they found that “diabetes complications are not only related to glucose control. Insulin Resistance, assessed as estimated Glucose Disposal Rate (eGDR), is strongly associated with both microvascular (retinopathy) and macrovascular complications regardless of HbA_1c levels.”

But, we have all heard all of the fear messages for far too long haven’t we? Let’s be honest, that is not going to motivate me or you, is it?

Hi, it’s Paul Coker I have been living with Type 1 Diabetes since 1977 and I am fascinated by insulin sensitivity, that I went to medical school and earned a Masters degree in Diabetes Practice in researching the topic.

In my personal experience and based upon my research when we become more sensitive to insulin then our insulin becomes more reliable, more predictable, more of the time and that reduces Diabetes distress and improves quality of life.

Conclusion:

Reducing your carbohydrate intake means that you will eat more dietary fat and that will increase your insulin resistance,

This makes it harder for people with Type 1 Diabetes to process the carbohydrates they eat and that means that they are tempted to reduce carbohydrates. Increasing insulin resistance further and fueling the risk of Diabetes complications.

In the next videos I will look at how does dietary fat increases insulin resistance and why not all carbohydrates are equal in terms of your insulin needs and your blood glucose levels.