How to Raise a Child with Diabetes on a Low Carb Diet: An Interview with Lester Hightower

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Friends for Life, the annual Children with Diabetes conference in Orlando, begins tomorrow. We’re very excited that this year’s sessions include discussions about managing diabetes on a low carb diet.  RD Dikeman, one of the founders of TypeOneGrit, reached out to interview d-dad Lester Hightower, who will be giving a talk about his son’s low carb diet at the conference. Here’s an exclusive peek at what’s coming very soon!

Hi Lester! We’re excited to see a low carb talk at FFL 2019. Can you please tell us about yourself?

Hi, RD, and thanks for asking for this interview. I am likewise excited that there are low-carb talks at this year’s FFL Conference. Three in total, I believe.

Professionally, I am an information technology leader and software engineer. I hold a bachelor’s degree in Economics from Florida State University and my career has mainly focused on technology related to the ground, freight transportation industry, in both railroading and trucking.

Personally, I have been married for 22 years and am the father of two children. I am a student and proponent of low carb eating and Dr. Richard K. Bernstein’s diabetes management regimen. I am also a founding board member of the nonprofit Rivere Foundation, D.B.A. Let Me Be 83.

Walk us through diagnosis and how you discovered the low carb approach for your son. The information on this approach is scant now, but back then it must have been a real trick to find out how to do what you are doing.

My son, Andrew, was officially diagnosed with T1D in June of 2010, a few weeks after his 5th birthday, and our story has a frightening and all too common theme of missed diagnosis by medical professionals. In mid-April of 2010 I resigned my job, almost exactly one year after selling the company that I helped found. I intended to spend the summer with my wife and kids, trying to make up for some of my absenteeism that resulted from selling the company and the tough professional year that followed. Andrew had been ill almost constantly, for months — at least since October of 2009 — and had been on repeated rounds of antibiotics, steroids, etc. He even suffered a collapsed lung in March of 2010.

When Andrew finished school in late May, I was determined to get him out of the house and to spend a lot of time with him. In doing so, I almost immediately noticed his unquenchable thirst and frequent need to urinate. For example, we started attending afternoon games of our local minor league baseball team and I could not drive from home to the baseball grounds without having to stop at least once and sometimes twice for him to use the restroom. He also asked me for something to drink repeatedly and nearly constantly. His mom and pre-kindergarten teacher had missed those symptoms, as I am sure they came on slowly and became “normal” to them, but with my transition from a little to a lot of time spent with him, I noticed. One only has to Google “unquenchable thirst and frequent urination” to find reams of results pointing to diabetes.

Frightened, but not yet wanting to admit what was happening, I started recording the volume of fluid that our roughly 40-pound, 5-year-old son was consuming. I began doing that on June 12th and looking back on those numbers is sad for me. For example, on June 12th and 13th he consumed 118 oz of fluid and on June 16th 150 oz (1.2 gallons)! On June 13th, we purchased Bayer Keto-Diastix from Walgreens and urinalysis with those repeatedly showed 0.5-1% glucose, which translates to 500-1000 mg/dL.

Even to my untrained eye, these observations indicated a fairly clear diabetes diagnosis. I have a string of emails to myself that were sent on the afternoon of Monday, June 14th, with links to copious information about type 1 diabetes, and we scheduled a pediatrician visit for the morning of Tuesday, June 15th. Feeling sure that a T1D diagnosis would occur, and with that, blood labs, we fasted Andrew on the morning of the pediatrician appointment. As a result, his blood glucose level was only 157 mg/dL when tested in the office and we were told that he was likely just fighting a virus. My wife and I were well past such glib answers, insisted on a pediatric endocrinology referral, and that appointment was set for 12:45 pm on Thursday, June 17th. Andrew did not fast that morning and in the endo’s office his blood glucose was 444 mg/dL, his A1c was 10.6%, and he was immediately hospitalized for three days. He was not yet in diabetic ketoacidosis (DKA), but a three-day hospitalization was protocol, primarily so that my wife and I could be trained in diabetes management.

Recall that I was unemployed, and so I poured myself headlong into diabetes research. The life-altering event was an Amazon.com order that arrived on June 30th. The big win from that order was Dr. Bernstein’s Diabetes Solution, but Jenny Ruhl’s Blood Sugar 101  was smaller and more approachable, and I believe that I read it first. The Eades’ book, Protein Power, was reassuring about the safety and benefits of moving my son, and our entire family, to a very low-carb, high-protein (LCHP) diet. Looking back at our food diaries, there is a marked reduction in carbohydrate intake on June 27th, but with some occasional high-carb experimentation with items like Glucerna Cereal with Hood low-carb milk until July 12th, at which time it appears that we stopped trying to cling to our high-carb past. The food diary and blood sugar meter readings guided us through that time of wanting to cling to the past and into our healthy, low-carb, high-protein and excellent blood sugar management future.

HbA1c since diagnosis

We know that low carb means to remove grains and sugars, but what else? What is then the focus of your son’s diet? Can you give an example of a day of meals?

Most of our meals are simple. They are anchored in an animal protein – meat, eggs and/or dairy – and complimented with green/leafy or other low-glycemic vegetables, with a small amount of tree nuts, and sometimes include a minuscule amount of berries. Example vegetables include asparagus, broccoli, green beans, turnip-, mustard-, or collard-greens, spinach, zucchini, summer squash, okra, cauliflower, etc. We also often eat salads with animal proteins added. Our goal is to provide excellent nutrition while avoiding rapid increases in blood sugar, and so we completely avoid things like breads, pasta, milk, corn, beans and rice.

As for an example day:

  • Breakfast: Scrambled eggs, sausage, 4 oz of a very low-carb yogurt, 1 oz of raw pecans, and 2 tbsp of diced blueberries and strawberries.
  • Lunch (at a BBQ joint): 3-rib plate (pork) with a double order of green beans and a side salad with ranch dressing.
  • Dinner: T-bone steak, yellow squash, broccoli, and a piece of low-carb frosted cinnamon bunt cake.

We are not deprived!

How well did your family adapt to low carb? 

Honestly, I think it’s easier when you have a young child at the center of it all. Our love and concern for him overwhelmed most qualms that we may have otherwise had. Plus, we not only saw the immediate improvements in his blood sugars, and therefore quality of life for all of us, but my wife and I started shedding excess body weight. At this point, over nine years later, it’s second nature. It’s a chosen lifestyle, not a diet.

On its face, it never really made sense to eat a high carb diet since carb is the most potent determiner of postpradial blood sugars and high blood sugars cause the complications. Why do you think this high carb approach is so universally pushed while we can see with our own eyes the flat cgm graphs and nondiabetic A1c results the low carbers are attaining?

Most likely, the lipid hypothesis (also known as the cholesterol hypothesis), but I really don’t know. Honestly, I don’t care; I just want to see it change. Unfortunately, change is hard and it takes time, plus there are many players involved that have vested interest in the status quo.

Besides the low carb what tips and tricks have your learned that have been the most important to you?

Low carb is vitally important, but it’s only one of the three main pillars that I think of in Dr. Bernstein’s regimen. His regimen is basically feature-complete – nearly all-encompassing – and most aspects of it are important. His national bestselling book is over 500 pages long and that much information is impossible to boil down to a simple explanation, but this is my best attempt to describe what I consider to be the three main pillars:

Low-carb, high-protein diet

  • Carbohydrate has a limit.
  • Protein has a goal.
  • Fat comes along for the ride.

Properly using insulins

  • Using the correct insulins.
  • Proper dosing and timing.

Precisely correcting lows

  • Using measured glucose doses.
  • Not over-correcting.

 

FFL 2019 - Success with Dr. Bernstein's Very Low Carb Diet

Where can we learn more?

From my Children With Diabetes Friends For Life Conference speech in Orlando on July 19th, of course.

But I also recommend LetMeBe83.org.

 

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I am a huge Dr. Bernstein fan as well – I’ve eaten low-carb for six years to manage my type 1. One of the most important “tips” I learned from his book is, to fix a low blood sugar, eat something that is mainly dextrose. It’s the simplest form of sugar and is therefore absorbed by the body the fastest, thus giving one the quickest “relief.” Orange juice was always my go-to before learning this, and I suffered for considerably longer and was more likely to overcorrect. I also never buy glucose tablets: Smarties, Sweetarts, and Bottle Caps are what… Read more »

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