Type 1 Switching to Keto

[gregorgregor30]

Hi Everyone,

I want to switch to Keto diet. I have done a fair bit of research into what I should eat what I shouldn't eat, meal prep, macros etc..

What I am really looking to find out is how people managed there insulin intake when switching to this, did regular hypos occur when doing this? I do plan to reach out to my DSN prior to starting this but I wanted to get some feedback from people who have made the switch and are having success with better glucose control (reduced HBA1C) and significant weigh loss.

I should ass that I am currently taking 10 mmol of Levemir on wake up and before bed. Fiasp for meals. I have refillable pens that have a minimum dose of 1 mmol.

Has anyone had to switch to a 0.5 mmol pen after switching to keto.

Any other advice you can offer would be great,

TIA

Gregor

 

[ringi]

@Mel dCP maybe able to help

 

[gregorgregor30]

@Mel dCP maybe able to help

Thanks a lot, wow look how good your HBA1C has got, Im sitting about 58 but I want to improve that

 

[MeiChanski]

Hello, I can't speak for keto, but I can speak for low carb. I am on fiasp and tresiba, I recently have been prescribed the freestyle libre sensors - previously I was on novorapid and levemir, then I did DAFNE in 2018.
-You can ask your diabetes team or your GP for the half unit pens.
-I don't know if it's worth asking your team about a carb counting course to fine tune your diabetes management. I think DAFNE gave me a more in depth insight. I wouldn't jump into keto without having the knowledge to adjust my insulin, otherwise hypos will occur.
- I have reduced the amount of hypos I had since the libre, hba1c went from 47 to 42 and from 20% to 56% in target range. I did it through low carbs, according to libreview, I've been consuming less then 140g of carbs a day. I have incoperated IF most mornings and have a coffee and cream without any hypos. Some times I'll have a coffee and cream and 1-2 meals a day.
- As for weight, my weight is stable, which is what I wanted because hypos made me eat more but they need to be treated. Once my basal is correct, my main focus is bolus and managing bolus with low carb made things simpler. Erratic levels made it very difficult, so with low carb, following DAFNE guidelines, libre sensor and 0.5 unit pens, I've been able to have a much smoother control. Libre gave me more information than a blood meter would, so I can see where needs improvement and adjustment.
-Of course there are other reasons for erratic levels, such as hormones, stress, exercise. so DAFNE did help me understand what needs to be done to minimise hypos and hypers. I know I need different ratios during the time of the month or when I'm doing exercise.

 

[Goonergal]

I’m Type 2 diet controlled can’t help with insulin and keto. As well as mel who was tagged above, @kitedoc and @NicoleC1971 may also be able to help

 

[LooperCat]

Thanks a lot, wow look how good your HBA1C has got, Im sitting about 58 but I want to improve that

Thank you - I’ve achieved almost non diabetic levels through keto, but have gained weight so I’m possibly not the best one to advise on all your questions. However, I’ll help where I can!

First up, stock up on your hypo treatment of choice! The first week or so can need it. I had to cut my basal in half pretty much straight away and for the first couple of months didn’t need to bolus at all, but I do now, both for carbs and protein.

Your nurse probably won’t encourage you to do it, tbh. They will warn you about ketones being the devil.

Have you done a carb counting course?

And yes, I needed a half unit pen, at a ratio of 1u:10g carbs, a unit was too much for a typical low carb/keto meal or a correction. I have a pump now which makes things much more accurate.

 

[gregorgregor30]

Thanks for the reply ot much appreciated and seems like things are going well for you. I've been type 1 about 8 years and first 4 was living a lifestyle of excess so I managed best I could. Since I've lived a healthier life in the last 4 years my hba1c has improved but I've gained weight so I'm trying to find a solution that can combat both. I really appreciate all the advice and need to think carefully about what I do next.

Hello, I can't speak for keto, but I can speak for low carb. I am on fiasp and tresiba, I recently have been prescribed the freestyle libre sensors - previously I was on novorapid and levemir, then I did DAFNE in 2018.
-You can ask your diabetes team or your GP for the half unit pens.
-I don't know if it's worth asking your team about a carb counting course to fine tune your diabetes management. I think DAFNE gave me a more in depth insight. I wouldn't jump into keto without having the knowledge to adjust my insulin, otherwise hypos will occur.
- I have reduced the amount of hypos I had since the libre, hba1c went from 47 to 42 and from 20% to 56% in target range. I did it through low carbs, according to libreview, I've been consuming less then 140g of carbs a day. I have incoperated IF most mornings and have a coffee and cream without any hypos. Some times I'll have a coffee and cream and 1-2 meals a day.
- As for weight, my weight is stable, which is what I wanted because hypos made me eat more but they need to be treated. Once my basal is correct, my main focus is bolus and managing bolus with low carb made things simpler. Erratic levels made it very difficult, so with low carb, following DAFNE guidelines, libre sensor and 0.5 unit pens, I've been able to have a much smoother control. Libre gave me more information than a blood meter would, so I can see where needs improvement and adjustment.
-Of course there are other reasons for erratic levels, such as hormones, stress, exercise. so DAFNE did help me understand what needs to be done to minimise hypos and hypers. I know I need different ratios during the time of the month or when I'm doing exercise.

 

[gregorgregor30]

Hi thanks for replying, how is it that you can put on weight whole doing keto? please excuse my ignorance . That's the last think I want to do.

I spoke to my Endo about 4 months ago and when I mentioned low card / keto she seemed positive about it but I said I wasnt ready at the time. I'm not sure if they are allowed to give out advice on keto or promote it rather. I've emailed my nurse today for some advice and I will ask about the pens. Using jelly babies for hypos currently. What were you or are you using?

I've heard about the keto flu, did you experience this? Is it bad?

Do you ever cheat on your keto diet, does it take you long to enter back into ketosis? The thought of giving up beer is scaring me

How are you testing your ketones?

Sorry for all the question. I really appreciate the help

Thank you - I’ve achieved almost non diabetic levels through keto, but have gained weight so I’m possibly not the best one to advise on all your questions. However, I’ll help where I can!

First up, stock up on your hypo treatment of choice! The first week or so can need it. I had to cut my basal in half pretty much straight away and for the first couple of months didn’t need to bolus at all, but I do now, both for carbs and protein.

Your nurse probably won’t encourage you to do it, tbh. They will warn you about ketones being the devil.

Have you done a carb counting course?

And yes, I needed a half unit pen, at a ratio of 1u:10g carbs, a unit was too much for a typical low carb/keto meal or a correction. I have a pump now which makes things much more accurate.

 

[ringi]

I've heard about the keto flu, did you experience this? Is it bad

I advoid keto flu, maybe due to knowing I needed to increase salt intake

 

[gregorgregor30]

**

I've been on a waiting list for DAPHNE for last 3 years. Still not heard.

I know my ratios for the most part and how to deal with exercise.

Hi thanks for replying, how is it that you can put on weight whole doing keto? please excuse my ignorance . That's the last think I want to do.

I spoke to my Endo about 4 months ago and when I mentioned low card / keto she seemed positive about it but I said I wasnt ready at the time. I'm not sure if they are allowed to give out advice on keto or promote it rather. I've emailed my nurse today for some advice and I will ask about the pens. Using jelly babies for hypos currently. What were you or are you using?

I've heard about the keto flu, did you experience this? Is it bad?

Do you ever cheat on your keto diet, does it take you long to enter back into ketosis? The thought of giving up beer is scaring me

How are you testing your ketones?

Sorry for all the question. I really appreciate the help

 

[gregorgregor30]

Indid read that, I guess that's good advice the and I'll make sure I do it

I advoid keto flu, maybe due to knowing I needed to increase salt intake

 

[LooperCat]

Hi thanks for replying, how is it that you can put on weight whole doing keto? please excuse my ignorance . That's the last think I want to do.

I spoke to my Endo about 4 months ago and when I mentioned low card / keto she seemed positive about it but I said I wasnt ready at the time. I'm not sure if they are allowed to give out advice on keto or promote it rather. I've emailed my nurse today for some advice and I will ask about the pens. Using jelly babies for hypos currently. What were you or are you using?

I've heard about the keto flu, did you experience this? Is it bad?

Do you ever cheat on your keto diet, does it take you long to enter back into ketosis? The thought of giving up beer is scaring me

How are you testing your ketones?

Sorry for all the question. I really appreciate the help

I’ll answer these one by one

Because calories still matter an I eat more than I burn, pretty much!

Dextrose tablets only for hypos - I treat them as a medical emergency that needs sorting quickly, not an excuse for a treat. And with a 3g tablet (or half of one) I can dose to raise me exactly how much I need to raise my level by. One tablet raises me 0.6-1mmol depending on time of day.

I had keto flu at the same time my husband and son had actual flu and did t realise what it was until after - it can be avoided/reduced by increasing your intake of sodium, magnesium and potassium and you will need to keep supplementing these.

No, I don’t cheat. I did once and ended up with a high I couldn’t get down for love nor money. I felt vile. Just not worth it. I drink red wine and spirits and the occasional Michelob Ultra (2.1g per can) beer if I want something cold and crispy.

I have a blood ketone meter

 

[DCUKMod]

**

I've been on a waiting list for DAPHNE for last 3 years. Still not heard.

I know my ratios for the most part and how to deal with exercise.

Gregorgregor, if you haven't done DAFNE, have you heard of BERTIE? BERTIE is an online resource for those living with T1. It's a totally free resource, others have spoken well of.

https://www.bertieonline.org.uk/

Being neither T1 nor insulin dependent, I couldn't really comment

 

[gregorgregor30]

Thanks a lot I'll take a look.

Gregorgregor, if you haven't done DAFNE, have you heard of BERTIE? BERTIE is an online resource for those living with T1. It's a totally free resource, others have spoken well of.

https://www.bertieonline.org.uk/

Being neither T1 nor insulin dependent, I couldn't really comment

 

[gregorgregor30]

That's great, you have all been very helpful. I really appreciate it. I think in going to give it a tray starting on a few weeks. Going to spend a bit of time first doing some more reading and planning.

I might have some more questions a long the way

Thanks

I’ll answer these one by one

Because calories still matter an I eat more than I burn, pretty much!

Dextrose tablets only for hypos - I treat them as a medical emergency that needs sorting quickly, not an excuse for a treat. And with a 3g tablet (or half of one) I can dose to raise me exactly how much I need to raise my level by. One tablet raises me 0.6-1mmol depending on time of day.

I had keto flu at the same time my husband and son had actual flu and did t realise what it was until after - it can be avoided/reduced by increasing your intake of sodium, magnesium and potassium and you will need to keep supplementing these.

No, I don’t cheat. I did once and ended up with a high I couldn’t get down for love nor money. I felt vile. Just not worth it. I drink red wine and spirits and the occasional Michelob Ultra (2.1g per can) beer if I want something cold and crispy.

I have a blood ketone meter

 

[ert]

Hi Everyone,

I want to switch to Keto diet. I have done a fair bit of research into what I should eat what I shouldn't eat, meal prep, macros etc..

What I am really looking to find out is how people managed there insulin intake when switching to this, did regular hypos occur when doing this? I do plan to reach out to my DSN prior to starting this but I wanted to get some feedback from people who have made the switch and are having success with better glucose control (reduced HBA1C) and significant weigh loss.

I should ass that I am currently taking 10 mmol of Levemir on wake up and before bed. Fiasp for meals. I have refillable pens that have a minimum dose of 1 mmol.

Has anyone had to switch to a 0.5 mmol pen after switching to keto.

Any other advice you can offer would be great,

TIA

Gregor

I've been on LCHF (less than 30 grams of carbs a day) since being diagnosed, which looks a lot like keto. I'm on low units of insulin because of it and follow Dr Bernstein's Diabetes Solution. I use a Novoecho pen with 0.5 units. I use 3.5 + 2 units of long-acting daily (set by my consultant) and 4.5 units of fast-acting with a typical meal (using Dr Bernstein's Diabetes Solution). I've only had one hypo in 2 months (on day 3 due to injecting into a muscle) so my blood sugars are stable. I drink coffee and cream to avoid my sugars from going too low, rather than sweets, but I do carry jelly beans and dexter tablets. I've also managed to lose weight (the 'bounce' from starting insulin after starving). I do run a lot and do weights which may help with the weight loss. I self-fund a CGM so do a lot of monitoring.

My GP, consultant and diabetes are aware of my regime, so would recommend asking your diabetes team before you begin.

 

[gregorgregor30]

Thanks a lot, that's such a small amount of insulin. Yeah, hopefully they will give me the help and advice I need. They have a been great in the past with other things.

How do you cope with cravings for carbs or how long did it take for the cravings to go away?

Thanks a lot.

I've been on LCHF (less than 30 grams of carbs a day) since being diagnosed, which looks a lot like keto. I'm on low units of insulin because of it and follow Dr Bernstein's Diabetes Solution. I use a Novoecho pen with 0.5 units. I use 3.5 + 2 units of long-acting daily (set by my consultant) and 4.5 units of fast-acting with a typical meal (using Dr Bernstein's Diabetes Solution). I've only had one hypo in 2 months (on day 3 due to injecting into a muscle) so my blood sugars are stable. I drink coffee and cream to avoid my sugars from going too low, rather than sweets, but I do carry jelly beans and dexter tablets. I've also managed to lose weight (the 'bounce' from starting insulin after starving). I do run a lot and do weights which may help with the weight loss.

My GP, consultant and diabetes are aware of my regime, so would recommend asking your diabetes team before you begin.

 

[ert]

Thanks a lot, that's such a small amount of insulin. Yeah, hopefully they will give me the help and advice I need. They have a been great in the past with other things.

How do you cope with cravings for carbs or how long did it take for the cravings to go away?

Thanks a lot.

Realistically, as a type 1, you can eat what you want to. You need a sort-of-reason or conviction to do otherwise.

I just switched overnight, but I'm an all-or-nothing-type girl. I read Dr Bernstein's Diabetes Solution from cover to cover and decided it was for me. I recommend it as a type 1's approach to LCHF. I used to be always hungry eating carbs, now I don't even notice if I skip a meal. Coffee and cream help too.

 

[bulkbiker]

I might have some more questions a long the way

If you're into facebook theres a keto/low carb group called Type1Grit who follow Bernstein's principles for low carbing T1's

~Heres the link

https://www.facebook.com/groups/typeonegrit/ its a closed group so you will need to be approved to join.

 

[gregorgregor30]

I’ll answer these one by one

Because calories still matter an I eat more than I burn, pretty much!

Dextrose tablets only for hypos - I treat them as a medical emergency that needs sorting quickly, not an excuse for a treat. And with a 3g tablet (or half of one) I can dose to raise me exactly how much I need to raise my level by. One tablet raises me 0.6-1mmol depending on time of day.

I had keto flu at the same time my husband and son had actual flu and did t realise what it was until after - it can be avoided/reduced by increasing your intake of sodium, magnesium and potassium and you will need to keep supplementing these.

No, I don’t cheat. I did once and ended up with a high I couldn’t get down for love nor money. I felt vile. Just not worth it. I drink red wine and spirits and the occasional Michelob Ultra (2.1g per can) beer if I want something cold and crispy.

I have a blood ketone meter

Thanks for the reply.

definitely need to be better with my hypo treatments. I usual tend to take the standard 15g of fast acting carbs,. at the moment around 4 jelly beans. I suppose on keto the chances of over dosing insulin at meal time reduces therefore there is an opportunity to get better at hypo treatment; I don't want to end up eating 30b of carbs in jelly babies.

My DSN replied to me today saying i should start by reducing my basal by 20% and them more if I need to, does this sound like an ok adjustment to start? I know someone mentioned cutting theirs in half. She has also left a 0.5 increment insulin pen for me to collect.

I also can get ketone strips for my Libre meter on prescription? Do you test regularly / how often? I get 10 in a box and wonder if they would question if I increased the frequency of collecting them. Atm i would get 10 per 8 weeks prescription.