20-50g: How Low-Carb Should a Type-1 Diabetic Diet Go?

When Nicole first began to normalize her type-1 diabetic bloodstream, she began by eating less than 20g of carbohydrates a day (not including fibre). Her HgbA1C went from 8.0% to 4.5% in under six months. Dark, depressive moods disappeared. Sugar cravings vanished. Energy increased. Hair stopped falling out. Her brain function improved. And… she had uncontrollable episodes of diarrhea.

Everything we tried wouldn’t stop the diarrhea. If she ate food, she’d have diarrhea. If she didn’t eat. She wouldn’t. She tended to skip breakfast, and only go out in the morning. This way she could get home for an early lunch, and a day of running to the bathroom.

Finally, we tried adding a little carbohydrates back into the diet. Mainly cooked carrots, beets, onions and peas. About 3/4 cup (measured raw) per meal. This totaled around 40g of carb a day. The diarrhea stopped. Her HgbA1C rose to 5.0%. And the sugar cravings came back on occasion. Energy levels decreased a bit.

Despite the extra carb, and slightly higher A1C, three years later, her thyroid recovered its function, her adrenals normalized, her gastroparesis became a memory. All impressive results. But when you’re still dependent on a dialysis machine to keep you alive, you know things could be a lot better. We’ve been working with Dr. Artour Rakhimov. He is certified in the Buteyko Method – an approach which has been reported to reverse kidney failure in Russia. Dr. Rakhimov  recommended Nicole try the ketogenic (high fat, low carb) diet again, in order to improve oxygen and blood circulation to the kidney tissues (along with the rest of the body).

We were reluctant for two reasons. First, because of the diarrhea Nicole experienced before. Second, because renal failure already restricts so much of what Nicole can eat. If you think low-carb is hard, try adding: low-sodium, low-potassium and low-phosphorous. (Please, don’t wait until your kidneys fail to start changing your diet.)

“Let’s try it for three days,” Nicole said the weekend before last. “See what happens.”

So we reduced the onion in her morning fritatta from 1/2 cup to 1 tablespoon. For lunch we removed the carrots and added more low-carb vegetables. She decided to have all her protein at lunch and breakfast. For dinner, she’s been eating 80% low-carb vegetables, with a 1/2 cup of carrots or beets. All dishes contain generous amounts of clarified butter and a tablespoon of fish oil on the side.

Today, it’s 11 days later and she doesn’t want to stop. She has not had any bowel problems at all this time around. Of course, she’s done at least 1,000 coffee enemas in the last two years. A lot of gastrointestinal healing has happened.

And, as before, she is finding life easier at the 20g per day carb line. Her energy is so much better that she’s been doing chores (like laundry) which she wasn’t able to do before. Carb cravings have lessened almost to nothing. Her blood sugars are noticeably more stable. We can probably expect her next HgbA1C will drop to the 4.5-4.9% range. Her moods been better. And, she’s scoring much higher on the body oxygen test (something I will discuss in a coming post).

But what about those low-carb meals?

“Delicious,” Nicole says. “I find them calming.” I thought she’d find them austere. But she’s happy as long as they are covered in our homemade sour cream. I’m sure some extra salt would be nice, but we’ll have to wait until those kidneys are functioning better.

Nicole's favourite breakfrast. A fritatta made with 3 eggs, 1 cup of frozen spinach, 1TB of onion, curry and ghee. Covered with 1oz of raw grated cheddar cheese and more sour cream. 2-3g carb.

Nicole’s favourite breakfast. A fritatta made with 3 eggs, 1 cup of frozen spinach, 1TB of onion, curry and ghee. Covered with 1oz of raw grated cheddar cheese and sour cream. 2-3g of carb. 4 units of Regular. Spinach makes for a very low-carb breakfast, which compensates for slightly higher carb lunch and dinner.

4oz of ground lamb, 2 cups of green beans, garlic, oregano, 2TB butter (with 1TB fish oil on the side). 8g carb. 24g protein.

A classic lunch dish, 4oz of ground lamb and 2 cups of green beans stewed with a little onion, garlic, oregano and clarified butter. 9g of carb. 5 units of Regular.

4oz chicken and 1 cup of celery root (celeriac) and 1 cup of celery roasted with a little onion, curry and ghee. 10g of carb. 5.5 units of Regular.


For dinner one night, 1-1/2 cups of green beans and 1/2 cup of carrots baked in curry and ghee. Served with a dolup of sour cream and a raw egg yolk. 9g of carb. 5 units of Regular.

About the Author: John C. A. Manley researches and writes about alternative treatments for type-1 diabetes and its many complications. His wife, Nicole, of 15 years has had type-1 diabetes for four decades. Together they have lowered her HgbA1c below 5.5%, regained thyroid function, increased kidney function and reversed gastroparesis. Read more about their journey out of the T1D matrix or subscribe to their Diabetic Dharma blog..