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Keto Diet and no Fast Acting Insulin

DCUKMod said:
Hi @JoeT1 - I watched this last night


The speaker is T1 GP, who is T1, using a keto diet.

http://type1keto.com/
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Wow. This was a real eye-opener for me. As I've discussed in other threads, I've been considering low-carb diet as one angle of attack on what is probably SIBO, but had concerns about exercise. This video has given me immense confidence in this approach, not least because running is my current exercise of choice. Thanks indeed!
 
Mel dCP said:
I’m aiming for 65% fat, 25% protein and 10% carbs. Does that sound about right?
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It’s closer to 75-85 fat, 15-20 protein and 20 or less TOTAL carbs
I’m 80/15/20 total carbs. But whatever works for you.
Keto isn’t about gobbling fat but rather minimizing carbs and protein because they both spike insulin. The new standards are .6 g per kg LEAN body mass but many eat over that. Then fill the rest in with healthy fats.
I’m on many keto forums and they vary in macros but the 20 or less total, not net carbs is standard on all. Most have protein set for women between 45-60 max divided through the day. The biggest difference is in fat. Some do 800 calorie coffees and fat bombs. Load up on bacon and it’s grease etc. Some say fat until satisfied.
I do Whole fresh food keto. An avocado a day is my main carb plus some veggies like brussel sprouts, broccoli or asparagus, some lettuce wraps with protein and fat in them. Most meals are protein, an avocado wedge and some random veg but small more frequent meals. I drink broth with ghee 2x per day but a little over a tsp ghee. I use butter and olive oil where needed. I snack on a few nuts or olives. I also use duck fat and beef tallow in my broth instead of ghee to get a variety of fats. I eat a wide variety of proteins. I do not eat chicken skins, bacon, bacon grease, lately no dairy except butter. But this is only the way I choose to do keto. There are many ways to choose from.
But again the carbs and protein have to be low enough to not spike insulin and to allow your body to burn your own fat reserves as fuel.

Hope that helps. Keto on....
 
If I can ask a couple more questions, how do I work out lean body mass? I’m pretty fat (years of feeding insulin with carbs as recommended).

I can’t eat mammal or bird meat, or cow dairy due to allergies (thanks, immune system!), so a lot of the standard keto foods are out. Luckily I can have goat butter! But if I’m still showing positive on the ketosticks, I’m in ketosis, right?
 

From you saying « first Hba1c » post diagnosis, I take that you were diagnosed recently with T1. Bear in mind that a honeymoon period might kick in, and thus that you might still be producing a tiny bit of insulin, which might be near enough for someone on a keto diet. I am by no means advocating not injecting, I’m just saying keto might take you very low in injection levels: I went keto a month after my diagnosis and ended up on no fast acting insulin for days and virtually no basal at all either for days - very probably thanks to some insulin still being produced by my body. My hba1c went from 116 on diagnosis to 45 three months after and after joyfully going full keto. I’m not saying that’s a one size fit all solution, and normal low carb is absolutely a very good option as well, but I agree with you that it really helps with bg control!
 
I’m new to keto but I’ve been T1 for 20 years this year - and I’m going whole days without needing any Novorapid.
 
Colin of Kent said:
When you're reading positive on your ketostix, it's time to take some insulin, pronto. This is ketoacidosis, which is different from ketosis.

http://www.battlediabetes.com/artic...e-difference-between-ketosis-and-ketoacidosis
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The glucose is negative on the sticks, the ketones are positive. My Libre shows me consistently within my range of 4.5-7.5mmol and my blood tests are also backing that up. I feel great and have none of the DKA symptoms - no nausea or shortness of breath. If I were to take even a unit of insulin, I’d have a massive hypo.
 

I agree with Colin that the one thing to look out for while doing keto + being T1 is dka risk. However dka happens if you have both high ketone levels plus high bg levels.

However being ketone-positive on a ketone testing strip does not on its own equate dka. It only tells you one thing: there are ketones in your blood. If you follow a keto diet, it means you have been doing something right, and although it is a good indication that you may well be in ketosis, it does not necessarily mean that you are (for example if you are full keto for a while and goes back to normal diet, you will have a period where your body is no longer in ketosis but still hasn’t evacuated all the ketones (which in my experience is the period where there is a need to be extra careful).

One of the tricks to manage T1 and keto I found is to test bg often to make sure one doesn’t go hyper, which would in turn open a highway to dka. In my experience it is essentially the complexity of the diet and the commitment required to full keto that forces medical professional not to recommend that diet, because of the risk that someone unable to do either or both of those goes into dka quickly.

I hope this helps!
 
So i'm still going keto, and happy with it so far. Lost about 4lbs in a couple of weeks, another couple next week and may start adding in a little more fat and protein to ensure hunger is satisfied.

My insulin needs are still low now, from quite needy in the first couple of months after diagnosis. I am taking Basal, to which has dropped slightly, and rarely now need to take a fast acting insulin, perhaps only after adrenaline.

Has anyone experience with this being the case for rather long periods of time? I know certain people have a honeymoon period, but seems a little strange to me that I needed quite a lot when eating still relatively low carb ~30-50g, and now i'm under 10g per meal, i'm at no fast acting insulin needed. Not complaining, just looking to educate myself and prepare for changes that may come.
 

https://bmicalculator.mes.fm/?gclid=EAIaIQobChMIqc-JxPuY2QIVUluGCh1OdA4dEAAYASAAEgIK6vD_BwE
Here’s a calculator. Then you subtract your BMI from your present weight to get your lean body mass
 
I still need both basal and bolus but I take very small doses.

I eat 5 small meals a day and take 1/2 unit with each and 1-3 units lantus at night. I have to really watch my protein as it has a profound rapid effect on my bs

The good news is I had my A1C Wednesday and it was 4.7 ! Happy dance
 
Hi everyone,

I don't often post on these forums.
I've been a T1 for over 25 years now and 'thought' I had reasonably good control (haven't suffered a serious hypo in years).

Then I watched the video posted earlier in this post.
Then I read Dr Bernstein's book (referred to as mandatory reading in the video!)

So I thought I'd give the diet a try.
It's been a week now.

and OH MY GOD!!!!

It's like night and day - my BG is now pretty much ALWAYS between 4.0 and 7.0 mmol/l yet I take about a third of the insulin I used to:

Before.........Now​
Breakfast...............8..............2.5........Novorapid
Lunch....................9..............4................. "
Dinner...................9..............5................. "
Bedtime...............15.............6............Lantus

Daily total...........41............17.5

I'm not very good at keeping to the carb allowance of 6g for breakfast and 12g for lunch and dinner as laid out in the book.
I'm more like 8g/15g/15g.

Why doesn't everyone know about this?

- I'm never hungry between meals (so I don't snack anymore)
- I never force myself to eat to keep the sugar levels from dropping
- I no longer feel tired at various times of the day
- I have no issues with managing my sugars when I exercise
- my sugar levels are just so **** stable!

I could go on, but I won't.

I haven't felt this positive about my diabetes.....ever.

Thank you to the posters on that first page...you've changed my life!

And finally, keep spreading the word!
I've been telling everyone I know who is, or has family members who are, diabetic or pre-diabetic.

Awesome!

RBG
 
Sorry, guys, but I really don't get the bernstein approach.

I downloaded the free sample to my kindle and the introduction alone was enough for me, I'm not going to pay to buy the full book. He comes across as a zealot.

He makes out that he and he alone was the only guy responsible for pushing against the forces of corporate evil to make meters available to all. That's patently not true. There was a lot more going on at the time but he ignores it, making himself out to be the hero of it all. Narcisist.

Then he tells us all about how he suffered complications and came back from it. Big f**** deal. He suffered complications because methodology wasn't that great when he was growing up, then better tools became available, so he got better. He ignores the fact that those tools are now available from the start for the younger generation, so they are unlikely to develop complications in the first place.

Flat lines? Sure, they look pretty from an aesthetic point of view, but are they really necessary? Ever seen a cgm trace from a non-T1? They're all over the place. Endos who have worn cgms reckon we are holding ourselves to unneccesarily high standards.

Does bernstein address cgm anywhere at all? His law of small numbers smacks of cowardice. He is a relic from the methods of the 1960s. There will always be a broad correspondence between a high carb meal and high dose. A high dose simply will not take you into any sort of death zone of the type suggested by bernstein. Any inaccuracies can be seen easily with cgm and corrected with a few biscuits, not an ambulance. bernstein spreads unnecesary fear.

Here's a test for you all to see how devoted you are to bernstein and/or keto.

You and I are going out for Saturday brunch.

I'm going to be having a full breakfast and that will include potato scones, toast, black pudding (one slice has 10g, so bernstein rules it out), haggis (we do brunch properly in Scotland. A slice is maybe 15g - the doc says no), tomatoes and I'm not even going to bother counting those.

I'll do all that quite happily, because I know from past experience how many u I'll need and if inherent T1 unpredictability throws it out, it's nothing a few g or u won't sort.

You, on the other hand, following the dictates of an elderly man who you've never met who is heavily influenced by outdated 1960s experiences which you will never have to live through, will have bacon and eggs.

I'll have a nice meal with few risks. You'll have bacon and eggs - and nothing else forever.

Look within yourself and ask, once the initial enthusiasm for all things bernstein wears off, is that something you're ok with for the next 40 years?

Test the waters. They're not that deep, despite the fears and cowardice bernstein seems intent on spreading.
 
Congrats !! It is amazing isn’t it? I too follow bernsteins laws of small numbers. It’s the only way I can keep bs steady. But I eat 20 or less TOTAL carbs, not net per day. Keotogenic. I LOVE it
 


@Scott-C,
We are all different in how we want to manage. Why can you not respect the choice other people make. Low carb diet is not for you but it works perfectly for some including me. Does it bother you ? not about fear and cowardice. It's just a differ t approach.
 

I do respect the choices other people make, but it doesn't seem to work the other way round.

Keto enthusiasts can be like converts to a new religion - they can be very insistent that they have found the truth, the one and only true way and that everyone else is wrong.

There have been numerous posts where keto people have accused people who are more relaxed about matters of being insane, reckless, irresponsible. They ruin their case by overstating it.

If keto works for you, fine, carry on, but I am entitled to point out it's flaws and limitations.
 

You may also find Dr Keith Runyan's blog interesting. He is a nephrologist with T1D and a triathlete.
https://ketogenicdiabeticathlete.wordpress.com/author/krunyanmd/
 
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