When people think about the principles of nutrition for type 1 diabetics, everyone's first thought goes to carbohydrates, which of course are important and play a huge role in our diabetes management, however, they are only a very small piece of a very large puzzle.

Carbohydrates and carbohydrate ratios, do not account for so many other additional factors that impact our glucoses and the way our diabetes responds to the food that we are eating.

One of the most underrated tools within type 1 diabetes management, is understanding the full breakdown of macronutrients within food and the impact that has on the way we digest that food and thus the way in which we need to bolus for it.

A food that has 50 grams of carbs, 5 grams of protein and 8 grams of fat will digest completely differently and need an entirely different approach to bolusing than a food that has 50 grams of carbs, 30 grams of protein and 12 grams of fat, however, if you just take carbohydrates at face value, you would end up taking the same amount of insulin in the exact same way, which exactly where the problem lies.

The first food discussed, would onset in terms of digestion much quicker than the second food, because there is not additional fats and protein to slow down the rate at which we absorb the glucose from the food into the bloodstream, therefore we would likely need to account for that in the way that we pre bolus, perhaps slightly extending our pre bolus for scenario one to reduce the risk of a postprandial spike given that onset digestion will take place quicker.

In the second scenario, there is a significant amount of protein as well as a more moderate amount of fat, not only will the slow down the rate a which digestion begins to occur, it will elongate the whole process, meaning that most likely, were you to bolus the full amount of insulin upfront, taking 100% of your dose in one go, it would likely result in you going hypo early on, and hyper once digestion ramps up. So this changes the length of which we would pre bolus for that meal, as well as the way in which we would account for it over a length of time, breaking the bolus down into micro-doses or extending it over a period of time, depending on your mode of management.

The deeper your understanding of this, the more chance you have to be able to bolus for lots of different types of food confidently and successfully.

If you want deeper support around digestion profiles, insulin timing, exercise, glucose stability and real-world Type 1 diabetes management, you can explore our Elevate Membership for more structured education and guidance.

In addition to this, there are certain things we can include and steps we can take to make managing our glucose levels around food more stable. Here are a few key things you should know to make balancing your bloods around food easier.

Soluble fibre helps slow down the rate we absorb glucose into the bloodstream, so opting for soluble fibre sources can be really helpful.

Low GI carbs work in a very similar way, so this is also helpful to know when picking your carb sources.

Cinnamon slows down starch digestion and can help stabilise your digestion profile, this is a great tool for things like yogurts or oats, which are typically breakfast foods and can cause more of a rise in bloods due to the stubborn nature of bloods in the morning.

Liquid food gets into the bloodstream quicker than solid, things like smoothies and soups will need a longer pre bolus most of the time because less digestive enzymes are needed to break the food down.

Walking after a meal helps by aiding glucose into the muscles which helps to slow down the rate of digestion, this is particularly helpful around more stubborn periods of insulin resistance like breakfast, or more carb heavy meals where the risk of a postprandial spike is high.

You can also explore our digital nutrition resources for more practical guidance around food choices, bolusing strategies and improving glucose stability around meals. Explore digital guides

People often think that if they eat low carb, all of their problems will be solved and they will not experience any spikes in bloods, however this is far from accurate for a diabetic due to the process of gluconeogenesis. This biological mechanism is largely handled by the liver and, on a smaller scale, your kidneys. When you run your glycogen stores into the ground, whether that is from a brutal gym session, keeping your carbs low, or a long period of fasting, your body kicks this into gear to keep your glucose steady and fuel the organs that demand glucose to function, like your brain.

If you are eating next to no carbs, your body will utilise this process for energy and you will need to articulate your insulin needs for protein and fats, identifying the timing of your doses to give coverage to the longer and more drawn out period of digestion. More often than not, when you do begin eating carbs again, after a long period of cutting them out, your body will be much more sensitive to them and you will need more aggressive doses and timings than you had previously been used to.

Cutting carbs out is not the answer to having controlled glucose levels as a type 1 diabetic, understanding digestion profiles and how to make your insulin work harmoniously with these factors, absolutely is. Investing time into learning and understanding this, has the potential to change your life.

For those wanting more personalised support applying these strategies to training, nutrition, insulin timing and day-to-day glucose management, explore our coaching programmes designed specifically for people living with Type 1 diabetes.

On top of everything discussed, as always - context matters, even when accounting for the rate at which we digest a meal, splitting and timing your dose adequately, we must also be able to consider the external circumstances which further implicate the effect on bloods. For example, if you are highly stressed and under slept, sitting down all day in back to back meetings, even if you are 100% accurate with counting your macros and planning your bolus around them, you need to apply the strategies that mitigate stress induced highs, such as extending your pre bolus time and adding some additional rapid to cover the resistance, as well as potentially trying to get a small amount of movement in afterwards.