[phasetransition]

Our almost 5 year old has had T1D for two years. We ended up going the way of a controlled lower carb diet for our entire family. Other than the greatly increased cost to eat this way, it has been transformative for diabetes management of our son, the amount of sleep we get, and the lessened risk of aggressive lows.

We've managed to keep our sons A1C in the 6-7% window after we changed our diet to be heavily carb controlled.

[layla5alive]

That sounds like great family teamwork. I wish my partner would entertain changing their diet to accommodate this (I've asked). I imagine the challenges of life are slightly more tractable when you genuinely deal with serious adversity as a family unit.

I understand it means an extra burden for all; but to me, voluntarily doing something challenging together for a family members' benefit seems preferable to facing each adversity largely independently.

As an aside, while likely much better than uncontrolled, 6-7% A1C still seems on the high end for lifelong. You probably already know this, but exercise immediately after carbohydrate consumption can also help - e.g. family walk after dinner (another thing my partner isn't interested in)

[slowking2]

Although it's possible for someone with type 1 to have an A1C below 6%, it's very difficult. I've known a few people like that, and they are all super users. It's also going to depend somewhat on the lab running the A1C test, personal biology (A1c is not only affected by blood glucose levels) etc. 6-6.5% is superb control! Parent should be very proud. 6.5-7% is still very good, I haven't looked at the distribution of A1c's for T1D recently, but that would be much better than median which I think is above 8%.

Especially with kids, it's difficult since you don't control how much they decide to eat making pre-bolusing meals challenging (part of why reducing carbs tends to be helpful for people is it reduces the need to pre-bolus and makes it less risky since you need less up front meal insulin).

[layla5alive]

I didn't mean to say it's not superb control for someone with T1D, only that there are likely still some negative health consequences at 6-7%, and that exercise after carbohydrates is one mechanism of potentially getting some additional marginal improvement.

[rzmmm]

This is good advice for pre-diabetics and type 2 diabetics but in type 1 diabetes exercise after meal often makes things worse. It makes insulin dosing less predictable.

[phasetransition]

We changed the entire family diet in part to help him not develop any complexes around food.

We would like to get him in the 5's, and I believe we'll get there. He was below 6.5% every checkup so far except the most recent one.

Between honeymooning and growth hormones, it's difficult to keep him in range from 10pm to 3am, while also not triggering a low after his stomach is empty.

[guerby]

Great work!

A researcher with T1D and present online:

https://andrewkoutnik.com/ https://x.com/AKoutnik/

Interview:

https://www.youtube.com/watch?v=CG8UU7P8FBU Can Keto Transform Type 1 Diabetes Treatment? A Decade of Insights from Dr. Andrew Koutnik