LCHF diabetic cyclist…

…now there’s a mouthful. The low carb high fat lifestyle (LCHF) is a way of eating that has been applied to many different goals. Also known by the synonym ‘Ketogenic diet,’ the idea is to switch your body from burning carbohydrates to fats. While also sometimes compared to the Paleo diet, there are some subtle differences there.

For some, LCHF is a temporary transition with the sole purpose of causing your body to burn off body fat. Here, the primary goal is weight loss, and often it is adopted only for a short period of time – weeks to months. In addition, many athletes have adopted the approach for performance reasons only. As with all things diet related however, there is ample conflicting information regarding the success of this approach.

There is, however, a third group that has adopted this lifestyle for completely different reasons. That group is Type 1 diabetics.

Cue Dr. Richard Bernstein. He has reached near-celebrity status among some in the diabetes community by touting the advantages “Intensive dietary management” of type 1 diabetes. As a type 1 diabetic myself, that also just happens to fancy himself something of an endurance athlete, I thought I owed it to myself to at least give this a try. After about 4 months, I’ve made my decision.

But first, let me be very clear here. There are many factors that come into play here. Everybody has different metabolism, different bodies, different dietary needs. What works for me may be terrible for others (or vice versa.) I’m also not a doctor. Like… at all. I’m just relating my own, personal experiences here. Do with it what you will.

Living with and managing type 1 diabetes is a continual balancing act. While maintaining proper blood sugar levels is indeed important, it must also be balanced against quality of life, as well as other (sometimes competing) overall health choices. With this in mind I started down the LCHF road.

The first couple of weeks were exactly as expected. The absence of carbs sent my metabolism into a tail-spin. Energy levels were at an all time low. Time on the bike switched from something I enjoy to something I just worked through to get to where I was going. But, also as expected, that extreme seemed to taper off.

Soon I was cruising along, pedaling more normally, and… my blood sugar levels were way more stable then they had been. Perhaps ever. One month went by… two went by. Before adopting the LCHF lifestyle it was not entirely uncommon for me to have swings of 80-100 within 30-45 minutes. Now, I was within a range of +/- 20 mg/dL throughout an entire day. Things were looking good.

But then something different started creeping in. My overall blood sugar levels were rising consistently. I found myself needing to correct for high blood sugar levels more and more. I started bumping my basal levels up. Things came back down… only to creep back up again.

One of the adaptations to the LCHF lifestyle I’d learned from others I talked to is the need to transition to taking bolus insulin in response to proteins as I previously did for carbs. I started experimenting here too, but it soon became clear that meals weren’t my problems. I would wake up in the morning and find a steady, consistent rise in blood glucose levels throughout the night on my continuous glucose monitor.

Interestingly enough, it was a completely different source that finally lead me to understand what was happening. That source: Strava.

Turns out that I simply in the same number of miles I had been previously. Initially I attributed this to a number of things. Office had been relocated, cutting my daily commute in half. The route also cut out most of the hills I’d been climbing to the office before the move.

But the most startling fact I learned from Strava was that I simply was not riding as often as I used to. I’d take public transportation a lot. Even when my commute was longer, I used to intentionally go out of my way to tack on miles, just to get some extra riding in. I didn’t do that at all any more. In fact, I began to realize that I was simply suffering through the ride to get to where I was going.

I wasn’t riding nearly as strong as I had before, and therefore was not enjoying it as much. By not enjoying it, I was avoiding it more and more. By avoiding it more and more I was losing the blood glucose management benefits of all of that exercise.

Without me being conscious of it, the diet change had impacted my cycling in a negative way. I’d traded energy and enjoyment on the bike for better control of blood sugar. That trade was beginning to have negative impacts on all aspects of my life – health, happiness. And, somewhat paradoxically, was now also beginning to undermine the very benefits to blood sugar management that I had hoped to gain.

For me the choice was clear. I’d given it a good go over several months. But my experiment with LCHF didn’t provide the overall results I was hoping for. It may work wonderfully for some. But with all things being considered it simply wasn’t a good fit for me.

And that brings us back to the balance I was speaking of earlier. Managing diabetes is a lot more than tracking blood sugar levels on a meter. That is a big part, but not necessarily even the most important part. Cycling provides a great deal of joy in my life. It is my primary stress management technique. It has positive impacts on personal relationships in my life. It has a positive impact on my professional life – I do better work on the job. Removing that from my life at this point would have a large number of negative impacts. And for me, maintaining a tighter control of my blood sugar is not worth sacrificing all those positive benefits. That doesn’t mean I won’t continue to monitor my blood sugar closely. I will continue to strive to understand how specific foods impact my blood sugar levels. But I also hold on to the belief that allowing my blood sugar levels to creep up to 140 or 160 after a meal is far less detrimental to my overall quality of life than not riding my bike any more.

My most important lesson out of this, however, is to always question. Always reevaluate your assumptions. It is good to experiment with different ideas. Just try to remember that a good life is an extremely complex tapestry. Focusing entirely on one particular thread can easily distract you when the other side of the tapestry is unraveling.