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Is ketosis safe for a type 1

GBS_82_

GBS_82_

Well-Known Member
Messages
70
Location
Croydon, London
Type of diabetes
Type 1
Treatment type
Insulin
Hi all

Happy New Year! Hope everyone's well.

I was diagnosed in Feb 2016 and - as is so often the case - have put on a bit of weight since diagnosis. I'm still just about a healthy weight but decided to try and bring it down during 2017.

As such, I've started low carbing (I did this for weight loss rather than diabetes management although it has also had a great effect on my blood sugars - I stay in range almost all day). Nothing crazy - I eattwo pieces of the very small wholemeal toast at breakfast (total of 16g) and green veg in the evening which usually gives me the small rise I need to be 8ish in time for bed. I bolus for breakfast, take my basal twice a day and monitor blood sugars throughout the day and will eat carbs if I really need to at any stage to boost my levels (typically a jelly baby at 11am).

Since I've been doing this, I've noticed that my ketones are a little higher - about 0.3 mmol/l. I'm obviously not the least bit worried about this as it's well within safe levels and hope it's a sign my body's burning a little fat.

However, I have read that the objective of many low carb diets is to go into ketosis - ketones of 1.5-3. Given that I currently have no intention of giving up my morning 16g of carbs I doubt this will happen to me. But I wanted to check- is it safe for a type 1 to go into ketosis?

When I was first diagnoses - horrible DKA was in hospital for two weeks - I was told to go into hospital if ever my ketones were 1.5 or above. Is it that type 1s just can't handle this level of ketones? Or is it that this is usually a worry because it suggests something - i.e. insulin - is not working properly. If I know it's being caused by low carbing and I'm still taking my basal and bolus where needed, is it a problem?

Really appreciate any insight.

Thanks everyone!

Gareth x
 
GBS_82_ said:
Hi all

Happy New Year! Hope everyone's well.

I was diagnosed in Feb 2016 and - as is so often the case - have put on a bit of weight since diagnosis. I'm still just about a healthy weight but decided to try and bring it down during 2017.

As such, I've started low carbing (I did this for weight loss rather than diabetes management although it has also had a great effect on my blood sugars - I stay in range almost all day). Nothing crazy - I eattwo pieces of the very small wholemeal toast at breakfast (total of 16g) and green veg in the evening which usually gives me the small rise I need to be 8ish in time for bed. I bolus for breakfast, take my basal twice a day and monitor blood sugars throughout the day and will eat carbs if I really need to at any stage to boost my levels (typically a jelly baby at 11am).

Since I've been doing this, I've noticed that my ketones are a little higher - about 0.3 mmol/l. I'm obviously not the least bit worried about this as it's well within safe levels and hope it's a sign my body's burning a little fat.

However, I have read that the objective of many low carb diets is to go into ketosis - ketones of 1.5-3. Given that I currently have no intention of giving up my morning 16g of carbs I doubt this will happen to me. But I wanted to check- is it safe for a type 1 to go into ketosis?

When I was first diagnoses - horrible DKA was in hospital for two weeks - I was told to go into hospital if ever my ketones were 1.5 or above. Is it that type 1s just can't handle this level of ketones? Or is it that this is usually a worry because it suggests something - i.e. insulin - is not working properly. If I know it's being caused by low carbing and I'm still taking my basal and bolus where needed, is it a problem?

Really appreciate any insight.

Thanks everyone!

Gareth x
Click to expand...

Hi Gareth - I'm not T1, but I'll tag a couple of T1 low carbers. @robert72 and @tim2000s are both low carbers, but I have no idea if they strive for ketosis, but they may know others who do.

Good luck with it all.
 
@GBS_82_ There's a big difference between nutritional ketosis and ketoacidosis. The latter is obviously very dangerous, but the former is ok and not uncommon eg upon waking or at times when we don't eat as much.

It's good that you're monitoring everything carefully. If it's working for you, then that should reassure you, but if you ever have any concerns, it's always sensible to double check with your DSN.

Good luck :)
 
GBS_82_ said:
However, I have read that the objective of many low carb diets is to go into ketosis - ketones of 1.5-3. Given that I currently have no intention of giving up my morning 16g of carbs I doubt this will happen to me. But I wanted to check- is it safe for a type 1 to go into ketosis?
Click to expand...

Hi Gareth,

There's no problem with ketosis; it is merely a normal metabolic state that anyone will go into in the absence of carbohydrate, as has been said above it is a very different state to ketoacidosis which will occur in the absence of insulin. Ketosis and insulin is fine.

The standard of diabetic care is such that virtually the only experience most health care providers have of ketones is in the context of ketoacidosis. So, when you say 'I've got ketones in my urine' they will freak out. Don't worry about that; as long as you are monitoring your bloods and taking your insulin ketoacidosis will not occur.

It is always worth stating that the first principle of diabetes of any sort is that it is an illness arising from a dysfunction in glucose metabolism, so all things being equal the removal of as much glucose as possible should be the first response. Low carbing in other words is exactly the right thing to do.

I wonder whether your blood sugar drops at 11:00 am reflect your insulin sensitivity going up after a normal dawn phenomenon reduction in sensitivity? Have you tried doing a basal test to see what happens to your blood sugars in the absence of carbs and bolus insulin? Might be worth a go; search for 'basal test' on here for more information.

Best

Dillinger
 
Hi Gareth - I cant add much more to the above. As a low-carbing T1, I've been in ketosis for several years now and am normally in the 1-3 range. As long as you have sufficient insulin and thus normal blood sugars then it's OK to be in that range. Of course if you have high BS and ketones are rising then you should seek professional advice.
 
This is really helpful - thank you all very much. I feel much more reassured now. The information online is quite confusing (I'm not the brightest) but you guys have explained it really clearly.

@Dillinger- thanks for the advice on basal testing. I have tried it a couple of times and it does seem that my liver just seems to release a bit less sugar at that sort of time. Other factors could exist such as a slightly delayed reaction from my fairly long walk to work and the fact that I do morning and evening basal and I suspect 11am is when evening basal hasn't quite left my system and morning basal is starting to kick in.

However, I really am still learning and will carry on testing.

Thanks again!

Gareth x
 
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