Keto Diet & Type 1

Hi and welcome to the forum

I will let other T1s offer advice, but I know that some have problems with pasta and pizza.

Hi @Leah96 ,

I've pretty much (hopefully) adressed your question regarding nutritional Ketosis on such a diet with stable BGs & ketoacidosis when BGs are high..

To be fair I do keep my carb count low, but I wouldn't call it keto.

Personally I would start with the foundations of basal, whatever diet you choose. Get that right? Then you have a "benchmark" for what you bolus for.

I'll tagg in @michita , who if I remember rightly is pretty low carb.

Leah96 said:

Hey thank you for your response!
Yes, my basal has been high for quite some time now as I was having high blood sugars - these have been gradually reduced and so with starting Keto I have reduced my basal to 28. I have read up that average basal is 24, which may explain why I’ve been having perfect bloods all day and then waking up with a hypo of 2.4 around 10 hours after taking my basal.
I know that low carb is a good thing for T1s, however reading that low bloods/low insulin can also cause DKA has thrown me off a little!

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DKA is the result of high blood sugars. Not a good thing.
But there can also be traces of ketones with normal parameter BGs on keto diet. "Nutritional ketosis."

How long have you been diagnosed T1?

Hi. My understanding is that high BS is the main cause of DKA and in the presence of ketones due to fat burning. If you have enough insulin to keep BS 'normal', DKA is unlikely.

Leah96 said:

Yes! This is what I thought! I have been T1 Diabetic for 11 years and have always been advised against high blood sugars resulting in DKA so I’ve always been very very cautious of high bloods, however today I read that it is rare but possible to enter DKA with low/normal bloods whilst on less insulin which completely confused me! For example today I have had under 20g of carb and I’ve not actually had to take any bolus, even though I’ve had 3 meals! I’ll of course be taking my basal (reduced) I just wanted to check on the info I read on low sugars and DKA!

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You may do well to join the type1grit facebook group who follow a very low carb way of eating to maintain stable blood glucose with less insulin following Dr Bernstein's principles.

https://www.facebook.com/Type1Grit/

Hello
Welcome to the forum! I hope you are having a good day

I’ve been low carbing since diagnosis 4 years ago. I wouldn’t call my diet ketogenic as I’m not that strict and my guess is I eat around 50g carbs a day from veggies etc. Luckily the diet works very well for me. I don’t need to carb count (I go by volume and guess 0 to 2 units per meal) and I don’t get noticeable bs rise from proteins.

To answer your question, DKA is associated with high BS so ketosis will not lead to DKA. You are taking your basal so you are taking enough insulin. No question. There is a rare condition called euglycemic DKA (EDKA) which happens with normal BS level normally associated with SGLT2 inhibitors. you can use search function on this forum to read about. Personally I have zero concern on EDKA and for me actual every day (and future) benefit from low carb diet simply outweighs. But it’s up to each of us to decide what feels most safe and comfortable in terms of dealing with diabetes

Hi, and welcome to the forum. I’ve been eating keto for a couple of years now, and have the best control over my blood sugars in my 22 years of T1. Wish I’d known about it years ago tbh! This is my CGM trace for the last couple of days. To be fair, I am also using a DIY artificial pancreas system, but even when on injections I could achieve similar results; it just took a lot more effort.




You do have ketones, but DKA is only really an issue if you have the unholy trinity of high BG, no insulin in your body and are dehydrated. The few documented cases of euglycaemic DKA have been when the person has been taking SGLT-2 inhibitors. Make sure you have a blood ketone meter to keep an eye on your levels. Mine were 0.9 this morning but can go up to 2.5. My insulin use has halved, I’m only using around 30u a day now. I eat 30g or less of carbs a day.

Leah96 said:

Hello, has anybody tried the Ketogenic Diet as a type 1 diabetic?
I have been managing my blood sugar levels very well since starting the diet on Monday, and my blood sugars have not gone over 10.5, and I have also been taking less rapid insulin (around 2-3 units per day, today I have taken none and my sugars are 6 after having very low carb breakfast, lunch and dinner).
I am aware of what Ketoacidosis is (DKA) and have never experienced this, however on the Ketogenic diet the aim is to enter Ketosis. Whilst looking further into Ketoacidosis I’ve read that it is possible to also enter DKA from not taking enough insulin or eating enough food - does anybody know about this, as I am taking dramatically less insulin and eating high fats and low carb, but my blood sugars are very stable, so I’m a little worried about this happening. Any help would be much appreciated!

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Do yourself a favour and read the book Dr Bernstein’s Diabetes Solution’. Most endos hate it and won’t accept what’s written in it because it challenges everything they’ve been taught. The doctor go wrote it is also an old insulin dependent doctor. He explains very clearly why low carbs is the BEST option for diabetics. Less to correct, calculate and manage. Great weight loss. Satisfying food. It’s not a diet book it’s a whole education on the disease itself. I’ve had type one for 38 years and have done a complete 180 on my diabetes management after reading this book.