Back when I first started writing about life with diabetes on this site, I wrote an article called Why I Started Following a Low-Carbohydrate Diet After Almost a Decade with Diabetes. It has now been a little over three years since I decided to markedly lower my carbohydrate intake in an effort to optimize my day-to-day blood glucose levels. So, I decided it was a good time to reflect on sticking with the plan for several years, and sharing what my life with diabetes looks like on a typical weekday.

5:00 am

In my world, it’s time to rise and shine, and I glance right away at my iPhone to see where my blood glucose level is tracking according to my Dexcom G6 continuous glucose monitor (CGM). More times than not, there have been no overnight alarms and I am greeted with a value in the normal, double-digit range. I take my morning Levemir injection, which varies depending on what part of the monthly cycle I am in, and also administer a small amount of Humalog if my blood glucose level is over 90 mg/dL.

After a shower, I prepare for breakfast and will often take a fingerstick reading to gauge whether dawn phenomenon is occurring today. I bolus for my breakfast as I prepare it. Usually, it consists of eggs, low-carb toast and avocado or eggs with tomato and avocado or sometimes extra protein (like bacon and cheese). One very consistent variable is coffee, which I drink with unsweetened almond milk. At this time, I also adjust my low alarm from the nighttime 60-65 mg/dL to the daytime 70-80 mg/dL.

After breakfast, I get to work. I work from home as a full-time biology professor online, as well as a part-time diabetes writer and editor here. I don’t often look at my CGM data as I work, because I know that my Apple watch will buzz if my blood glucose crosses the lower or upper threshold (which is usually set to 120-130 mg/dL). Most days, it does not go out of range, but if it does touch the upper limit, I quickly administer the appropriate insulin correction, make a mental note of it, and move on with my day. I have always found mornings to be the trickiest when it comes to insulin dosing, so sticking to a very consistent low-carb breakfast helps immensely.

7:00 am

My daughter usually wakes up at this time and we spend some time playing and then she has her breakfast. At this time, I do some basic cleaning and house chores and prepare to take her to daycare. Usually, my blood glucose levels are stable and don’t require more input of insulin or glucose to stay in range.

9:00 am

As I drive back home, I often stop by Starbucks for a second coffee. My order varies, but I keep it low-carb by sticking to a limited amount of cream and sugar-free syrup (if any). Usually, as with my morning coffee, this requires a small amount of Humalog (typically only ½ unit). I spend another few hours working, and my blood glucose levels are typically uneventful during this time.

11:00 am

It’s time for lunch, and my absolute favorite is an enormous salad with a source of protein and full-fat dressing. Usually, it comes in at 12-15g of carbohydrate and about 24-30g of protein. Typically, the base ingredients include assorted lettuce, spinach, cucumber, tomato or Pico de Gallo, olives, avocado or guacamole, and sometimes fresh herbs from the garden. The protein source is either chicken salad, grilled chicken, leftover steak, tuna salad, or salami, and sometimes, feta cheese. I use different salad dressings, including Caesar, Greek, or one that I make on my own. My favorite home-made recipe is to combine olive oil and red wine vinegar and add salt, pepper, oregano, and garlic powder.

2:00 pm

After another few hours of work, I really cannot ignore my smartwatch anymore. Time to stand, Maria! So, I try to engage in some physical activity. Often, it’s just cleaning, whether around the house, or outside, dealing with the chicken coop, etc. If I feel that I have the time, I may take my four dogs for a quick walk, down to the river abutting our property. Thankfully, I do not feel guilty for not doing this every day, as we have plenty of backyard space for canine free-play.

I find that the middle of the day is my most predictable and stable when it comes to blood glucose levels. My lunch typically keeps me quite full. If I ever find that blood glucose levels are trailing down due to particularly vigorous physical activity, I usually eat a handful of nuts and this remedies the situation. If I do ever find myself wanting a snack mid-day, some favorite choices include low-carb pancakes, nuts, cheese, an open-faced, low-carb sandwich, or seaweed with cream cheese, smoked salmon and cucumber. If I have non-starchy veggies, like peppers and celery, available in the fridge, they also make a good snack, with salad dressing or guacamole.

4:00 pm

It’s almost time to go pick up my daughter, and I start to think about the dinner menu if it isn’t already happening in the crockpot. Sometimes at this time of the day, I notice a slight increase in my blood glucose level, as the evening Levemir dose is upcoming soon. If needed, I administer a small correction with Humalog. At around 5 pm, I administer my evening Levemir dose.

6:00 pm

It’s dinnertime and it often involves a low-carb casserole, pot roast with vegetables, burgers (bun-less for me) with salad, or any variety of baked or grilled protein sources with a vegetable casserole or baked or sautéed non-starchy vegetables. There are so many different options when it comes to preparing protein and vegetables. I am somewhat guilty of sticking to tried-and-true recipes, but I think I need to get more adventurous and try new things!

Next, it’s family time and we soon prepare for our daughter’s bedtime routine. Usually, my blood glucose levels are quite stable, although sometimes, particularly when the meal is higher in protein and fat, the Humalog dose timing can be a bit off and I may experience a slight drop in blood glucose levels at around the 1.5-hour mark after the meal. I rarely need to correct this, as my blood glucose level will typically trend back up as the protein digests. If needed, I eat a few Extreme Sour Smarties, my favorite choice for treating hypoglycemia.

Many people find that using regular human insulin (R) can circumvent this timing issue. Since I don’t often find it to be a problem to use Humalog to account for the protein content of the meal, I do not use R. However, if I find that a particular meal does not match my bolus timing, I may choose to administer the dose after I finish eating, or intentionally eat any carbohydrates on my plate first.

8:00 pm

Unless I have pressing work matters to catch up on, this is usually my kick-back-and-watch-TV time. Also, I often have a glass of dry red wine at this time. I find that I do not require any insulin for a glass of Cabernet Sauvignon or Pinot Noir and many other varieties. If I find that my blood glucose level is a bit lower than usual, I will often have a piece of cheese or two as I drink my wine. Usually, I also adjust the low alarm on the CGM back to the lower threshold, as the food variable no longer applies, and I will (likely) not have any fast-acting insulin on board until the next morning.

10:00 pm

Lights out is between 10-11 pm, usually. Right before bed, I do some core-strengthening exercises, and they usually do not affect my blood glucose level. I cross my fingers and toes for no overnight alarms and prepare to rest for another day.

Weekends in my world are definitely more eventful and a lot more fun! Most often, they involve eating out, and I have gotten quite good at adjusting menu choices to suit my needs over these last few years.

Sometimes, and particularly in the winter, I also make low-carb desserts, which are quite delicious and do not cause problems when it comes to maintaining glycemic control.

At the end of the day, we all know that living with type 1 diabetes is not simple. I feel that by minimizing the impact that food has on my blood glucose levels, I have been able to achieve very predictable and successful insulin dosing patterns, and as a result, very stable blood glucose levels around the clock for years, without much mental effort at all. As a result, the time I spend thinking about diabetes is minimal, I am less distracted from work tasks, and have more free time to enjoy my life.

I am impressed by those who can achieve similar results eating many more carbohydrates. For me, personally, the mental burden of worrying about large fluctuations and the potential for more distraction from my life is not worth it. However, I applaud and respect everyone’s personal approaches that work well for them.

We would love to hear how you approach your diet as a tool to help optimize blood glucose management. Please share your thoughts in the comments!

Read more about Apple, continuous glucose monitor (CGM), dawn phenomenon, Dexcom, Humalog, insulin, Intensive management, iOS, iPhone, Levemir, low blood sugar (hypoglycemia), low-carb diet, type 1 diabetes.