hypothetical question about T1D and survival without insulin

[t1d2019]

Hi everyone,

I am a T1D myself for nearly 4 years (since 16 yrs old) and I’m still learning about what insulin really does the body in depth/scientific terms.

I know the basics and the ins and out as I have to inject novarapid as well as my lantus daily and I don’t really have any problems with it. I just have this random question in my head. (DISCLAIMER VERY VERY HYPOTHETICAL, I NOR ANYONE ELSE SHOULD NOT DO THIS!!)
So a keto diet includes very little to no carbs meaning that there is a reduced chance of hypers.

My question is what if I were to abide by a completely ketogenic diet as well as only eating careful amounts of carbs in cases of hypos WITHOUT using any insulin at all? As in stop the use of insulin completely?

Of course in cases of hypers it’s needed but for arguments sake, assume there to be no hypers as I tried the keto diet for a week and experienced no high blood sugar?
What other factors would we need to think about and what happens to a diabetic not taking insulin completely excluding the element of carbs?

(Again this is very hypothetical and definitely a bad thing to do personally but i just haven’t seen any reports or articles on the number of ways this could affect a T1D negatively or even positively)

Thank you

 

[EllieM]

My question is what if I were to abide by a completely ketogenic diet as well as only eating careful amounts of carbs in cases of hypos WITHOUT using any insulin at all? As in stop the use of insulin completely?

That would allow you to stop the use of your bolus insulin (unless you need it for correction doses) but even without carbs humans need some insulin. (Which is why you have a basal dose).

Some new T1s go through a honeymoon period where their insulin production recovers a bit and those ones often have a period where they don't need insulin, specially if they are very low carb. But unfortunately when their insulin production declines further there comes a point where there isn't enough to cover your background needs, even on a keto diet. (Before the discovery of insulin T1s lives were prolonged by essentially following a keto type starvation diet, but they died in the end).

However, they did an interesting study in Scotland where they tested the c-peptide (ie insulin production) of all their outpatient T1s who'd been T1 for more than 3 years. A significant number (over 100 of 800) were still producing some insulin. This led to a number of rediagnoses (to T2 and MODY) and a few came off insulin.
https://www.diabetesincontrol.com/preventing-misdiagnosis-between-type-1-and-type-2/

Edited to add, and welcome to the forums

 

[plantae]

I don't know for sure but as a t3c I think I went through a honeymoon period as well. When I first came out of hospital 5 years ago my blood sugars were crazy and because most of my pancreas was gone the doctors said I'd need to be on insulin. I asked if I could try controlling things using diet alone with regular appointments/supervision and the doctors agreed. With diet alone I got blood sugars (daily and HBA1c) into the normal range. The doctors said they'd never seen anyone get their HBA1c down to normal in just 2 months. For 5 years everything was normal just by me controlling what I ate and exercise. It wasn't always easy, but it worked. The reason I'm saying I think I had a honeymoon period is that just recently the diet stopped working. Blood sugars out of control and insulin was/is the only option. It's like my limited beta cells were working for that 5 years and then suddenly decided they'd had enough. I'm on insulin now and my honeymoon period, if that's what it was, is over. I'm still very conscious of what I eat -- a habit followed for 5 years is hard to break, and I don't want to break it anyway

 

[plantae]

My question is what if I were to abide by a completely ketogenic diet as well as only eating careful amounts of carbs in cases of hypos WITHOUT using any insulin at all? As in stop the use of insulin completely?

My diet is not ketogenic, but it's low carb. I've read that the full keto diet can be dangerous for T1 diabetics but I don't know if that's because of insulin or the risk of DKA or...? I don't know but am interested in hearing. It's definitely something I'd talk to my health care team to about before starting though

 

[Goonergal]

My diet is not ketogenic, but it's low carb. I've read that the full keto diet can be dangerous for T1 diabetics but I don't know if that's because of insulin or the risk of DKA or...? I don't know but am interested in hearing. It's definitely something I'd talk to my health care team to about before starting though

Take a look at this site authored by a doctor with type 1. NB Its about keto and type 1, not about type 1 and completely avoiding insulin!

Type 1 Keto – Rethinking Type 1 Diabetes

 

[Zhnyaka]

historical background:

Diets which involved cutting back sharply on carbohydrates and then increasing the
proteins or fats to compensate, achieved nothing – or, worse, caused a higher rate of acidosis and death in coma because of their fat content. The answer was to continue to cut back on carbohydrates, but to cut back one everything else, too, so that the diabetic’s total calorie intake was reduced.
...
the choice came to this: death by diabetes or death by what was often called “inanition.”

it doesn't sound very attractive.

I don't know how appropriate it is to refer to personal experience, but this almost cost me my life

 

[Jaylee]

Hi everyone,

I am a T1D myself for nearly 4 years (since 16 yrs old) and I’m still learning about what insulin really does the body in depth/scientific terms.

I know the basics and the ins and out as I have to inject novarapid as well as my lantus daily and I don’t really have any problems with it. I just have this random question in my head. (DISCLAIMER VERY VERY HYPOTHETICAL, I NOR ANYONE ELSE SHOULD NOT DO THIS!!)
So a keto diet includes very little to no carbs meaning that there is a reduced chance of hypers.

My question is what if I were to abide by a completely ketogenic diet as well as only eating careful amounts of carbs in cases of hypos WITHOUT using any insulin at all? As in stop the use of insulin completely?

Of course in cases of hypers it’s needed but for arguments sake, assume there to be no hypers as I tried the keto diet for a week and experienced no high blood sugar?
What other factors would we need to think about and what happens to a diabetic not taking insulin completely excluding the element of carbs?

(Again this is very hypothetical and definitely a bad thing to do personally but i just haven’t seen any reports or articles on the number of ways this could affect a T1D negatively or even positively)

Thank you

Hi,

Welcome to the forum..

This is worth a read.. https://bantinghousenhs.ca/2016/07/29/before-banting-treatments-for-diabetes-in-the-pre-insulin-era/

It was reported, it didn’t turn out too well…