Personally, I think DAFNE is the key – with that knowledge, you can handle any food you want. I find the Bernstein “all carbs are evil” approach a little too extreme for my liking. I do like carbs, and with DAFNE I can eat them and get perfectly good control.
That said, if I want to get really tight control, or if I’m having issues and want to try and settle things down a bit, I find it easier if I eat fewer carbs. By fewer I mean probably less than about 90g a day, nothing like the small amounts Bernstein advocates.
The truth is that the best route is whatever works for you, as an individual. Nothing else matters. Juggle kippers for 28 minutes every morning if you find BG nirvana always follows (actually that’s one thing I’ve not tried yet). D is frustratingly fickle and individual. While it’s great to compare notes and share experiences for ideas, it soon becomes clear that what works for one person won’t necessarily work for you.
I think the DAFNE promise of ‘eat whatever you like and just shoot for is’ is unrealistic. Similarly, extremely low carb would drive me (and my family) mental as it is quite difficult to manage in many social situations. Added to that very low carbers seem to find that their body becomes increasingly adept at converting protein and fat to glucose, but since this conversion takes much longer it can make the use of current ‘rapid’ insulins a bit tricky without some fancy dose splitting as the insulin might be acting more quickly than the food.
I guess I average about 130-160g a day. I’d agree with Bernstein’s general idea of ‘smaller doses, smaller mistakes’, but will also quite happily have an entire day’s worth of carbs in a chip shop blowout from time to time. On the whole though (perhaps because of the advice I was given at diagnosis all those years ago) I fare best sticking to fairly consistent, fairly moderate carb.
Bernstein is all very well, but sounds like a pretty miserable existence! Also, his method was developed in the 1970s, before the development of fancy modern insulins & treatments, so to me seems rather outdated. Faster acting analogue insulins mean that us modern diabetics can eat carbs while still maintaining reasonably good control. Dafne rules!
(also, anyone else mildly offended by Wikipedia’s claim that Bernstein “at 74 years of age, has surpassed the life expectancy of type 1 diabetics”?)
I’m nearly 2 years into being a T1 and did my DAFNE 1 year ago. Pre and mostly post DAFNE I stuck to circa 100g of carbs a day and had it fairly much buttoned down. With DAFNE you can choose to be low carb or not. In the last 4 months I’ve chosen not to be so low carb and have put on half a stone in weight (8st 7 to 9st)… (holiday, giving up the smokes and generally needing chocolate!) This half a stone has made a big difference to my insulin intake including my background. So, I’d say yes to DAFNE but don’t do what I’ve done and actually eat what you want all the time….
Since diagnosis 6 years ago I’ve made absolutely no* changes to my diet at all – I tend to eat the usual mix of high carb / low carb food and just bolus accordingly. Works for me and, in any event, I could never ever ever stick to any sort of lower carb diet – I have no willpower at all.
* I do tend to avoid orange / apple juice though – I find it a real pain to get right in terms of balancing it.