T1D Management - Looping Update

T1D Management - Looping Update

Back in March I wrote a post about my initial experience with Loop. Since then a lot has changed in the world, my daily routines have completely changed, stress levels are way up, and my blood glucose levels have reflected the craziness. Through it all, however, Loop has worked very well to keep me within normal ranges - not perfect, but the major spikes and major drops haven't really happened.

Below is a screenshot from app.tidepool.org showing 4 recent weeks on Loop - not bad, predicted A1C of 6.5, average BG of 132, 84% in range.

Past 4 weeks on Loop

A couple weeks ago my wife and I started a Keto diet - I'm not going into all those details, it's a pretty well documented and popular diet plan. What I will note is that the ketogenic diet is NOT broadly popular among T1Ds nor is it commonly recommended by endocrinolgists for T1Ds, BUT there is a fantastic community online, including a Facebook Group specifically for T1Ds on keto, where many individuals are having great success. It's not something that I would recommend approaching without doing your own research and having a very good understanding of the differences between ketosis and DKA. Personally, I wasn't comfortable trying keto prior to being on Loop - having the safeguards in place to protect for dropping blood glucose levels gave me confidence that I could do this with little danger of a severe hypo.

For the last week I've adjusted my target glucose to 83, instead of my previous 100 goal - this is based on reading Dr. Bernstein's book "Dr. Bernstein's Diabetes Solution". The below image is across the last 2 weeks - so one week of following keto with a target glucose of 100, one week following keto with a target glucose of 83.

The difference is incredible. In addition to more stable glucose levels overall, low carb is making adjusting up or down much more simple. Loop is keeping me well within range. Targeting 83 over the past week I think is a little too aggressive for Loop and relying on Dexcom - testing my blood glucose with my meter will show that Dexcom is usually within 5-10 points, but if Dexcom is reporting 75 and I'm 10 points down, and I'm really 65, that's not great. This coming week I'm adjusting my target to 88 in hopes of avoiding more lows - my highs are practically non-existent at this point. In fact, my definition of "high" has changed - in Nightscout, I've adjusted my ranges to be very tight:

Anything above 120 is now high, and anything below 67 is now low, with my target range set to 70-100. I've already gotten used to seeing a lot of green.

For the past (almost) 16 years of my diabetic life, I have been told by every member of my various medical teams that I should avoid a low-carb diet. That I would gain weight, that I "needed carbs", that 100 was the perfect, non-diabetic glucose level. My eyes have really been opened over the past month to how much crap I've been told by medical professionals. The diabetes treatment industry is incredibly lucrative, from the early "disease management" stages - glucose meters, test strips, insulin, insulin pumps, CGMs, etc - to the "disease complications treatment" stages - neuropathy, heart issues, kidney failure, etc. I've been told that as long as I keep my A1C at or under 6% that I was managing my disease well and would have a better shot at avoiding some complications, but that complications were eventually inevitable, and that as a diabetic I naturally had a shorter life expectancy. THAT'S JUST NOT TRUE.

Dr. B, and thousands of other Type 1 diabetics, are living proof that complications are not inevitable, and that I can have a normal life expectancy.

I'll never have a normal life - I will always be a Type 1 diabetic. But I am now 100% convinced that with a low carb, ketogenic diet, I can avoid diabetic complications and live a full, rich, healthy life. I can watch my kids grow up, and be here for them for a long time. I can enjoy a long, wonderful life with my wife.

My family is worth more than carbs, no question. I'll post more about Dr. B's plan and my thoughts soon, but I highly encourage any diabetics - type 1 or type 2 - to give it a read. It may just save your life, and it will certainly change your perspective.