Hypos milder whilst on keto - is there any scientific evidence?

R

ratherbegliding

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Hi everyone,

I've been a T1D for 30 years now but only discovered the joys of a keto diet 3 years ago.

I know everyone is different, but for me it's like the difference between night and day - I started seeing the positive benefits within 12 hours of going keto.

My personal experience has been that I have much fewer hypos, and when I do go low it's all very gentle and easily remedied - a big change to where I was 20 years ago!

These days I am also very fortunate to hold a recreational/sport pilots licence (which is a very limited form of licence designed for people with 'medical issues'). I find the restrictions, well, too restrictive and I'm trying to get my licence upgraded to a full Private Pilots Licence.

However, dealing with the medical standards people is proving somewhat challenging.

So my question to the collective knowledge-base is this:
Does anyone know of any medical studies which investigate the reduced severity of hypoglycemic events among T1's for those following a keto/LHCF diet?

Any assistance would be much appreciated.

Many thanks,

RBG
 
DCUKMod

DCUKMod

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@ratherbegliding - we have a member who holds a full commercial pilot's license and his day to day occupation is flying.

Ihave no idea if you have issues in addition to your T1, impacting on your status (and I'm not asking), but I would have thought that whilst having a very good look at your T1, they will be looking at he wider landscape.

Unfortunately, I can't recall the commercial pilot's user name, but if you do a forum search on commercial pilot or commercial license (or something like that), he may pop up. Alternatively, others may have a better memory that me!
 
Rachox

Rachox

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I believe @ScottyD might be the member @DCUKMod might be thinking of? His avatar certainly suggests he’s a pilot.
ScottyD please forgive me if I’ve got this wrong.
 
DCUKMod

DCUKMod

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Ah, I had guessed at ScottyD too, but I was wrongly thinking there was a space in there - Doh!

Thanks, @Rachox
 
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kokhongw

kokhongw

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Dr Keith Runyan (T1D) has a particularly insightful blog post on the topic.

https://ketogenicdiabeticathlete.wo...-diabetes-mechanisms-avoidance-and-treatment/

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Here's some extracts...

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This is the general idea ... ketones when glucose/insulin levels are low, may be neuroprotective.
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kokhongw

kokhongw

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ratherbegliding said:
Does anyone know of any medical studies which investigate the reduced severity of hypoglycemic events among T1's for those following a keto/LHCF diet?
Click to expand...

Given the lack of support for low carbs and keto for the last few decades, and the overriding fear of ketoacidosis and its unfortunate association with ketosis for T1D, I doubt there has been any researchers brave enough to suggest such a study... though things may change with the Typeonegrit folks...
 
R

ratherbegliding

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@DCUKMod , @Rachox - thanks for the lead. I'm in New Zealand, so the rules aren't quite so enlightened here.

@bulkbiker - Yes, it was Dr Bernstein's book which got me started with keto. Awesome bit of literature which should be required reading for all newly diagnosed diabetics.

@Robbity - Yup, came across that one too.

@kokhongw - thanks for that, really interesting read! Will spend a bit more time with that blog. Although as he says, there doesn't seem to be a wealth of studies into the effects of a keto diet on T1's.....

So, the medical review panel have declined my application for a medical waiver. Their opinion, in it's entirety, reads as follows:

"The medical experts note the history of hypoglycaemia and recent glucose logbook readings. They consider the risk of hypoglycaemia to exceed that which is considered to be compatible with CAA NZ medical certification."

Now, to put this in perspective, I test 7 times a day and in the most recent month of readings data I supplied I had 5 readings of 3.5mmol/l or less. So that's about 1 a week. I feel they are missing the point that whilst these events are technically a hypo, the fact I am on a keto diet means that they are mild and easily treatable - nothing like what life used to be like before!

Hence I'm trying to find reliable/scientific evidence to support the above.

Apparently I have the right to appeal, but not sure if that's going to achieve anything without some sort of suitable material.

Thanks for the help so far everyone - keep 'em coming!

RBG
 
bulkbiker

bulkbiker

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ratherbegliding said:
@DCUKMod , @Rachox - thanks for the lead. I'm in New Zealand, so the rules aren't quite so enlightened here.

@bulkbiker - Yes, it was Dr Bernstein's book which got me started with keto. Awesome bit of literature which should be required reading for all newly diagnosed diabetics.

@Robbity - Yup, came across that one too.

@kokhongw - thanks for that, really interesting read! Will spend a bit more time with that blog. Although as he says, there doesn't seem to be a wealth of studies into the effects of a keto diet on T1's.....

So, the medical review panel have declined my application for a medical waiver. Their opinion, in it's entirety, reads as follows:

"The medical experts note the history of hypoglycaemia and recent glucose logbook readings. They consider the risk of hypoglycaemia to exceed that which is considered to be compatible with CAA NZ medical certification."

Now, to put this in perspective, I test 7 times a day and in the most recent month of readings data I supplied I had 5 readings of 3.5mmol/l or less. So that's about 1 a week. I feel they are missing the point that whilst these events are technically a hypo, the fact I am on a keto diet means that they are mild and easily treatable - nothing like what life used to be like before!

Hence I'm trying to find reliable/scientific evidence to support the above.

Apparently I have the right to appeal, but not sure if that's going to achieve anything without some sort of suitable material.

Thanks for the help so far everyone - keep 'em coming!

RBG
Click to expand...

There is a well known George Cahill study where subjects in ketosis were injected with insulin when fasting to drive their blood glucose down into the high 1's and low 2's. This was shown to have no visible adverse effects.
Tried to find it but can't..
Stephen Phinney refers to it in quite a few lectures and the date 1972 sticks in my mind as the publication date (but I coudl be wrong).
I'll see if I can uncover it. Or does someone else maybe have the link?
 
M

Member496333

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It is said, and observed, that those who are in nutritional ketosis very often have a lower glucose requirement in the brain. That is to say that they can function perfectly well in what would normally be considered (in the wider population) as hypoglycaemia conditions. This may be a factor if you are talking about the physical response rather than just the actual numbers.

EDIT: apologies as I see this had already been mentioned by @bulkbiker.
 
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kokhongw

kokhongw

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bulkbiker said:
There is a well known George Cahill study where subjects in ketosis were injected with insulin when fasting to drive their blood glucose down into the high 1's and low 2's. This was shown to have no visible adverse effects.
Tried to find it but can't..
Stephen Phinney refers to it in quite a few lectures and the date 1972 sticks in my mind as the publication date (but I coudl be wrong).
I'll see if I can uncover it. Or does someone else maybe have the link?
Click to expand...

Dr Keith Runyan's blogpost referred to Dendrick's fasting study...

upload_2019-8-21_16-39-4.png


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC332976/
upload_2019-8-21_16-48-9.png



And there was a separate MCT study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671041/

upload_2019-8-21_16-48-43.png


upload_2019-8-21_16-50-3.png
 
kokhongw

kokhongw

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Last edited:
kokhongw

kokhongw

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Another insightful note from the chapter...
upload_2019-8-21_17-17-37.png
 
M

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kokhongw said:
Another insightful note from the chapter...
View attachment 35115
Click to expand...

I recall when I had my first (and only) "hypo" at 4.4mmol/L. Now a perfectly normal number, but at the time it was extreme hypoglycaemia for my body. I have never felt so cold and horrifically ill. Right to my core. I was so confused it was like I had lost all cognitive function. With the help of someone else, I managed to 'treat' it but swung back to 13+ very quickly and honestly I felt so bad that dying would probably have been easier. I did not know it was possible for a human to feel so dreadful. Wouldn't wish it on an enemy :hungover:

So yeah, false hypos are not false when you experience them, is my point. Be careful out there folks :nurse:
 
kokhongw

kokhongw

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kokhongw said:
I think it may be because of Ludwig's tweeter post...which refers to a separate 3 subject study...
https://twitter.com/davidludwigmd/status/977518260135620608?lang=en

View attachment 35114

The link to the chapter..
http://coconutketones.com/wp-content/uploads/2016/10/CahillGF_CerebMetabolism.pdf
Click to expand...

It should be noted that these are simply proof of concept studies with non-diabetic obese subjects.

T1Ds may have very different challenges in finding/maintaining the right level of ketosis...
 
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