Meet Sara, a 63-year-old type 1 diabetic who is very active.
Sara had gestational diabetes during her second pregnancy. She used a meter to measure her blood glucose and consulted with a dietician, who advised her to eat a lot of carbs. She thought it was bad advice and designed her own low-carb plan. Sara gave birth to a healthy baby.
Sara never considered type 1 diabetes an autoimmune disease, so she didn’t make the connection that her earlier diagnoses of Graves disease at 12 and Hashimoto’s at 19 put her at an increased risk for other autoimmune diseases. Additionally, her sister has rheumatoid arthritis, and her mother died of a rare autoimmune disease.
Sara realized she was at greater risk of getting type 2 diabetes because she had gestational diabetes and ate what she thought was a good diet, including lots of fruit and grains. Despite biking, running, and teaching a spin class, her A1c continued to rise. In 2011, at age 51, Sara was diagnosed with breast cancer, and six months later she was diagnosed with type 2 diabetes. Her fasting blood sugar went from 91 to 163. Sara says this was a “big wake-up call.” Her doctor prescribed metformin.
On an easy bike ride, she had an elevated HR of 163 and later learned that metformin raises exercise HR significantly.
Sara felt something wasn’t right, so she consulted with an endocrinologist. After reviewing her history and taking one look at her—she’s 5’5” and weighs 130 pounds—he proclaimed she wasn’t type 2. She presented with none of the risk factors: obesity, a history of heart disease, smoking, or a sedentary lifestyle. He diagnosed Sara with latent autoimmune diabetes in adults—type 2 LADA—a subtype of type 1 diabetes, sometimes called type 1.5.
He told her to eat whatever she wanted and take her insulin. She included lots of fruit in her diet. Sara started gaining weight—15 pounds in 4 months.
On a diabetes group online, she noticed people were crushing their numbers with low-carb. The postings of CGM—continuous glucose monitor—trace readings were great. Sara wasn’t experiencing them and decided to go hard-core low-carb. Today, she’s usually under 30 grams of carbs a day and has been low-carb for 10 years.
Recently, her A1c (a blood test that measures average blood glucose for the last three months) was 4.5—a very healthy score. Her coronary artery calcium score (CAC) was zero, meaning she has no calcified plaque in her arteries.
Sara says, “I’ve never felt better, and I’m 63 and can do a lot of stuff 30-year-olds can’t.”
Sara focuses on protein and fat and thinks this is particularly important for postmenopausal women to build muscle and strength. She describes her meals as “protein led, filled in with veggies.” She eats meat, eggs, low-carb veggies, and cheese, and puts cream in her coffee. Her snacks can’t require insulin—she can have a few berries with cream.
Sara eats her first meal at noon. This window of fasting has made a huge improvement in her insulin sensitivity, and she says it’s reduced her basal insulin needs by 2 units.
As an exercise enthusiast, Sara prefers using a pump to administer her insulin. On long bike rides, she may have a dip in blood sugar, and a pump is an easy way to manage her blood glucose levels.
Sara is active in the LADA community on Facebook. “When you find the path or door out, you want to share it.”
