mono812

In general yes, but again, unfortunately there are a lot of complicating factors. I can eat meals with 60g carb content and have my blood sugar levels barely move at all and I can also have, for instance, a beer with 15-20g of carbs that causes a 6 to 8 point rise. The trickiest part for me is finding the right balance between not having a massive meal peak, but also having stable levels in between meals. What works best for me personally is eating 'slow' meals i.e. meals that have a low glycemic index. These don't necessarily have to be low on carbs, but should be high in fiber, protein and unsaturated fats, which again is also very personal since each of our guts responds differently resulting in different rates of blood sugar production for different meals.

The problem with just eating low carb meals in my case is generally that it offsets the balance in between meals, i.e. I'll start seeing a consistent rise that might be something like 0.5-1 point per hour which eventually adds up. Of course you could increase your baseline insulin to offset that again, but it requires a lot of experimentation to get that balance right.

I do occasionally switch out my somewhat carb heavy lunch for a lighter low carb meal if I'm really busy and don't have time to go for a walk for instance. Generally that does work just fine to keep the initial rise low, but requires another 2 units of insulin about 2.5 hours after the meal because my blood sugar level keeps rising.

So in short, yes moderating your carb intake and especially ensuring your meals are slow are ways to make managing your blood sugar levels easier, but in my opinion it still requires experimentation to find out what works or does not work for you personally.

Imho you can't really do a zero carb diet that's healthy. Keep in mind that even leafy vegetables have a bit of carbs in them. Low carb is possible and does indeed generally keep your blood sugar levels more stable. But even a meal that's mostly low carb vegetables and some meat still requires insulin if your pancreas has stopped working entirely.

I'm obviously a patient and not a doctor, but from what I've read as a Type 1 diabetic with (next to) no insulin production you have a life expectancy in the order of weeks, no matter what your diet is.

It's actually a quite complex question that does not have a clear cut answer. In case of T2D you can 'go into remission' meaning you can get your blood glucose levels to 'normal levels' with little or even no medication (T2Ds are not necessarily using insulin, they can also use medication that increases insulin sensitivity such as metformin). Generally weight loss, exercise and a healthy diet are what allows them to accomplish that and a keto / low carb diet can definitely help there.

For T1Ds I'm afraid even a keto diet still contains too much carbs to live healthily without insulin. Unfortunately if your body has fully stopped producing insulin and you don't take any artificial insulin your life expectancy is not looking good regardless of how you live.

Interesting stuff! I'm a late T1D and there is just so much that subtly influences your blood sugar levels. I adhere to quite a strict diet and adapt my insuline dosage based on not just the carb contents and glycemic load of the meal, but also the starting point / trends I see in my libre readings. If you can predictably consume carbs (and glycemic load) you can also inject early with confidence (or even post-meal if your meal is really 'slow' or your blood sugar level is low). Going for a 20-30 minute walk during a meal spike (mostly after breakfast and lunch) does wonders for me too.

I manage to maintain roughly 99% TIR (4-10mmol/l) on my Libre with this, virtually no hypos and just the occassional bit of hyperglycemia when I just don't want to care. Although obviously this does require you to plan a lot of things in advance and requires effort and all of this is just based off of personal experience and experimentation and does not necessarily translate to anyone else.

I'm still really hoping for a more low-effort solution to T1D treatment (or even a cure), but I'm skeptical that we'll see that anytime soon.