The 90% Time-in-range challenge

90% Time in Range - Is it possible with Type 1 diabetes?

You can now view the results of the challenge in the weekly reports below:

I have set up a ‘weekly monitor’ page, where each week I will upload updated graphs to show the progress across various indicators, such as

average blood glucose,
average insulin sensitivity,
calorie and dietary data (split of carbohydrates, protein and fats)

See you around!

Let’s kickstart this blog with an easy challenge: 90% time in range over a week.

Doctors told me that such a goal is practically impossible for an insulin dependent type1 diabetic.

But hey, I am here to run experiments on myself, and I’ve got nothing to lose, so let me challenge the status quo.

Experience tells me that this is possible. One year ago I tried intermittent fasting for a while, and to my great surprise, for the first time in my life I could achieve a 93% time in range. Then I stopped, probably because breakfast was too tasty to continue skipping it.

But now I am back at it: with a few adjustments, a plan and absolutely no fears I am confident I can pull this out (and you can too!)!

In this blog post, I cover:

my starting point. Current blood glucose, HbA1C, insulin sensitivity;
the tools I’ll use in the challenge, and why;
the rules I’ll abide to;
how I’ll track progress.

The Blood Glucose rollercoaster

My starting point is not the best: my HbA1C (the average blood glucose level over 3 months) has been ranging between 6.5 - 7, and my current time in range is around 70%.

*My current time in range, in green. Not ideal!*

Additionally, I’ve been struggling with some rollercoaster-like blood sugar levels, caused by some repeated indulgences at the dining table.

Of course, insulin sensitivity is impacted: my daily insulin-to-carb ratio ranges between approximately 20:1 and 15:1, meaning that one unit of insulin covers 15 to 20 grams of carbohydrates, on average. I consume around 300-450 grams of carbohydrates per day, so I am injecting around 20-30 units a day.

What I want to achieve is:

minimise the the up-and-downs first,
stabilise my blood glucose levels throughout the entire day (and night).
increase my insulin sensitivity. I know it’s possible.

How to improve time in range as a type 1 diabetic

3 tools for a bulletproof blood sugar

How do I plan to achieve such an ambitious goal? Here are the tools I will use:

A high carbohydrates, whole food plant based diet (my diet for the past seven years now). The real caveat here is to keep the fats low, stick to ‘green light foods’ and minimise your intake of processed ones.

*Here* *for a thorough explanation of the list.*

Physical exercise, which is also a constant in my days since seven years, more or less.
Time-restricted feeding, also known as intermittent fasting. This is the real new additions to my protocol!

Whole Food, Plant-Based diet and diabetes

It might seem counterintuitive for a T1 diabetic, but carbohydrates are really not the enemy when it comes to high blood glucose. The real cause of insulin resistance is the amount of fat in your diet. Try it yourself! Keep the fast low and eat whole carbohydrates for a while, you’ll be amazed by how your blood glucose will improve.

Physical Exercise and diabetes

It is no secret that physical exercise helps with controlling the blood glucose levels. Even a short walk after a meal can help in controlling the spike for me. I will just continue doing what I’m doing: endurance training for 3 to 4 hours a week and strength training all the other days of the week.

Why Intermittent Fasting and diabetes

Intermittent fasting is probably the most interesting and important factor here. I already experimented with it in the past, and it proved to be the single most impactful factor for stable blood glucose, everything else untouched. For some reason, I stopped, but I am ready to have another go at it. It may take a bit of courage at the beginning - it surely did for me, and there are a lot of social conventions and pressures around eating that make this step a bit harder than the rest. But the results are just outstanding, so I will start skipping my favourite meal of the day, breakfast, and eat approximately between 1pm and 7pm.

How I plan to achieve 90% time in range with type 1 diabetes

Let me quickly lay out some rules for myself, to make the whole process easier.

95% Green Light Foods, 5% processed foods.
The only ‘processed’ foods I’ll use will be things like sauces for dressings, some soy products (yogurt, soy milk, some tofu), some 100% pure dark chocolate, and some sugar-free jam.
An 8 hours eating window, max. A narrower one is also ok.
Daily exercise.

Holding Myself Accountable

I will post updates on a weekly basis, including:

The time in range for the week (and a comparison to the previous period);
The insulin-to-carb ratio for the week;
Some pictures of my meals, with breakdown of calories and macros (most of my recipes are inspired by my dude Derek Simnett!);
Reflections on what worked, what not and how to improve that.

Now, to the challenge. I am excited to see how this goes, and quite confident I will see some improvements! If you feel inspired and want to partake to the challenge, drop an email or a comment, let me know how it goes!

Deep Dive

I claimed that carbohydrates are not the enemy. I regularly enjoy large bowls of fruits, grains and potatoes without concerns. I just keep the fats low (especially the more refined ones like oil), as those are the real cause of insulin resistance.

Avoiding carbohydrates is a bad idea if your goal is to be in charge of your diabetes rather than the other way around. Why? Have a listen at this!