Editors Note: Paleo eating appears to benefit quite an array of health conditions. Many are autoimmune in nature, all appear to share characteristics of systemic inflammation. Type 1 diabetes is one of the most devilish conditions to address because of the dual activity of autoimmune disease and increased systemic inflammation due to glucose dysregualtion. Standard of Care dictates that one should eat ample carbohydrates and “steer the boat” with insulin. A perusal of the morbidity/mortality for Type 1 diabetes should raise a red flag or two as to the efficacy of this approach. There ARE better ways, but folks need to take accountability for their situation and be willing to tinker. Having a doctor who is supportive and curious can sure as hell help!
A HUGE thank-you goes out to Dave Wendel for sharing his story and results. There are several research projects underway that will help to “prove” the power of an evolutionary medicine approach. In the mean time we have (I think) ample N=1 results which seem compelling to give an ancestral diet and life-way a shot. Well, if you think your ass is worth saving…
Why I chose to go Paleo by Dave Wendel
I am the type of person who doesn’t just buy into any old idea, thought or lifestyle. Even though I move fast and accomplish a lot, with an almost laser like focus, I have to believe 100% in what I am doing before I start. It took some time for me to even consider going Paleo.
I have always been athletic, enjoying downhill skiing, biking and hiking. I have always had a lean body and the ability to eat anything I wanted without concern that I would gain weight. I received my undergraduate degree in History and Psychology and then headed off to the Culinary Institute of America in Hyde Park, New York. Needless to say I love food and can often be heard saying butter makes it better!! Upon Graduating from the CIA, I moved to Washington, DC where I worked in several different restaurants. Realizing that I wanted a more grounded life, I left the restaurant industry and went to work for a specialty food distributor at age 32.
Shortly after starting this job I got sick. I thought I was going crazy because my vision was off, things were blurry, I couldn’t concentrate, I lost a ton of weight, I had a white tongue and was drinking boat loads of water. I had this sinking feeling that I knew the cause, but really didn’t think it could happen to me. Well, it did. I went to the doctor for blood work and my blood glucose came back around 479 mg/dl (normal is 70-126mg/dl), while my A1C was 12. The original (incorrect) diagnosis was Type 2 diabetes. In fact, I really had Type 1 diabetes, caused by an autoimmune attack on my pancreas. When I went to my eye doctor they said that because of my uncontrolled high blood sugar that my ocular pressure had changed, resulting in my vision actually getting better, but certainly not for the right reasons. After getting on insulin, my blood sugar came back down and my eyes went back to their original state of needing contacts.
It took several months to find a good endocrinologist, but after I succeeded I was able to get even better control over my diabetes. I started pumping insulin instead of taking shots and really was able to control my BG very well. When I would have blood work done my A1C was usually around 5.6 to a 5.8, and my endo was very pleased with the results. As time went on my cholesterol starting going up along with my blood pressure and my once fabulous A1C started to go up as my overall control was getting worse. This could have been attributed to my pancreas still putting out a little insulin, but I am skeptical of that being the cause because it was about 4-5 years since I had been diagnosed. During that time period I was also diagnosed with hypothyroidism.
As time went on my weight slowly crept upwards even though I did a lot of training for century bike rides. I really was dumfounded by this because I rode at least 100 miles a week! I also had to start taking blood pressure and cholesterol medication which did not please me at all. I really didn’t want to be taking 5 different medications before I even hit 40.
My wife, Ann, (a physical therapist) has Hashimoto’s Thyroiditis and both of us have had blood testing for celiac disease. Even though we both tested negative, Ann decided two years ago to go gluten free in an effort to manage her muscle and joint pain due to inflammation. This was before she knew about Paleo or the benefits; all she knew was that if she skipped the gluten her digestive track was much happier and she had less pain. Six months ago she discovered Paleo and stopped eating rice, grains and legumes and focused on healthy fats, grass-fed beef, proteins and vegetables. Me, I still loved my carbs because after all, I could just pump insulin to cover the carbs I ate.
For the last two years I had been modifying our meals so she would not eat gluten (or she would just skip the bun/bread, etc.). The kids and I went on our merry way, but slowly this gluten free life style was sinking into my thick, stubborn skull. When Ann decided to go Paleo she also started eating a lot more coconut milk and salads – two things I really enjoy – so if there was some extra I would eat it. In the mean time she was doing Primal workouts and looking and feeling really good. I had lost weight from the year prior but even with that and really working hard to control what I was eating I still looked puffy and my blood glucose results sucked. It was time for a change. The thought of giving up my beloved carbs, pizza, beer, bread and so on was terrifying. Carbs are really like a drug; they just keep you coming back for more and are probably why America keeps getting fatter. I hate to admit it but I am slightly vain, I want to look good. I don’t need to be huge and muscular, but I like looking fit; so if giving up gluten, grains and legumes would help reduce inflammation and get me off the roller coaster with my BG then it was worth a shot.
I bought Robb’s book The Paleo Solution and started reading through it. I was amazed to learn so much about the root causes of the problems that I dealt with as a T1. After 2 years of resistance, I decided to stop eating gluten. I credit my wife and Robb with this feat. It’s actually easier than you think it will be because there are still so many good foods to eat. Once you stop eating lots of bread and high carb foods your body forgets and you actually don’t feel like you are missing anything at all.
Since I stopped eating gluten and got off the carb roller coaster (and began eating protein and good fats) I don’t get that major hunger that leads to binge eating. My intestinal track also seems to be happier. As a very visual person, seeing my blood glucose results in a graph really knocked the Paleo Lifestyle out of the park.
When looking at the graph you can see that when I checked my BG it was all over the place. The most desirable result is between 80-120 mg/dl. Prior to September 19th my average total insulin usage for a day was around 37-48 units, with 24 of those units coming from my basal dose. After September 19th you can see my carbs went from 100-200 g/per day to almost nothing. Instead of my numbers being way out of range when I check my BG, I was now consistently hitting the 80-120 mg/dl mark. Additionally, my insulin usage had dropped by almost 50% to around 24 units a day.
The other huge drop was in my standard deviation (the deviation between BG results). Say I checked my blood and it was 80 and then I check two hours later and it was 230, and then again later and it was 140, the deviation is difference between the results which are then averaged. Many doctors believe a low deviation number is more important than your actual BG number because a large deviation means that your control isn’t very good and that your blood sugar levels are all over the place which is BAD!!
For people who are skeptical, look at my data – it shows what the Paleo Solution can do for you. I have been doing this for 3 weeks and I think the results are amazing. I can’t wait to get my blood work done because my ultimate goal is to get off the cholesterol and blood pressure medication along with having a fabulous A1C. To go from huge BG swings to a consistent BG in three weeks is nothing short of amazing. The numbers don’t lie, and I feel better than I have in years.
Todd S. says
Thanks for this. My father is 63 and is type 1 diabetic. I’d like to get him to take this to heart, but he is really a mainstream type of thinker. Whatever the ADA says is gospel, the USDA recommends he eats his whole grains and surely they have his very own best interests in mind. Still, I’ll try.
Stephanie says
Hi Todd – let your dad know that Amy, Elizabeth, and I are part of the ADA (not the American Diabetes Association – the American Dietetics Association, but still a credible org) and we strongly believe in Paleo. We’d love to talk to him and hopefully give him the push he needs if he needs to hear it from a different ADA 🙂
Loren says
on the American Dietetics Association website, there is a page called Healthful Vegetarian Meal Ideas, and there is TONS of soy, bread and legumes.
Is there a place on the site that talks about going paleo?
Is it even possible to be vegetarian and primal? (Can it be healthy and sustainable?)
Amy Kubal says
Loren, unfortunately the ADA doesn’t have paleo resources at this point – but we’re working on that. As far as a primal vegetarian – um, no.
miked says
isn’t Mark Sisson’s wife a primal pescetarian?
Diane @ Balanced Bites says
It’s great to have articles and stories like this for the T1 clients I get who think that Paleo sounds crazy. Even though my success with previous T1 clients has been great, sometimes just reading someone else’s story and seeing their numbers makes it really click.
Abel James says
Given the clear data and anecdotal support behind the effectiveness of paleo-style nutrition for those with diabetes, isn’t it amazing that people still call eating like our ancestors “crazy”?
BJ says
Thanks for sharing this. I’ve had similar experiences with eating paleo and seeing its effect on my blood sugars.
I have a couple of pieces of advice for any type 1 diabetics considering trying this:
1) If you use an insulin pump or multiple daily injections, be aware that the fast-acting insulins, like Novolog or Humalog, seem to cause my blood glucose level to drop faster than food will raise it. It seems to me that Regular insulin is better suited for the low-GI nature of paleo eating. I’ve been able to successfully address this using the “combination” and “extended” bolus features on my pump. For example, if I have a meal with 30g of carbs, the pump will calculate the bolus required, but rather than delivering that amount of insulin all at once, it delivers it over the course of an hour. I speculate that doing this causes the activity of Novolog to more closely mimic that of Regular insulin.
2) Be sure to account for protein, because it affects blood sugar levels as well. Whenever I eat very low-carb (0-20g/day), I notice that I still need a decent amout of insulin with meals, which are often very high protein. I assume that gluconeogenesis is the root cause here, so I’m trying an experiment right now to see if lower protein and higher fat still affects my blood sugars the same way. I haven’t been to scientific in evaluating this previously, but I imagine that each person has an insulin:protein ratio, in the same way that you set up an insulin:carb ratio on a pump. Unfortunately, this likely varies from person to person and will take some experimenting to set right.
Otherwise, I agree that paleo really keeps the variance down in my blood sugar levels. Whether this is due to the “law of small numbers” or not, I really don’t care, because it just works.
Steve Parker, M.D. says
Most of the diabetics I hear about who try the paleo diet happen to be type 2 diabetics. I haven’t found a single scientific article looking at the paleo diet for type 1’s. So, thanks for sharing, Dave.
Endocrinologist David Klonoff wrote in 2009: “The Paleolithic diet might be the best antidote to the unhealthy Western diet.”
-Steve
Reference: Klonoff, David. The beneficial effects of a Paleolithic diet on type 2 diabetes and other risk factors for cardiovascular disease. Journal of Diabetes Science and Technology, 3 (2009): 1,229-1,232.
Elenor says
Thanks Mark and Dave,
I’m sending this to my sister and bro-in-law, whose 15-yr-old Type 1 is still allowed to eat for dinner (at a restaurant when I visited): a bowl of peas, a heaping plate of curly fries (wanna bet they were cooked in bad oils?), and a chocolate mousse. (And that was his entire dinner! {shudder})
They don’t seem to realize that lots of insulin is NOT healthy either! {sigh} Fingers crossed!
Myra says
I will definitely be sharing this article. Since I read Dr.Atkin’s book in 2002 I have believed there is hope for better health for diabetics but I never know how to tell people what to change and give them scientific proof. I believe you have to back your evidence with actual science so you don’t end up sounding like an idiot and, in a sense, disproving or landing doubt on what you are trying to get across to someone. Just because I know how I feel on a Paleo plan doesn’t mean that someone else will even attempt to change, they’ll just say they “need grains” and my body must be different. 9 times out of 10 I just don’t say anything.
This makes it easy though, I can just share this link and people can see for themselves. Thank you for the great info!
Dave Wendel says
Thanks for all the awesome comments!!
Update-
I just saw my Endo this weekend. My blood pressure was excellent along with my cholesterol numbers. I did get my doctors blessing to see what my numbers would look like if I stop taking Zocor hopefully they will stay nice because I really don’t want to be taking Statins. My A1c is down from 8 to 7.1 and I would expect that by my next visit it should be in the high 5’s to low 6’s and to be honest this is where it usually resides.
I have also been tweaking my basal rate down as well; it takes time because you have to learn how to effectively count carbs in salads and other foods which often don’t have a high amount of carbs to begin with. Bolusing too much will lead to a big BG drop which I don’t want so it is a balancing act.
The biggest thing I have noticed since going Paleo is I don’t get cravings like I used to before when I ate gluten, rice beans and grains.
I also want to thank Robb for posting my story.
Dave
Stephanie says
You’re such an inspiration! Thank you for sharing your story and your amazing success.
Cassandra says
Absolutely great story Dave. I too am a typeI on the pump along with a sensor that checks my BG every 5 minutes or so. I have been trying to stabilize my BG roller coaster since I was diagnosed. I can say that I’ve battled having a healthy weight almost my entire life. I could never figure out what I was doing wrong when my twin sister would be doing the same exercises and eating relatively the same would drop weight. In addition I too have an inactive thyroid as does my twin sister. This has been a very frustrating obstacle in my life and had definitely taken it’s toll on my overall health. Your story has given me inspiration to finish the book and get started. I don’t feel so alone with this disease. Thank you.
Wouter says
If it helps, Cassandra, I can attest to similar results to Dave’s.
My H1Ac has gone down, bloodpressure better, cholesterol better, and insulin use down to about 35% of what is was (no bolus needed at all anymore, gone from 130 units to 43 a day). And consistently stable bloodsugars.
Melissa says
Did you lower your basal rates yourself?
Jacque Gerlach says
Thanks for posting this, it’s great timing. I just posted a similar story on my blog about my 8 year old son who has type 1 diabetes and on an insulin pump. We have been on the whole30 challenge for 17 days now and his numbers have been absolutely perfect. A huge difference from what they used to be. We have had 3 different endocronologists and none of them have ever suggested cutting out sugar or wheat to help with controlling his diabetes. I’m glad that we found out about this and did it on our own. It is making the world of difference. You can read my blog post about it at http://wholefamilystrong.com/praise-reports/. Thanks!
Jacque
Zach says
Very inspiratonal! I’ve been dabbling with going 100% paleo for a while now. I’m 23 yrs old and in good health, but it is definitely never too early to go paleo!
Babs says
Love it! I am finding the same thing with my BG levels too. 🙂 I am not insulin dependent but I was really headed that way. After yet another frustrating discussion with my doc and the nutritionist who were both telling me to watch carbs and then saying that 40-60% of my calories should come from “complex” carbs I just about melted down in the office.
I decided to eschew everything I was being told by them and just see what my body was doing with different foods. Turns out that all those carbs were very detrimental to my BG – big surprise…not. Oatmeal for breakfast (recommended by doc, nutritionist and a friend who is diabetic): numbers through the roof. Eggs and veggies and a bit of bacon: perfect numbers.
Then I found Paleo and really started reading about it. It seemed like exactly what I was looking for! I started the 30 day challenge and I have just decided to do away with the 30-day part – this is how I will be eating for LIFE.
Arnold says
Hello Dave & Robb, great article and inspiration. I’m T1 diabetic for 28 years now (33 years old). I’m on Paleo for about a month now, but I had to take it easy. In the beginning, I went cold turkey and had several low BG’s due to the amazing effects. So I reintroduced some more carbs (no gluten) with fruits and potatoes. I’m wondering about the following and your thoughts on it would be great: I reduced my basal rate by 40% and I’d like to understand better how much I can actually reduce it when my body starts entirely to burn fat between meals. What I’d like to understand is for what the body needs insulin between meals if any, or is it more likely that the basal insulin is used as well to cover some “slow” meal carbs?
And yes, the insulin:protein ration is currently the big challenge 😉 Thank you very much for your great posts and your simple solution (and I love meat :D) to so many problems. Kind regards
Dave Wendel says
Hello,
The body needs some basal Insulin through out the day. Are you blousing for your meals? I find that if I eat protein, salad and vegis that I barely need to bolus maybe 5-6 grams of carbs which isn’t much. But hey if you have to reduce your basal more I would say go for it but I would also recommend that you run it by your doctor to be on the safe side!
I actually just reduced my basal the other day as well so we will see the more time goes by the better my results seem to be.
Hope this helps,
Dave
Nora says
I also have T1 and eat a low carb diet (mostly paleo but I do have a bit of dairy). You really should read the Diabetes Solution by Dr. Bernstein. It is intense but kind of like a bible of low carb eating for diabetics. In regard to the protein/insuin ratio, you will have to experiment with that. I take insulin to cover 50% of the grams of protein. So, for example, if I eat 20 grams of protein in one meal, I will count that as 10 grams of carbohydrates for calculating my insulin needs. One thing that helps me is to keep my breakfast pretty much the same everyday. Then I don’t have to think about how much insulin to take for that meal. Actually, most of my meals are pretty similar to each other. I just vary the protein source and the veggies. Anyway, I could go on forever! Good luck!
Kat says
Do you ever get that sweet tooth or a desire for fruit instead of all the savory-ness that comes with veggies and protein? This seems to be challenging for me…also type 1 for 17 years now.
Mike says
Dave and Arnold,
Thanks for the post, and follow-up comments, it is important to hear from T1 Diabetics in this conversation. I am the father of a 14 year old that was diagnosed with Type 1 about 8 months ago. We are still injecting Humalog for corrections and bolus purposes during the day, and Lantus at bedtime; no pump yet. I have been paleo for about 3 months and feeling great, and truely believe this is the healthiest direction for my son, and rest of my family as well.
A specific question I would appreciate more discussion on, however, would be dealing with low blood sugar readings. As you know this can be particularly frigthening and tough to manage, especially in my son’s case as he is currently participating in football and exercise really brings him down fast. Also hesitant to send him to bed too low. Sounds like you are treating with fruits, correct?
Thanks to both of you, and to Robb for this post on this important (and scary, especially for parent’s of younger kids) topic.
Dave Wendel says
Hello,
Thanks for the great comments and responses to my post. 8 months of T1 isn’t too long and there is a good chance that he is still in the honeymoon period where is pancrease is still producing some insulin which can make it tricky to keep everything stable.
As for your question about low blood sugar I am not going to lie I keep glucose tabs by my bedside but OJ works wonders if you are low. Anyone who has gone low knows it is not a good time so eating something sweet is key.
One other thought is I used to use Lantus twice a day, I would split my dose and it worked great. Lantus sits under the injection site and is slowly absorbed by the body but this changes when you add exercise into the mix. Lantus will often absorb much faster causing you to go low unexpectedly. If you have the means I highly recommend pumping because fast acting insulin is much more realizable and easier to control when sports are involved.
If you so is low before bed give him some OJ you don’t need a lot but you don’t want to go to bed low.
Regards,
Dave
BJ says
I agree with Dave, that glucose tablets are the best choice, and use juice otherwise. I tried to treat lows with fruit, but it just didn’t raise my blood glucose fast enough.
And I’m actually a little conflicted on the merits of using an insulin pump vs multiple daily injections. The ability to program the basal rate with the pump is an absolute advantage over a long-acting insulin like Lantus. Fast-acting insulins like Humalog/Novolog are also ideal for correction boluses.
But, to me at least, fast-acting insulins aren’t the best thing to use for meal boluses when eating paleo. They seem to “out-pace” the food’s effect on blood sugars, leading to lows. Interestingly, these engineered insulins seem better suited if you’re eating more of the high-GI types of foods that the ADA recommends. It’s almost as if Regular human insulin is actually better suited for the types of food you eat on a paleo diet…
All in all though, I think it’s pretty easy to argue that the advantages of a pump outweigh this one disadvantage.
Mike says
Thanks BJ,
Great stuff
Dave says
As far as for fast acting insulin and Paleo most of the time I don’t even bolus but there are option called dual wave and square bolus so you can spread the insulin out over a period of time so you don’t go low from taking a big hit especially if you are eating a lot of fat.
Dave
Amy Goodowens says
Hi Dave,
Thank you for your comments. I am also a t1 on an insulin pump. I started eating paleo about 6 weeks ago with huge, incredible results. I have always tried so hard to count all the carbs and eat the whole grains like my Dr. told me too. I was always hungry, always craving sugar, always chasing a high or low. I am a runner and even with all the running I was gaining weight and A1c going up and up. I am now doing Crossfit and eating paleo and have lost 11 pounds. I feel great, I am not craving sugar and I have fantastic blood sugars. I am so excited to see what my next blood results are with my A1c. Thank you for posting, I am telling everyone I can think of to come to this website. I am getting alot of skeptical looks when I tell my dental patients about what I am doing, but if it can change someones life like mine I don’t care. I am have cut my basal rate and insulin amounts almost in half. I am sold and not going back to grains, wheat, legumes, sugar lifestyle. Thanks. Amy
Shawna says
Hey guys (and gals),
I’m a T1 and have been for almost 20 years. I was lucky to meet Dr. Ron Rosedale the year I was diagnosed (incorrectly as T2). He steered me onto a good fat, moderate protein and low carb/fiber carb diet. My A1Cs have ranged between 5.3-7.5 whilst I’ve been trying 🙂
I keep glucose tabs with me all the time…have you noticed that the second ingredient in them is hydrogenated fats?!! I’m using honey sticks now.
After i was dx’d I was taking 60 units of lantus and about 20 units rapid. I now take 11 units for basal and about the same for my proteins and CHO (via pump)…return to your roots…in every way…. we should consider ourselves lucky as we have the knowledge and mechanisms to limit our insulin circulation. It appears that insulin levels are directly related to aging….
Shawna
Mike says
Thanks Dave!
Next tough step, getting a young teenager to listen to his parents!
All the best
alix says
My son has had t1 for 2 years now. he was dx a month before his 14th birthday. the biggest adjustment for us was going low-carb, luckily we have always had a very healthy diet (sans the wheat). Dropping the grains was not easy for him but the kids and i decided to join him in this and we all have benefitted.
I have had to let my son suffer some consequences of his choices ( this is not easy as i want to step in) I think it is the habits they learn now that they will take with them into adulthood. They have to experience the consequences of their choices to learn. My son’s numbers were high for a while and he felt like garbage. It took him feeling like this to make the decision to keep his numbers lower. I am sure he will do this again. All iI can do is give gentle reminders and step back ( i would not do this with a younger child). Growing up is difficult enough but to have diabetes added makes it even more difficult. It is through these challenges that our kids will most likely surpass their peers in perseverance, fortitude, compassion (the list goes on) and overall health due to the need for healthy eating and experiencing immediate consequences if they choose not to.
Health is their (our) birthright. How different people choose to experience health is up to them. It is not our birthright to stay sick, reach for “crutches” to get through life. If we choose to live that way we are failing to take responsibility our life. My son knows health is his birthright. Just because he has T1 does not make him unhealthy to the contrary he is probably healthier than many of his peers. It is our responsibility to take responsibility for our birthright and do what we have the power to do to preserve it.
Beck says
Wow amazing. I have had diabetes for 23 years (now 27) and the read that your whole family change their lifestyle to encourage a better one for your son is beautiful. As for the healthy thing I would 100% agree that I am way more healthy then the average person because I have to monitor my food so closely most T1 should be.
Wouter says
Remember that the Humalog is not out of the system immediately. In my case, having bolused earlier (i.e. for breakfast) will mean my blood sugar goes down at *much* higher speeds than if I hadn’t (and haven’t needed to, thanks to a carb-free breakfast).
I also keep some glucose tablets ready at hand, but if I can keep enough self control, just lowering my pump’s basal rate for a few hours can be enough.
Margaret says
LOVE all the data! Anecdotes are one thing, but your numbers really tell the story. Thanks for that.
Adam says
I recently just did a self experiment, or as I call it a “reverse” challenge and was wondering how I submit it as a blog entry? Not sure if this is the proper way to propose a blog post for the site, but alas I cann’t find another way.
Amy Kubal says
Hi Adam! Send me your testimonial and we’ll get it up! [email protected] Thanks!!
Adam says
Sent as of 190157D*OCT, thank you for the quick replies from yesterday.
Amy Kubal says
You’re welcome! 🙂
Robb Wolf says
Send it to the webmaster!
Hunter says
Ive dealt with type I for nearly thirty years and tried lots of different diets with very good results as far as glucose control goes. After almost ten years now following Paleo I am hoping that it has had good effects on my health. I say hoping because I had no problems before and now after ten years on the diet still am in good health. For me it is a question of long term benefit and keeping all the major problems associated with diabetes at bay.
Cheryl says
Thanks for the inspirational story Dave. I am also a Type 1 (LADA). I still have some pancreatic function but supplement my endogenous insulin with 20 units a day of basal and bolus with 1 to 2 units of fast acting only when necessary. About 3 months ago I decided to switch from a fairly standard low carb diet to about 90% paleo. I still consume dairy.
Although I have not had the dramatic improvements most people seem to experience, I have found it much easier to control my blood sugars since the change in diet. At my last diabetes management appointment my doctor asked me to fill out a form which comprehensively tracked my food, exercise and pre and post meal blood glucose for 3 days. Although my last 3 A1c’s have been “excellent”, ranging from 5.8 to 6.1, he wanted to see what my day-to-day management was like. As requested, I completed the form being conscious not to alter my diet so I “looked good” on paper. Despite “knowing” that I my control was tight I was surprised at how tight it actually is. I had no blood glucose excursions outside the “normal range”.
Today, I gave the completed sheet to my doctor who’s response was “Wow. At conferences they show us slides of graphs like this so I knew it was possible in theory. You are the first patient I’ve ever had who’s graph is like this. Can I keep it to show my other diabetic patients that it is possible to achieve these numbers with diet?” I agreed he could keep it. Despite knowing I eat low carb, my doctor has absolutely no interest in the details of how I have achieve this level of blood glucose control through dietary manipulation. I can only hope other patients, he shows my chart to, rather than feeling like failures ask him for details about the type of dietary changes they need to implement to achieve numbers like mine.
As was to be expected, my latest blood tests show, that in the last 3 months, my HDL has doubled, my LDL also rose a bit and my triglycerides have halved (a total drop of 277% since January). Any doubts I may have secretly harboured about the value of a high fat diet are well and truly quashed by these results.
Robert Holman says
My onset story is almost identical to David’s, Type I onset at 30, initially diagnosed as Type II and then went to Joslin for a correct diagnosis as Type I. I pump and run a CGM (Continuous Glucose Monitor)- two items critical in keeping tight control of diabetes. I went strict paleo late last year and have since seen my insulin usage go down to, on average, 17 units a day (my basal is at 12.4 units) and I’m within a BG (average) range of 70-140 73% of my day, below 70 16% of the day (overnights are tough – even though I cut my basals in half) and only above 140 11% and most of those are user error (mis-counting food effects).
I have the same charts as David and would love to share them – just not sure how. I went from a 6.5% a1c in Feb 2010 to a 5.8 in June 2011 (and could do it standing on my head).
Lynn says
I am bordering on type II. I began the Paleo diet to stave it off. Most of my (4)siblings have full blown type II. So far I have convinced them all to eat a low carb diet. Three sisters are doing fantastic. One is Paleo along with me. She is beginning to see the difference. My brother not so much. His blood sugar still is out of control. He thinks 100 carbs a meal is low carb. He also thinks light beer is ok. As soon as he tips back a few though, he eats carbs. His doctor has warned him that his liver enzymes are not good. I am wondering if his alcohol addiction is caused by his low blood sugar,(high insulin levels) and he needs to grab a can of tuna instead of a beer.
Every time I read an article or story on a Paleo website, I gain more insight into what goes on in our bodies. These life experiences that you are sharing with this community are life saving.
Dave, I am forwarding your story to a friend who is type 1. She found out in the emergency room when she almost died after losing 85 pounds through keto acidosis. Her CO2 levels were in the heart attack zone.
Right now she has gained all of her weight back treating her sugar/carb addiction with insulin and her doctors conventional wisdom.
melissa says
Dave,
did you change up your exercise routine at all? do you still do endurance activities or are you more weight training and sprinting here and there? thanks for sharing. i just found out i have LADA last november. this lifestyle definitely helps, but i am torn with my exercise. i love kickboxing, but it seems to me that the anusura yoga i am doing helps keep my sugars normal and because i am not “kicking ass and taking names” when i work out, i am not always hungry it seems. but, i also need less carbs and don’t seem to be on a roller coaster on the days i do and around yoga compared to the days around when i do kickboxing. thanks again!
Dave says
Hello,
I did not change my exercise routine in fact I do indoor/outdoor rock climbing and during the summer I often do 2-3 century bike rides that have up to 13,000 feet of climbing which is fun but painful! I know it falls under the cardio routine but I do it because I love to ride. I am going to be adding in more intervals and Primal types of workouts to balance envy thing out. Don’t give up yoga or kick boxing both are great! Also if you were just diagnosed you may still be honeymooning which definitely makes managing your BG a lot easier.
If you are worried about going low just drink OJ that will jack your BG up in know time.
To anyone who wants mo info or to chat my twitter name is dwendel
Thanks
Dave
melissa says
what are you eating before your long rides? i seem to have problems fueling up for any type of endurance exercise. do you eat a lot of carbs on those days?
thanks!
Squatchy says
Great story, thanks for sharing. I just hope more and more people realize this stuff is actually very beneficial and get off the crazy train at the next stop 🙂
Erik says
Great post! This stuff is so beneficial. Thanks for the work that you do!
Parry Reehal says
Hiya
thank you, for this great story, i just found out about yoursef from my GP, being indian from India i am a vegi., can you please shed some light on this please, i am also type 2 for the last 12 years, and started to take inslin i take 12 units in 24hrs.my blood suger readings were avrage 12 – 14, since taking inslin it has drop right down to 8 – 9.
i am also longtime sufferer of lower back problem, they say there is no cure, please help.
Robb Wolf says
Your diet might be very problematic for your health. Not sure what more to say. You could reverse at least the type 2 in less than a month. But it’d require changing your diet significantly. Loren cordons next book looks at the state of health in India…it’s not good.
I guess good luck is all I can offer.
Maria says
I just read that the WHO predicts that india will soon hold the top spot for highest heart disease rates in the world. Why is this? They seem to consume plenty of coconut milk/curries, veggies. I didnt think their diet was mainly vegeyarian anymore. Is it the rice/grains? What is it? Thanks in advance.
Stephen says
It’s the sweets. Indians love sweets — gulab jamun comes to mind as but one example of the many sweets in Indian cuisine.
That, coupled with increasing standard of living. These bloody diseases of civilization…
Adora Buecher says
I’m a 40y/o type 1 diabetic on a Paleo diet. I converted 7/11, I only cheated 1 day, but, I ate every chocolate baked thing I could for about 8 hrs, and felt bad for 5 days after. I “reformed” by going very low carb paleo, and measuring everything, I was still having cravings, and over eating, so I checked out the site “gettingstronger.org”, which I loved, and it helped. However, I continued to feel unbalanced and deeply stressed, tying not to eat so much.
Thanks to barefoot running and movnat, I’m not fat, but I want to be thinner, not suffer with cravings, and enjoy better health. So, I tried raw paleo, I’m much more grounded, very managable desires to over eat, more like bad habits. I eat all of the carbs I want, but only from sources that I don’t overeat, like apples, pears, and grapefruit. Everything else is low carb raw vegies (and sauerkraut), coconut and raw meat, and fish. I’ve only been at it 2 weeks, but I’m not having unexplaind cavings, and I’m eating well, but not stuffing myself. I feel good and I don’t think I’ve suffered any bad bacterial effects. The meat isn’t even as bad as I thought. The first bite or 2 of a new thing is just gross, but its like a swich goes on and I want more, then I’m really hungry for it, then I’m done. I feel stable, like I can trust myself at least with the meat itself. I still have to watch other foods a bit, but the draw isn’t strong to gorge. A wonderful farmer gave me a huge deal on less desirable grass fininshed beef stuff like liver, heart, tounge. I picked up wild frozen tunna, salmon, and cod from the grocery store. I wanted to try something that hadn’t been frozen 1st so I bought a grass fed lamb tenderloin, which I seasoned more, and it was the best tasting. I like this stuff much more than I thought I would and my BS are better this week than last. I forgot about eggs which I mix with seasoning, oil, and lemon to make a good salad dressing out of.
I’m on the pump and I used an ave on 18units/day this week, down from24/day last week. I was between 20-35 on regular paleo, and a bit more with heavy overeating. Low carb paleo I did very well, 12/day, but I felt so bad, I think I wasn’t ready metabolically. Still, I’d like try it again in the spring. My average BS are 150’s, but I before paleo I ran all over and averaged 180’s. I’m due for a hA1c, in the summer it was 7.1.
I love this website, my daughter is pure cooked paleo, and I want to stay in the “paleo club” so don’t kick me out. I’m assuming, since I haven’t seen it addressed, that raw is not really part of paleo. Please share your thoughts, so I can learn more. Lastly, if you want to do a paleo diabetes study, I want in, so tell me what info you need and where to send it. Thanks, Adora
Andre Chimene says
Andre Chimene here. I am a Certified Personal Trainer, Type 1 and working out here in India with Dr. Ron Rosedale. India is number 1 in diabetes and heart disease. 60% of all heart patients live here. They have followed the US off the cliff by cutting out Ghee and coconut. They have listened to their US and England trained docs who hate fat and love sugar. They don’t eat enough protein either. All Indians are welcome to contact me at [email protected]. India is getting killed with diabetes and they are 10 years behind us in the change of high fat/moderate protein/low carb Paleo that the US is just starting to catch onto.
The web makes us a small world and Robb your pods etc. will help get the word out. Thanks for the voice and I want to get you together with Dr. Ron Rosedale. I just listened to your pod with Mark Sisson and all 3 of you are on the same page. Andre
Maria says
Thanks for that explanation, Andre. This is very interesting info to me. I like studying the diets of other countries and the connection to disease.
Aaron Kennedy says
Dave,
Great article! I have a very similar story and with the same overall results. I was diagnosed at age 35 with type 2 wrongfully. I found a very good endo and was properly diagnosed with type 1. I have also been diagnosed with hyperthyroid. Since I have turned to paleo, my hyperthyroid is controlled as well as my BG. I had the same issues as far as my numbers being all over the place. I didn’t understand it. But since I have been eating paleo for the past year my numbers have been great. My a1c is 5.6 and I am training hard without any issues and competing in local CrossFit events. I have read your book Robb and my favorite meal is the paleo pancakes! I eat those things every morning, they are the bomb! Anyway great info and I wish you all the best!
Diane says
For more on Paleo & Type 1 Diabetes (and endurance athletics!) check out this post: http://robbwolf.com/2011/11/18/sean-paleo-type-1-diabetes-endurance/
JJ says
I have a question? I am a type 1 diabetic and want to do the Paleo diet. I have been reading up on it and sounds very beneficial to my health. The only problem I am having is the majority of the recipes use some sort of coconut. I hate the flavor of coconut! Is this going to be a problem with coconut oil, flour, milk, etc in the majority for the diet?? Can you taste it in these forms? Are there other alternatives? Thanks for any advice.
Robb Wolf says
hmmm…99% of folks love coconut…this is literally a first time i’ve heard this! Just work your way around it as best you can.
DaveK says
JJ, I used to hate the flavor of coconut, too. But I’d never really had real coconut, just the flaked coconut they put on cakes, etc. Once you have the real thing, you might appreciate it more. Try buying a real coconut and drinking the water. It made a believer out of me!
JJ says
Ok, Thanks for the advice! Yes, most the coconut I have had was the flaked stuff. I did try the water recently and didn’t care for it. It also made me puffy like if I had a lot of salt.
So, I will work around it as I go! Thanks again JJ
Lisa Sellers-West says
Have you tried unsweetened Almond milk? they also have unsweetened vanilla almond milk- Silk makes it. We use cocunut oil when we make the almond butter pancakes- but for all other cooking/sauteeing we use olive oil. hope that helps 🙂
Dyan says
I am so pleased that I ran across this blog. I was diagnosed 26 years ago at the age of 33 with t1…my blood sugar was about 800 and I was almost unconscious. It has been impossible to get information about diabetes in an older athlete. There is a great deal of protection surrounding diabetes anyways but add the age to it and your off to the bone yard. If I had a buck for evey time I heard “what do you expect you’re almost 60 and a t1” What I expect is exactly what you all claim. I need to maintain my weight and have enough energy to exercise several hours a day. That does not seem too much to ask. I am getting 3 books on the subject today and I am jonesing. Thank you for getting me excited again. My currest a1c was 7 which is up from my last. I have years when I have maintained mid 5’s. Lately not so much. When I was pregnant 24 years ago I had to adjust my diet when I came up with a 3.9 which felt horrible. I am a pump user. Thanks again and I hope this turns out to be all that you promise.
Kirsten says
My 13 year old son has had type 1 diabetes for 10 years (using a pump for 8 years). His control used to be terrible with a normal HBA1C of around 9 (even though I always counted his carbs).
We had the usual tests for celiac etc on a regular basis, but they always came back negative. I suspected that his uncontrolled sugars had something to do with his food, even though the doctors assured me it didn’t. So I took him off gluten a couple of months ago and cut out a lot of the processed foods he had been eating.
His HBA1C is the best its ever been (7.1) My son feels a lot better and so do I (I went on the same diet as him to support him). His BGLs are now between 4mmol & 8 mmol most days. His pump charts look a lot like David’s..
We do include dairy in his diet as he loves smoothies and they are a great way to start the day.
sue says
I am Type 1 diagnosed at 40 yrs -12 years ago . I have been following Dr Bernstien/Primal / Paleo for 18 mths- brilliant ! If I do eat ouside these it takes 1-2 weeks on the pump again to get back to no Bolus and 4.5 units insulin a day (pump) as basal……….my HBA1C is 5.2
Unfortunatley can not discuss this with my Drs……..I tried to once and was told in no uncertain terms it was dangerous so…..i have learnt to ‘Hush my mouth”…..lol….I feel wonderful- the best in 25 yrs !!!! All my tests show all is very well within too.
I was so pleased to come across this discussion as I had begun to wonder Was I the ONLY one !! …lol
John says
I am a T1 that was diagnosed ~9 years ago at age 31, and Sue, I have the same problem. In order to get my pump I had to go through a nutritional training…and no offense at all meant to nutritionists/dieticians in general, but talk about outdated information! Seems like it might be more acceptable to tell them that I eat sugar-coated whole wheat cereal all day than try to explain how I eat in a paleo-ish way.
I suppose that I understand their concern about deviating from an accepted eating plan because of the potential dangers involved, because as diabetics we CAN make mistakes, but it seems like as reasonably intelligent adults our endos and their teams would at least take the time to research other ways of eating and living.
In any case, I only recently have gotten more serious about paleo and working out, but even my half-assed paleo diet has improved my A1C quite a bit. I look forward to improving it more and living a very long time!
John says
*reasonably intelligent adults = diabetics
I’m pretty sure that my endo is more than reasonably intelligent!
Peter says
Thanks for the inspiration! Type 1 here that needed to hear it’s not only doable but brings such great results. I ordered Robb’s book and can’t wait to get started. Are there any other specific books that I should be reading?
Megan says
I am a T1 diabetic and have been for almost 15 years. I was always a “rebel” about taking care of my diabetes, maybe as a way of pretending to not have diabetes. My health definitely suffered because of it. I have “high” cholesterol for a diabetic and I’m only 24. I’ve definitely developed an intolerance to gluten and possible soy and dairy. Regardless of blood work results (which commonly are negative when actually positive) I’m pretty sure I have some kind of hypothyroidism due to multiple symptoms. I was tired every day regardless of sleep, exercise, anything. A friend let me borrow this book and since I have started following the Paleo diet I have noticed a huge increase in energy and the overall way I feel from food. It hasn’t been long enough to have my blood work prove anything, but I am taking a slightly lower dose of lantus at night and very little humalog to correct blood sugars and carbohydrates eaten. I feel way better about this because I was taking 4-5 injections of humalog a day when I was eating food with gluten. The one problem I have noticed, and I’d love to know if anyone else notices this, is that after exercise, my blood sugar actually rises! For example, before bed last night, when I took my lantus, my blood sugar was around 150. I woke up in the middle of the night and checked again to find my blood sugar was relatively the same (my dr. has asked I check at night to make sure my new lantus dose is not causing spikes or drops in my blood sugar). When I woke up this morning my blood sugar was still stable. I had a few nuts, which usually don’t spike my sugars and some water before heading to the gym. I only worked out about a half an hour and tested my blood sugar about a half hour after I was done and it was 286! Could this be because I am “stressed” when working out and releasing cortisol or adrenaline? I’ve noticed activities such as snowboarding cause this spike as well. Maybe when I have done Paleo a little longer this will pan itself out, but I was wondering if anyone else was having this problem and what their solutions were? Thanks!
Janie Gaffney says
I believe that vigorous exercise causes a spike in blood sugar for many people due to adrenaline or cortisol release. Sustained relaxing exercise, like walking or swimming should lower it for you.
Chris Loughrey says
I’m very curious about this myself. I’m a pump user (animas 2020) and my control is very good, I’m already low carb (1/2 paleo!) but not doing anything like this consciously yet.
The thing I’m wondering is, I count carbs for bread/pasta etc but never for vegetables. I find I have no need to do this as my basal insulin can take care of any small amount of carbs in it given that veg is digested so much more slowly than wheat etc.
Does this change if I go full paleo? What are other pumpers experiences of this and what changes did they need to make?
Heather says
I noticed this was posted a year ago. Dave are you still following a paleo diet? If so I would like to know more of your experience. My husband has a very similar story to yours. Misdiagnosed Type 2 at 30, shortly after diagnosed type 1 then a year or so later he was diagnosed with Hashimoto’s.
Like you mentioned in your post; he is very fit, does a lot of cycling but his weight is slowly increasing no matter what he does. Again, I would be very interested how did eating no carbs and being active? Any input is appreciated.
greg white says
The weight increase could possibly to do with the ‘lot of cycling’. From memory what Robb says in the Paelo Soluiton is that he had clients upping their cardio and they put weight on due to too much cortisol produced by over doing the cardio. If not already i’d suggest to buy the book. As a T1 Diabetic i am finding (not finished it yet) the book very enlightening and i’ve been primal (a la Mark Sissons) for a year now.
Lisa Sellers-West says
Hi – I was diagnosed in 1969, 2 weekes bfore my 7th birthday with type 1 diabetes. I had been to several military doctors for about 6 months prior to the diagnosis because I was wetting the bed 2x a night; eating and drinking everything in sight; itching everywhere; borderline hyperactive; and feeling crappy most of the time as I constantly had a cold. Those doctors told my parents that I was just going through a stage and I would be ok. Finally my Dad decided we were going to a civilian docter. caveat- it was 1969 and the whole world did not know about diabetes-especially juvenile diabetes like thety do now… so grace is given. So this new doctor diagnosed me as I walked through his door on the first visit. My blood sugar was off the chart- and the chart only went to 1000 so it was higher than that. They (Dr.) cancelled my birthday- I couldnt have cake that year- and sent me home with pork insulin and glass syringes 🙂 I did not care for him but my Mom did because now we knew what was wrong- she read everything and we started the diabetic journey. So I will be 51 in February so I have been T1 diabetic for 44 years and it has been a crazy journey. I was rebellious and ate and drank what I wanted to all through high school and college. My A1C – when they came up with that was always 11-13. I hated beer but I did love Vodka and Cranberry juice- another stupid choice. In my first year of college- Christmas 1980- I went into ketoacidosis in the middle of the night while staying ay my boyfriend’s parent’ house andthe doctors were not told I was diabetic so they decided my appendix had ruptured so they were prepping my for surgery. My boyfriend remembered to tell them I was diabetic right before they administered anesthesia (YAY) at which time I slipped into a coma and my heart stopped. Fortunately they recussitated me and I remained in the coma for 3 days. I behaved better for 6 months and then went back to the old way a living by pushing through in spite of how I felt. Fast forward to 1988- met my now husband- a former pararescueman in the Air Force who decided he needed to know all he could find out about diabetes and life went on. In 1989 we had a healthy baby boy of 71/2 pounds – I insisted on a c section because we had orders to Alaska from Florida and the movers were coming the same week he was due. So we were off to Alaska when Ryan was 3 months old. I was never obese but I only lost about 10 pounds of the pregnancy weight so I stayed at 172 lbs for years instead of 145lbs. I did weight watchers 3 times, Curves and other regular gym stuff but nothing very consistently. In 1999- total fluke- I had a vertebral arterial split that should have killed me before the knife like pain went through my head at the gas station. We were living in Albuquerque and moving to Columbus, OH. My husband had already gone to start our business in Ohio and our 10 yr old son was hanging out with my parents in Tennessee. I drove myself to the hospital with an unbearable headache- thinking it was a diabetic thing and sat in the ICU for a week while they ran every test and scan they could think of with no explanation. Never lost consciousness so after a week I left with no diagnosis and went to Ohio with my husband. A neurologist at OSU ran a bunch of tests and diagnosed what had happened- I should have died instantly back in NM. Two years ago, Steven (husband walks in with a book and says “would you read the intro and tell me what you think when I get home tonight? Let’s just talk about it- don’t go through the pantry and throw out stuff, OK?” OK I say- ha had been trying to get me to do The Zone for a bit with him but I hadn’t looked at it much and my knee jerk reaction was that it looked complicated. So, I read the intro to The Paleo Solution and was immediately and WHOLEheatrtedly on board. I did not throw anything out but I did put all things “not paleo” in a box in the garage. We began our paleo adventure! Six months later- I started doing Crossfit. I have NEVER felt better. My A1c’s are 8; I have lost 27 pounds; and my doctors are doing cartwheels along with my husband and parents. 🙂 Thank you Robb- your book helped me turn the corner to a much more satisfying life. We now own a gym where we do crossfit and tell all about the paleo solution and our friends feel better too. 🙂
Amy says
Wow guys. There is a diabetic low carb expert who was not mentioned once in this entire comment section. He isn’t paleo per se, as he was around before paleo was common and he does allow some full fat dairy. Dr. Richard Berncstein is a Type 1 diabetic with an a1C of 4.5. He wrote an amazing book called Diabetes Solution in which he details how to maintain normal blood sugar. The guy knows what he is talking about. The book answers most of the questions above. I have type 1 and I follow his guidelines.
Chris says
I have had an epiphany in the last few days…
I am a type 1 late onset diabetic on a paradigm insulin pump with glucose sensor. I am currently 37, was diagnosed when I was 26 years old with late onset type 1 DM. I weigh 128kg, 1,89m tall and I feel miserable most of the time. I average 80-110 units of insulin a day, have rollercoaster sugars on a regular basis and can feel my life slipping through my fingers…
Being a medical specialist I have extensive knowledge of diabetes and all the complications – I see people everyday in theatre, ravaged by diabetes and obesity. Amputations, cardiac bypass surgery, joint and back surgeries, vascular surgeries, placement of dialysis lines for renal failure etc etc etc. Despite all this that I see, I cannot seem to stop eating, especially all the unhealthy stuff. My biggest problem is with sweets, carbs, bread, pasta and the like – I just cannot seem to help myself. One helping of a cheesy pasta bake is never enough! I will willfully overeat, then feel guilty afterwards and deal with the resultant massive spike in glucose with an orgy of insulin via my trusty pump!
I have started excercising about a year ago – I excercise 4 times a week at a private gym at a physiotherapists practice under supervision of personal trainers with at least a B.Sc. excercise science or biokinetics qualifications. The type of excercise we do seems very much like what you are advocating – lots of combo moves, bodyweight excercises, stuff like physio balls, rip-trainer etc. feature heavily. I usually start with 20min of cycling on a stationary bike to warm up, followed by 30min of training as above. Even though I have almost dropped a pant size in a year of excercise, my weight is still the same, I struggle to get up in the mornings to excercise, and my motivation to continue this path is really low.
I try to eat healthy – breakfast will be fat free yogurt (125gr), blueberries (125gr), a sachet of low GI muesli and a cup of coffee. 2 Sticks of sweetener on the yogurt and two sticks of sweetener in the coffee…
Lunch – usually supplied by the hospital, consists of mostly fatty or deep fried protein, rice, potatoes, mash, buns, starchy veg like yellow pumpkin (sweetend often), peas etc… You get the idea.
Dinner is usually chicken or fish (crumbed portions) with 2 veg, salad and carbs (rice/oven bake chips etc.)
And inbetween??? A plethora of sins. 10:00 in the morning and 14:30 in the afternoon there is a sandwich platter in the theatre tearoom filled to the brim with white bread, cheese, poor quality cold meat etc. Also at least once or twice a week there will be a medical representative with sweets, treats, snacks, cakes, chocolates etc. I find it difficult to say no sometimes…
So as you can see, I start the day fairly healthy, and it all goes downhill from there :(.
I heard of this Paleo diet recently, heard the reports about Tim Noakes’s thoughts on a Paleo like diet, but due to my medical education I have scoffed at these reports as “not proved in double blind randomised controlled trials”, “just another version of the Atkins diet”, “pseudoscience”, “what about the protein load’s effect on your kidneys?” and so forth.
However the more I read the more I find diabetics who have had remarkable changes in their BG control and general well-being following this diet plan. Everyone cannot be deluded – they have blood results and physical results to show!
So here I am, hopefully at the beginning of a new chapter in my life. I have started this morning with a blood glucose of 21mmol/l – due to me refilling my pump last night and forgetting to restart the pump after filling. Had nothing for breakfast except a cup of coffee. 2.5 hours later my sugar came down to below 10, I ate a fried egg, two rashers of bacon and a 175gr plain unsweetend yogurt. I have already set a temporary basal of 70% of my normal, already had a hypo of 3.4 (corrected with a few super C sweets) and can already see a flattening of the BG curve on my pump.
I have bought a few books and will study this lifestyle in detail and hopefully be able to report back in a few months with a vastly improved quality of life. I am tired of feeling and looking like shit, of being moody and depressed about my body and the slow killer (diabetes) inhabiting it, of feeling like a failure everytime I fail with a new diet (setup by traditionally trained dieticians).
I want to feel and look great. I want to be around to see my two young sons growing up. I want to grow old with my beautiful wife. I want to start living…
Daniel says
I know this is an older post but I’m hoping to get more Type 1s who are like minded to join our group.
https://www.facebook.com/groups/Type1DiabeticAthletes/
tara says
what do you use to treat lows on a pale diet? i am also a type 1, but am concerned about the best way to treat a low BG. i do have a cgm, so i’m thankful for the ability to keep an eye on my numbers.