Relatively new to keto, looking for advice

[Rachy]

Hi all,

Background info: Type 1 since 12, now 30. Using Freestyle Libre and Novorapid/Tresiba.

My 18 years of diabetes has certainly not been easy; I have rebelled, I have ignored it, I have been DKA twice. I have been very lucky with no complications so far (apart from slight background retinopathy.) A few months ago after turning 30, I decided it was time for a change so after a HBA1C result of 53, I decided to try low carb. I have been doing this since November 2021 with a small Christmas blip and the results were dramatic overnight. I usually ranged between 4-15mmol on a daily basis but low carb has kept me in such tight control throughout the day. I was amazed and still am but have a few issues and although I read a lot online/Facebook groups, it can be overwhelming. If anyone can give any sort of advice, it would be much appreciated.

• My appetite has pretty much gone most of the time. I find I have to remind myself to eat 3 times a day and don't seem to feel that hunger anymore. Is this normal?
• My energy levels are ok but sometimes I do feel quite tired - do I need supplements of any sort or can I get everything I need from keto diet alone?
• I eat anything and there isn't much I don't like so for example I have been eating: turkey bacon, eggs, keto shakes, low carb rolls and bread (found them today at only 2.6g carb per roll!), meat jerky, lots of veggies, nuts, seeds, almond milk, cheese, salads. My diet is varied but I find that I struggle to get over 20g of carb a day.. this isn't because I'm restricting myself - I just don't feel like anymore! However my diabetes nurse thinks I should be eating 100-150g a day! I can't seem to justify eating all the carbs for the sake of it..
• My urine ketones seem to hover around 4 (I have ordered some blood ketone strips) and my urine is very dark. I drink so much water in the day but still feel thirsty - would anything help this?
• Last point would be that we are trying to conceive so I have the worry in the back of my mind that my levels should be 4-7 for healthy pregnancy and although low carb is allowing this, I should be eating carbs for a healthy baby if it was to happen..

Sorry for the long post, my mind is all over the place trying to get things right. Any advice is very much appreciated.
A confused and tired Type 1,
Rach

 

[HSSS]

Yes a change in appetite is common. The food is much more nutrient dense so we don’t need so much bulk. Just make sure you are eating sufficiently over the course of the day. Unless your diabetes control or other medications require regular meals then eat when you’re hungry or suits you. No need for a schedule otherwise. I’m not type 1 but assume that if you are basal/bolus you can adjust for this.

You might be low on electrolytes. Sodium magnesium and potassium. Check the foods you’re eating or try a supplement to make sure. It really can make quite a difference

your nurse is using standard guidance for carbs. And a mistaken belief carbs are essential, rather than a small amount of glucose being essential which can come from protein via gluconeogenisis.

if your urine is dark it’s highly likely you are dehydrated. Carbs hold water and without them the water and the electrolytes flush through faster. Other than that have you had kidneys etc checked recently?

Plenty of women conceive and carry whilst low carb and even keto. Having wholesome nutritious foods are what’s important. What do you feel would be missing or potentially harmful ? Again I’m not a midwife or a dr but it’s certainly not unheard of or without precedent. I would however expect a degree of panic from this professional inexperienced or uneducated in keto. All I can suggest is do lots of homework and source good advice you trust.

 

[Mbaker]

I immediately thought electrolytes as well. If we had it in the country I would recommend LMNT, failing that 2 to 3 teaspoons of "LO-SALT" per day (especially if you are exercising) and a few squares of 100% Montezuma - that will cover Potassium, Sodium and Magnesium.

This article is worth a full read possibly:
Our comprehensive guide to salt — Diet Doctor

 

[EllieM]

I think we have to be very very careful here. I've been googling and failed to find any studies on low carb (let alone keto) and T1 pregnancy and a lot of sites saying "you need carbs when pregnant".

I have no idea what the truth is here (maybe go to the Typeonegrit facebook site for info from T1s who've actually done this) but I can see massive issues if @Rachy has to lie to her diabetic team in order to follow this diet.

Plus if @Rachy has a past history of DKA then I can imagine that her diabetic team may be less likely to let her go on a diet where ketones are present in the blood as a normal by product??? (Disclaimer, I am not a doctor).

My oldest son is 30 so my two T1 pregnancies were a long time ago (and my biggest issue was loss of hypo awareness due to too tight control, I would have killed for a cgm but they weren't around then).

Good luck with your journey @Rachy , whatever you decide to do.

 

[HSSS]

Coincidentally just saw this. I’ve not read it myself but thought it might be relevant and give some pregnancy nutrition evidence.


“Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition. Her work is known for being research-focused, thorough, and critical of outdated dietary guidelines.

She is co-founder of the Women's Health Nutrition Academy and the author of two books, Real Food for Pregnancy and Real Food for Gestational Diabetes. Lily’s bestselling books have helped tens of thousands of mamas (and babies!), are used in university-level maternal nutrition and midwifery courses, and have even influenced prenatal nutrition policy internationally. She writes at https://lilynicholsrdn.com

The Fabulously Keto Podcast is available on most podcast apps and platforms.
https://fabulouslyketo.com/podcast/071”

 

[Mathewted]

Hi all,

Background info: Type 1 since 12, now 30. Using Freestyle Libre and Novorapid/Tresiba.

My 18 years of diabetes has certainly not been easy; I have rebelled, I have ignored it, I have been DKA twice. I have been very lucky with no complications so far (apart from slight background retinopathy.) A few months ago after turning 30, I decided it was time for a change so after a HBA1C result of 53, I decided to try low carb. I have been doing this since November 2021 with a small Christmas blip and the results were dramatic overnight. I usually ranged between 4-15mmol on a daily basis but low carb has kept me in such tight control throughout the day. I was amazed and still am but have a few issues and although I read a lot online/Facebook groups, it can be overwhelming. If anyone can give any sort of advice, it would be much appreciated.

• My appetite has pretty much gone most of the time. I find I have to remind myself to eat 3 times a day and don't seem to feel that hunger anymore. Is this normal?
• My energy levels are ok but sometimes I do feel quite tired - do I need supplements of any sort or can I get everything I need from keto diet alone?
• I eat anything and there isn't much I don't like so for example I have been eating: turkey bacon, eggs, keto shakes, low carb rolls and bread (found them today at only 2.6g carb per roll!), meat jerky, lots of veggies, nuts, seeds, almond milk, cheese, salads. My diet is varied but I find that I struggle to get over 20g of carb a day.. this isn't because I'm restricting myself - I just don't feel like anymore! However my diabetes nurse thinks I should be eating 100-150g a day! I can't seem to justify eating all the carbs for the sake of it..
• My urine ketones seem to hover around 4 (I have ordered some blood ketone strips) and my urine is very dark. I drink so much water in the day but still feel thirsty - would anything help this?
• Last point would be that we are trying to conceive so I have the worry in the back of my mind that my levels should be 4-7 for healthy pregnancy and although low carb is allowing this, I should be eating carbs for a healthy baby if it was to happen..

Sorry for the long post, my mind is all over the place trying to get things right. Any advice is very much appreciated.
A confused and tired Type 1,
Rach

Rachy, it's about one year since you posted; how did you get on? Really interested to hear and hoping you made progress toward your goals.