Any Type 1s on a Keto Diet?

[RAPS_od]

I read a book called The Ketogenic Diet for Type 1 Diabetes. I'm wondering if there's anyone out there who's tried it as well. I know there's a lot of info for T2s on low carb and all, but don't see much about T1s.

 

[DCUKMod]

I read a book called The Ketogenic Diet for Type 1 Diabetes. I'm wondering if there's anyone out there who's tried it as well. I know there's a lot of info for T2s on low carb and all, but don't see much about T1s.

RAPS_od, our colleague @Mel dCP is pretty much keto, and had fabulous results reducing her A1c as a result.

I think there are fewer keto fans amongst the T1 population, due to the potentially additional dietary/treatment options available.

 

[kokhongw]

The Facebook group TypeOneGrit by RD Dikeman and Dr Bernstein is fairly keto centric group for Type1...
https://www.facebook.com/Type1Grit/

But they are geared towards Low carb, appropriate protein...not so much on the high fats...

 

[himtoo]

there is a reasonable sized group of type 1's in the instagram community doing keto

 

[bulkbiker]

And quite a few on www.ketogenicforums.com

 

[kitedoc]

Hi @RAPS_od , As well as @Mel dCP I am, but far more recently.
What is it you wished to know about?

 

[mike@work]

Hello @RAPS_od !

And here is one more
Have been in ketosis for about 3+ months, was low-carbing before that, for about ½ a year...

Some problems with keto I admit, but I'll return with questions on the forum later...

 

[gemma_T1]

I read a book called The Ketogenic Diet for Type 1 Diabetes. I'm wondering if there's anyone out there who's tried it as well. I know there's a lot of info for T2s on low carb and all, but don't see much about T1s.

I have the book ... haven’t started yet though!

 

[kitedoc]

I read Dr Bernstein's Diabetes Solution.
But everyone is warned not to try LCHF whilst on insulin by yourself as hypos and ketones etc may be problems.

 

[LooperCat]

Just a quick reply, as am at work! I’ve been doing keto for 14 months now and (with the aid of a Libre and Omnipod) have dropped my HbA1c from 89 to 40 (it did get as low as 37, but my last one was up a bit) in that time. Initially you have quite a lot of hypos, but you need to drop your insulin considerably.

 

[Juicyj]

I read Dr Bernstein's Diabetes Solution.
But everyone is warned not to try LCHF whilst on insulin by yourself as hypos and ketones etc may be problems.

To be honest I haven't heard of anyone being warned against LCHF so unsure if the advice here is different to Aus ?

 

[michita]

To be honest I haven't heard of anyone being warned against LCHF so unsure if the advice here is different to Aus ?

I was but that was 3 years ago so maybe things are different now, I hope.

senior consultant (he said he was “senior” consultant) told me he could even cancel my driving license if I continued with low carb diet. It was very threatening and sounded like he meant it. Some or most doctors still think low carb diet causes more hypos and against it even in uk, no ?

 

[Juicyj]

I was but that was 3 years ago so maybe things are different now, I hope.

senior consultant (he said he was “senior” consultant) told me he could even cancel my driving license if I continued with low carb diet. It was very threatening and sounded like he meant it. Some or most doctors still think low carb diet causes more hypos and against it even in uk, no ?

A consultant would have issues with a t1 on mixed insulin, but on a basal/bolus regime it would not be an issue as your simply adjusting your insulin based on carb counting, it sounds like you had an unfortunate experience there Michita.

 

[jane1754]

I read a book called The Ketogenic Diet for Type 1 Diabetes. I'm wondering if there's anyone out there who's tried it as well. I know there's a lot of info for T2s on low carb and all, but don't see much about T1s.

I've been Type 1 for 10 years and my BGs have looked like the Himalayas. I've recently been given a CGM (from my Diabetes consultant) to go with my pump and using this I soon found that bread, pasta, potatoes - in fact anything with lots of carbs - shot my blood glucose up well into double figures. I read Dr. Bernstein's 'Diabetes Solution' and Dr. David Cavan's 'Live well with Type 1 diabetes' , and since then have been eating low carb and using lots of Keto recipes easily found on line. My blood glucose has become more stable, though not perfect yet, and I have not had more hypos than before. In fact, because of the CGM I've had fewer hypos. In addition, my husband, daughter and one of my brothers, none of whom have diabetes, got intrigued and all three have been tying low carb and have lost weight which they didn't want and feel better for it! I'd recomend going for it, as long as you keep close watch on your blood glucose.

 

[kitedoc]

To be honest I haven't heard of anyone being warned against LCHF so unsure if the advice here is different to Aus ?

I am meaning against trying it without some health professional advice because of the risks of hypos. Probably not an issue so much for T2Ds except again if on insulin or other BSL-lowering medication.

 

[kitedoc]

I was but that was 3 years ago so maybe things are different now, I hope.

senior consultant (he said he was “senior” consultant) told me he could even cancel my driving license if I continued with low carb diet. It was very threatening and sounded like he meant it. Some or most doctors still think low carb diet causes more hypos and against it even in uk, no ?

In your place I would be reporting such a 'senior' consultant to the GMC. That sounds like intimidation and plain ignorance.

 

[Jaylee]

I read a book called The Ketogenic Diet for Type 1 Diabetes. I'm wondering if there's anyone out there who's tried it as well. I know there's a lot of info for T2s on low carb and all, but don't see much about T1s.

Hi,

My take on it. As with any diatary choice in changing carb level intake.

Start with the "base line foundations" first. It kind of defeats the objective if one hasn't adjusted basal for fasting levels & need persistent hypo treatment or correction dosage?
https://mysugr.com/basal-rate-testing/

Always keep a close eye on BGs with any medication tweaks & changes in dose.

 

[jane1754]

I am meaning against trying it without some health professional advice because of the risks of hypos. Probably not an issue so much for T2Ds except again if on insulin or other BSL-lowering medication.

My consultant said he had no problem with me trying LCHF and/or Keto, but you do need to alter your insulin according to what you are eating (otherwise you will get hypos). If on a pump, like me, the pump does the calculation for you, otherwise you have to do carb counting and work out the amount of insulin yourself. After all, it's a calculation the properly-functioning pancreas and beta cells would do automatically: measure the insulin against the glucose intake (isn't God clever the way he made us!), so it makes sense for us to try to do the same. The DAFNE course, which many Diabetes departments offer, helps with carb counting. I did an online course 10 years ago provided by Bournemouth hospital, which really helped me before I was considered 'eligible' for the hospital one.

 

[kitedoc]

Hi @jane1754, yes, I followed my insulin to carb ratios as I lowered my carbs and included 50% of the grams of protein intake as carbs in the calculation. I also found that my basal amounts needed easing back a bit also. My insulin to carb ratio for the morning is stronger (less carbs per unit of insulin means higher dose of insulin per g of carb) than later in the day.
So for 100g --> about 30 g carbs my insulin went from total of 40 units per day at about 50:50 bolus to basal
down to about 26 units total with 30:70 bolus to basal.
I also found that I needed to increase my salt intake and I added in some magnesium tablets to deal with the keto 'flu (see dietdoctor.com) in the first week.
After 6 weeks on this diet my HBA1C had dropped from 46 to 39 (so the HBA1C reflects to previous 12 weeks of BSLs with more influence from the BSLs in the last 6 weeks compared to the first 6 weeks, as I understand it).
My weight is down 2 kgs at the 8 week mark and steady. My mood is lighter.
I was going well until some stress sent my BSLs up. I think I then was adding in a few more carbs and then was oscillating in and out of keto which made me feel worse and started a bit of a see-saw of insulin in and BSls down too far and then up too far.
The trick for me was to then ease back the carbs, I was having milk in my coffee (and as a 'heart-starter' I need two coffees in the morning)!! so that changed to cream. I increased my protein at breakfast from one to two eggs and cut out the milk/chia/linseed meal/hemp meal.
Hypos have ben quite sparse and slight. I try to use a small number of gluco-tabs to deal with them, which reduces the risk of over-doing it and ending up with high BSLs.
My main concern was that I would end up with insufficient Vitamin C in my diet but I looked up foods containing vitamin C and found a number of vegetables which would meet my needs - such as lightly cooked broccoli, Brussel sprouts, and I try to eat some raw capsicum (peppers) each day. Those things also help to prevent constipation.
I have avoided fruit but decided I might have the occasional strawberry in season. Nuts I take are walnuts as these have the best omega 3 content. Fish I have most days, usually reserving them for after exercise (within about 30 minutes) as that helps to build muscle.
The one 'trap' is high BSLs arising from a blocked/bent cannula. With ketones already present I find the high BSL is more difficult to control and I am concerned about an escalation into a dangerous level of ketones. I use the graph below to help guide me and have worked out a protocol with my DSN of how to deal with this situation.
Also I have moved to exclusively using steel cannulas. I find that they do not kink, bend and thus are much more reliable.
My DSN tells me that many her clients on pumps are changing to steel cannulas for this reason.
I hope the above helps and please keep asking questions as you need to!! Best Wishes.

 

[Cobia]

To be honest I haven't heard of anyone being warned against LCHF so unsure if the advice here is different to Aus ?

Yep got told its unsustainable.... opinions can change..,