Whole30-A-Z-heaader1

The Whole30 + Type 1 Diabetes

While many have had life-changing results from ourWhole30 program, once in a while we have the opportunity to delve into more complicated “problem solving mode” with our consulting practice. A few months ago, we had such an opportunity with Meggie D., a type 1 diabetic who was having trouble controlling her blood sugars, despite a generally healthy (low-carb/Paleo) diet. We worked with her closely for about a month, making very specific recommendations for meal timing, macronutrient proportion and food choices. This is Meggie’s story.

My experience with Whole30 and Type 1 Diabetes

by Meggie D.

“First of all, this is not going to be a fantastical story of diabetes reversal, so prepare yourself. I was diagnosed with Type I diabetes at the age of 11, and I am currently 27 years old. Over those past 16 years I have kept a pretty average control on my levels (Average being an HbA1c that was usually in the 6-7.5 range). Most of this time was spent on the high-carb diet recommended to me by my doctors. Within the past 3 years I have tried the low carb style of eating and later the paleo style of eating. For me low carb is completely essential for a Type I Diabetic, and paleo is close behind.

Diabetes is an ongoing guessing game and balancing act of activity to carbs to stress levels. When you remove the carbohydrates from the equation you greatly reduce the volatility in the guess. With the (modified) paleo lifestyle my HbA1c levels are consistently under 6. My insulin levels are also slightly reduced as I am not eating as many carbs. My Endocrinologist/Nutritionist however, hates this diet. Her reasonings were as follows: Decreasing carb intake would significantly impact my energy throughout the day. No whole grains means I will not be getting enough fiber. No whole grains also means I am missing so called “crucial nutrients.” Too much fat will cause heart disease and high triglycerides. (The list goes on.)

Although I have eaten a modified paleo diet for the past year and a half, I was still having problems with morning highs. I wear a continuous glucose meter (CGM) which gives me a moving average of my blood sugar over time. This allows me to see and correct for unexplained highs/lows. I was noticing that my levels would stay perfectly flat all night at around 100 then I would wake up and eat breakfast and see a spike shortly after sometimes as high as 250! Breakfast, I should mention was always the same: three eggs, ¼ of an avocado and a dash of hot sauce. Pretty low on the carbs – yet I was routinely giving myself a correction bolus mid morning. It is likely that this was something I struggled with over a long period of time; however the CGM really shed some light on the problem.

Enter Dallas and Melissa. We chatted extensively about my nutrition, blood sugars and overall stress levels. Dallas and Melissa love a good problem, and immediately set to work on coming up with a variety of practical, immediately applicable recommendations. I went on a specially customized version of their Whole30 program, designed to both improve my overall blood sugar management and, most importantly, eliminate my morning blood sugar highs.

During this time I continued to wear my CGM and monitor my blood glucose to see the effects of removing certain foods (as recommended) from my current eating regime. I immediately noticed that the morning spikes began to level out, and instead of a drastic jump to 250 my jumps went from 100 to 150. After the 30 days ended, and I began to slowly add food items back into my diet. I noticed that the biggest positive effect came from the addition of extra veggies, especially in the morning. To this day I try and get a full load of vegetables at each meal to help regulate and even out my blood sugars.

My customized Whole30 program was an invaluable in helping me pinpoint idiosyncrasies in my control of diabetes. The concept of running my own test experiment on myself through what I put in my body gave me a concrete and revealing conclusion about the changes I needed to make to see the results I was looking for. I am currently on day 12 of my second Whole30 program, and am looking forward to the new findings my body reveals. My blood sugars have been great, and I am excited to see what my new HbA1c level is at my next doctor’s visit.

Thank you to Melissa and Dallas for your dedication to helping me identify the factors to change my control on diabetes. Your support and insight are invaluable resources to those of us looking for progression in a variety of setbacks whether medical, strength or emotional.”

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Comments

  1. says

    Hi Meggie! I am a fellow type 1 diabetic on paleo (but I omit the fruit). I think it’s great you’ve seen the great effects of paleo on your diabetes and A1C. I am also in the 5% club :) I just wanted to give a quick suggestion on your morning rise. I get the same dawn phenomenon effect, where my glucose will be about 50-100 mg/dl higher than desired mid-morning. After weeks of tracking my numbers consistently, I now take a small dose of novolog (yes, post-breakfast, without food), to cover the dawn phenomenon effect. If you’re still running a bit higher than desired, even with your food changes, maybe work with your doctor to see if that might work for you. I found it’s all I need (besides the diet) to keep my numbers perfect all day long. Best of luck!

  2. says

    I’m guessing you’re a Robb Wolf listener, so I probably don’t need to mention this, but… in the latest podcast (episode 73), he talks about the A1C test, and how he’s learning some interesting things about it, diagnostically speaking. Definitely worth a listen.

  3. says

    @Joey: Thanks for dropping in – nice to hear from you! Hope all is well, and thanks for the comment.

    @Adam: Yes, there’s lots of stuff out there about how the A1C all by itself isn’t the end-all, be-all. Meggie is very diligent about tracking all sorts of stats on herself – she’s very committed to making sure all of her numbers AND her perceived statistics (sleep quality, energy levels, training performance, recovery, etc.) are in line.

    Thanks for the note – we’re a bit behind on our podcasts, in fact. We’ll give it a listen.

    Melissa

  4. says

    Thanks for posting this! I also have Type 1 and have been eating paleo for over a year now. I eat the exact same thing for breakfast – 3 eggs and half an avocado – and it blows my mind how high this can send my blood sugar sometimes. I just don’t get it.

    It looks like Meggie is having a lot of success, that is awesome and further confirms that I am on the right track.

  5. Meggie says

    Thanks for the advice Joey I have tried the extra am bolus but my schedule is too erratic to get a consistent result. If i workout in the morning at any level of intensity it compounds the dawn phenomenon anyways…

    Adam – I have talked to Robb about my health a few times although it has been a few years. I am also very behind in his podcasts and will have to catch up on the A1C piece, thanks for the memo.

    Thanks again Melissa and Dallas for all the helpful brainstorming and advice!

  6. says

    Hi Meggie – I also take an extra bolus 20 minutes before I work out. Both this bolus and the dawn phenomenon bolus are new for me this year, but working great. I tried various types of crossfit workouts (without taking extra insulin), and found that whether I did slow, heavy strength, or a fast-paced bodyweight WOD, my sugar would rise by 100-150 mg/dl. I became so frustrated that I actually stopped working out (except for long walks) for a few months. Missing my strength, I hit the books again and found that Dr. Bernstein advises diabetics that working out in the afternoons (or at least 3 hours post wake-up) is ideal. Erratic schedules can definitely make our lives difficult. The more steady schedule, the easier we can control our type 1.

    Ooh – and congrats Melissa & Dallas for getting hitched!!! Woo hoo! LOVE your tatoos :)

  7. Apple says

    I recently found this site through marksdailyapple.com. Thank you for this post! I just got diagnosed type 1 about 7 months ago. I started eating lower carb immediately but it wasn’t until January that I decided to go paleo. That was when my morning blood sugar started skyrocketing! I take correction insulin in the morning and don’t eat breakfast until late, usually just wait until lunch to eat if my blood sugar is over 180 when I wake up (it often is). Lately I’ve realized that if I don’t eat dinner, I have blood sugar more in the 110-130 range when I wake up.

    I don’t think I want to live eating lunch only forever just to get normal blood sugars. Can you elaborate on the specialized whole30 that you tried? I’m getting desperate!

  8. says

    @Joey: Thanks!

    @Apple: Unfortunately, the program we worked out for Meggie was tailored exactly to her issues and her needs – there is no one size fits all solution for a problem as complicated as “dawn phenomenon.” However, we do offer a four week consulting program (http://whole9life.com/personal-consulting), if you’re interested in working closely with us.

    Best,

    Melissa

  9. Apple says

    Gotcha, that makes sense. If only it were so easy…. I will look into the consult!

  10. Jamie says

    Check out Dr. Richard Bernstein’s work for more information on dawn phenomena and low carb diets for type 1 diabetics. Very paleo friendly.

  11. Jess says

    @Apple: I’d suggest googling “Somogyi effect”, too. That’s another cause of high blood sugar in the morning, with a very different cause. Meggie presumably ruled this out with her continuous blood monitoring, but it’s something to look into, in addition to the Dawn Phenomenon, if your blood sugar is high in the mornings.

  12. says

    Thanks so much for sharing! My son is 8 and has had type 1 diabetes for over 4 years. Our whole family started on the whole30 challenge 19 days ago and have already seen amazing results. I wrote about it on my blog at http://wholefamilystrong.com/praise-reports/. His numbers have gone from never being stable to being right on the money every time. It’s wonderful to know we have finally found a way to manage his diabetes. I certainly wish one of our 3 endocronologists had mentioned this way of eating as an option to consider. Thank you whole30 for all the help you have given to my family!

  13. says

    I too am a T1 diabetic and have been for the last 25 years (I am now 32). For years, I ate the high carb diets nutritionists and doctors promoted as the “healthy” way to eat. My health suffered greatly for it as I always has issues controlling my BGs no matter how strict I was about the diet and daily routine.

    Having tried low carb over the years as well with success – but still a feeling that I could be doing better health wise – I returned to a moderate carb diet but ensured that nothing that touched my lips contained any form of dairy or gluten. It took 6 months, but many symptoms that I had my entire life cleared up. From there, I dropped all grains and legumes and followed the Paleo diet.

    I was doing great but still has odd BG fluctuations as those discussed in the above posts. I discovered by trial and error other foods that directly affected my BGs sometimes right away and other time 8 hours later: all nuts, eggs, pineapple, peppers, and beef (I am completely fine with all other meat and seafood). It was a long process to discover this which I later confirmed with allergy testing. My spikey middle of the night and morning BGs subsided. Once I got the insulin pump and CGM, my food sensitivites were reconfirmed because if I eat any of these foods, my injection sites become itchy and inflamed for both the infusion set and sensors and I have to change both.

    I had to remove the foods though from my diet for 3 months before I noticed changes. After 6 months, my BGs were better and after 9 – 12 months I feel great. It can be a slow process for some while others notice results fairly quickly.

    Most people with autoimmune diseases have my sensitivities to foods, chemicals, and pollens that can go unnoticed because you are not getting hives or other strong reactions necissarily. The key is to listed to your body. Blood sugars that are constantly spiking for no real reasons warrants further investigation. It could just be how you work, but it could something that you are putting into your body as well.

  14. Jacqueline says

    Good morning!! I have an almost 10 year old type 1 diabetic. We try and keep her levels level, but they are constantly up and down. I have only just today come across these articles, what is paleo? and would this diet benefit my daughter? all she wants to eat are carbs. I keep low carb low sugar, and always fruits and veggies around and encourage her to eat them, but its a constant battle? any advice would greatly be appreciated! thanks

  15. Adam says

    Martin Berkhan at Leangains actually had a post about why insulin spikes happen in the morning (it’s related to cortisol). He also talks about why this can cause hunger soon after breakfast (but this may or may not happen depending on other factors). I don’t know how feasible a breakfast-skipping IF program is for a t1D, but it’s interesting to think that it may not be some unexplained aberration of people’s metabolism.

    http://www.leangains.com/2012/06/why-does-breakfast-make-me-hungry.html

  16. andee says

    How did you deal with Lows on the whole 30? Do you use just fruit or do you use a fast acting glucose? I’m not sure how to deal with it.

  17. says

    Andee,

    Your health always, always, always comes before the Whole30 rules. If you find yourself in a low, then use whatever your doctor recommends to get your blood sugars back into a normal range, even if that thing happens to be a form of sugar. The idea is to eliminate or reduce these instances of highs and lows with the program, so that you don’t bottom out so often, but until things start to regulate, work closely with your doctor, and follow his/her advice to do what you need to do to keep yourself healthy.

    Best,
    Melissa

  18. Casey says

    I am on day 7 of the Whole30 and overall feeling great, but I am struggling with my BGs creeping up more than usual (150s-170s rather than low 100s). This is the first time in years that I have added meat and poultry (AND FAT!) into my diet… was only eating fish/veggies and very little grains/legumes/sugar since it is hard for me to keep my levels on the lower end with these in my diet. Anyone else experience this while adding more animal protein and/or fat?

    I tried posting on the forum and facebook, but so far no responses… hope to get some advice! thanks! :)

  19. says

    Casey,

    While it’s really hard to say exactly what’s going on with you without a full consultation, I suspect that your going from little animal protein to far more animal protein is stimulating gluconeogenesis (conversion of protein to sugar), especially if you’ve got some stress going on (lack of sleep, too few calories, psychological stress, etc.

    In addition, if you’ve been really reliant on sugar for energy (which I suspect you were based on your description of your old diet), your body is still not fat adapted well enough to start using dietary fat for fuel – and is converting more protein to sugar to keep you going.

    This should be a transitional period, as your body adjusts. If you can deal (and your doctor says it’s okay), continue with the program and see if it doesn’t get better within the next two weeks. I’d be surprised if things don’t start to even out by then.

    Hope that helps – and again, please make sure you’re working closely with your doc on this stuff.

    Best,
    Melissa

  20. Casey says

    Thanks so much, Melissa! I think you hit the nail on the head about gluconeogenesis. My levels start to increase 2-4 hours after a meal when the sugar has run out– I used to eat every 2-3 hours so it makes sense that this is new. For now I am giving extended boluses for meals which seem to be helping! I am definitely in it for the long run (Doc is ok with it)– I have recruited my fiance and my parents to do the Whole30 with me so no backing out now, plus I really do feel great other than some frustrating BGs!! Thanks again for your help! :)

  21. Nichole says

    I am a type one diabetic interested in the whole 30 program. My only hesitation relates to low blood sugars. If carbs are off limits, how could you possibly treat a low?

  22. Gina says

    Hi ,
    I have been a type one diabetic for over 20 years. I am 29 now and found out that I am allergic to gluten, dairy and oats. My nutritionist suggested starting paleo. I also have candida. Has anyone else experienced this??? I also have tried the ideal protein diet which worked until I went to the doctor and found out I was consuming too much protein and that it was showing in my urine.
    I wanted to try paleo. Any suggestions. Has it helped people’s A1C? How long did it take for you to see results? Also, did you drop or gain weight? I feel like any time I try something beneficial for my health I tend to gain more weight. Help!

  23. Suzan says

    My daughter is also type1 diabetic and I myself did paleo for two years – but am afraid it is truly a toxic plan. Please watch Forks over Knives and the scientific data concerning the healthy way to eat.
    A plant based diet and whole foods is a much better plan for your heart, eyes, kidneys, etc.
    Best of luck to you and best of health!

  24. whitefox999 says

    Suzan, surely you have the best intentions, but I sincerely doubt you’ve read much of the scientific research if you’re referencing Forks Over Knives. No doubt removing processed foods in favor of whole foods is widely agreed-upon by both paleo and vegetarian/vegan groups, but the concept that animal protein cause damage to the “heart, eyes, or kidneys” is not supported by research. If you disagree, please provide some links.

    Here, i’ll start: http://www.ncbi.nlm.nih.gov/pubmed/19604407
    “Over a 3-month study period, a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes.”

    The diabetes diet was plant/whole-grain based, just like Forks Over Knives promotes. T2D and T1D are both insulin-based diseases, and HbA1c improved more with a paleo diet than the diabetes diet (though BOTH were better than whatever the subjects were eating before). Thus a paleo diet should be better for diabetics than a diabetes diet. Make sense?

  25. whitefox999 says

    Gina, as you can see from my comment to Suzan HbA1c can improve with a paleo diet. Protein in the urine certainly isn’t a good thing, because it indicates kidney damage -> healthy kidneys can handle a ton of protein. Read this for more info: http://robbwolf.com/2011/06/16/clearing-up-kidney-confusion-part-deux/

    “3-Increased urine albumin: No Bueno. The kidneys are damaged, protein that should stay in the vascular system is leaking into the urine.” In the article, for a hypothetical patient with kidney problems Robb recommended “low protein (10-15% protein) low carb (less than 10%) high fat (mainly from coconut products), ketogenic diet.”

    Now, I don’t think you should go that low carb. Try carbs from veggies and fruits but cut back on potatoes/rice and see how you do. As you can see, there’s a plant focus but if you’re going to get most of your calories from fat you’ll need to eat plenty of coconut oil/eggs/avocados/olive oil/nuts.

    Ex: omelette for breakfast, salad for lunch, bit of fish and veggies for dinner, with nuts/fruits/almond butter in between. Simple enough, right? Somebody can feel free to chime in if they have any improvements to add, but try the whole “no dairy no grains no legumes” paleo thing and see how you do.

  26. Jon justh says

    Meggie, will you marry me? I need a paleo / diabetic woman! :) thanks for the post

  27. Patrick says

    I would like to ask the same question as Nichole… Did anyone address this? I am also a Type-1 Diabetic and am very interested in this program but am concerned about treating low-blood-sugars… I am nearly eating this diet now, I eat tons of vegetables, some protein and drink nothing but water and gatorade (only when I am in “a low”). I am very active… I run, lift weights and do cardio…