Flattening the CGM Curve: How I Avoid Roller Coaster Blood Sugars

Flattening the CGM Curve: How I Avoid Rollercoaster Blood Sugars

As a teenager with Type 1 diabetes, my two top-level goals are having the same blood sugar levels as the healthiest non-diabetic and helping other people with  Type 1 diabetes learn how to achieve normal blood sugars and flatten their CGM curves. To reach both goals, I follow Dr. Bernstein’s low carb approach laid out in his book Diabetes Solution, and I share my results on social media.

When I was diagnosed with Type 1 in 2013, the Bernstein protocol was not well known, and only now is it beginning to get real traction. Once considered dangerous, Dr. Bernstein’s low carb information used to be hard to find, and so I consider others’ social media sharing of glycemic results to have saved me. Even at the age of 9 when I was diagnosed, I understood that the flat CGM lines I saw from others, and then on my own CGM graph, were key to a healthy life with Type 1 diabetes. Together with my dad and Dr. Bernstein, we started sharing my CGM results on social media and developed Dr. Bernstein’s Diabetes University on YouTube, to disseminate information on implementing the low carb approach to normalize blood sugars. Here, I continue to share my numbers in hopes that it will encourage others to discover the low carb approach and set similar short and long-term goals. The truth is that anyone can have the same success that I have had.

 

Blood Sugars:

Target Range: My goal is healthy, normal blood sugars and that means I keep my blood sugars consistently between 70 and 100 mg/dL. This results in the flat lines you see above in my continuous glucose monitor data.

HbA1c, Average BGL and Standard Deviation: My last A1c was 4.7%, and in the past 90 days my average blood sugar was 86 mg/dL, with a standard deviation of 18 mg/dL.

 

Diet:

How much carb and what type: I eat about 30g of carbs a day, typically in the form of fibrous vegetables for phytonutrients. I do not eat grain, starch, sugar or sugar fruits.

How much protein: The emphasis of my diet is healthy protein foods. As I am a growing and very active teen, I aim for 2g of protein per lb of bodyweight or more. I don’t limit my intake of protein foods. Basically I eat a simple ‘meat and veg’ diet with the occasional low carb treat thrown in.

How many calories: I don’t know. I use satiety as a guide for food quantities and eat regular meals.

Cheat meals: I have never cheated with high carb foods. There’s no point to it.

 

Insulin:

Basal: I use Tresiba and have traditionally split the daily dose, but recently switched to one shot a day in the morning. My basal dose has decreased somewhat dramatically as I have moved out of puberty and in the last year has gone from 35u a day to 20u a day.

Bolus: I use Humulin-R (Regular), per Dr. Bernstein’s protocol. Regular insulin is slower acting than the ultra-rapid insulins and is a perfect match for low carb, high protein meals. I typically bolus 6 to 10u per meal. Using Regular insulin eliminates much of the cognitive load of worrying about roller coaster blood sugars throughout my school day and is truly ‘set it and forget it’.  Using Regular in conjunction with a low carb diet has dramatically increased my quality of life.

Corrections of highs: I use small doses of Novolog to correct high blood sugars (I tend to correct anything over 110 mg/dL). When needed, as instructed in Dr. Bernstein’s book, I will use intramuscular injections. I haven’t been over 200 mg/dL in years and am rarely over 140 mg/dL.

 

Hypoglycemia:

Corrections of lows: I treat all lows with glucose tabs and preferably liquid glucose which I make from a weighed amount of powdered dextrose (glucose). Correcting with glucose is fastest and most accurate per Dr. B.

Number of severe lows: A major benefit of the Dr. Bernstein protocol is that I really do not have severe lows and do not fear hypoglycemia.

 

Healthy Growth:

I know some parents fear that a low carbohydrate diet may be bad for the growth of their children – if you look into the research, the truth is the opposite. It is the high blood sugars that stunt growth. I’ve been on my current growth trajectory since I was diagnosed and started low carb at age 9. I’m 16, I am 6’1” tall and weigh 170 lbs. I play football and basketball at the varsity level.

That’s a quick summary of my numbers and it is important to note: I am now not alone. Things have dramatically changed since I was diagnosed in 2013 and there have been significant strides in the treatment of Type 1 diabetes. The low carbohydrate approach has gained momentum as a viable treatment option. A Harvard study published in the journal Pediatrics and covered in the New York Times demonstrated unprecedented glycemic control for type 1 diabetics following a very low carb diet for Type 1 diabetes, and there is a documentary on the power of low carb diets for Type 1 diabetes in final editing stages. Best of all, we see a proliferation of enthusiastic sharing of flat CGM lines and low carb recipes in social media, which are a testament to the changing times and a continuous inspiration. Flat CGM lines are everywhere.

I know that by continuing to achieve my daily, measurable glycemic goals, I can achieve my long-term goal of a long, healthy, and complication-free life. I hope that sharing my numbers will help others learn about their options, find the motivation to commit to this protocol, normalize their blood sugars, and achieve a healthy life without roller coaster blood sugars.

David Dikeman
David Dikeman

David Dikeman is a 16 year old type one diabetic diagnosed at the age of 9. Since diagnosis he has followed Dr. Bernstein’s low carb high protein protocol and has consistently attained A1cs at 5.0% and below while averaging blood sugar in the 80s. David is a passionate advocate for type 1 diabetes management and has spoken at children’s hospitals and nutrition/metabolism conferences. He is currently working with Dr. Bernstein as an intern and will be pursuing a career in the field of medicine.

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Tom Wolff
Tom Wolff
3 years ago

You didn’t mention which CGM you use, and why.

DianaH
DianaH
3 years ago

Very useful information, David! I am also trying to improve A1c and using the FreeStyle Libre sensor with the NightRider and LinkBluCon app to keep track of change in my glucose levels. Reason I brought NightRider and LinkBluCon app because they helped me in finding which specific food is increasing my glucose and how much which is helping them in picking the right quantity and food. I just the a picture of the food I am about to eat and “Food Insights” option in the LinkBluCon shows how my glucose is changing in the next 3 hours

TP
TP
3 years ago

Great article! My son was also dx at 9 yrs old is 17 now. Would love for you to put together an article of a weekly meal plan, one detailing the nitty gritty of this approach. I think in order to reach teenagers with this way of eating they have to see it can be achieved. Thanks for sharing.

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