Keto + T1D Issues

[KetoOptimized]

Hello! I am a type one diabetic. I have been following keto for almost 3 or 4 months now. At the beginning, I was just doing 'low carb' to reduce my insulin intake but being a bit of a perfectionist I soon found myself going for the deep end on what could be achieved. I have reduced my basal insulin from 32u twice daily to 13u twice daily, and my bolus insulin only 1 to 5u a day. I have lost a good amount of weight and soon will be following keto to just maintain weight. Everything there is going good.

My problems is that on strict keto I find my diabetes, glucose and insulin to be a lot less predictable, and I want to collect information from other diabetics who have had other abnormal issues while on keto. I have a keto shake which has 5g of carbs. For this I would normally take 1u bolus (ratio is 1u for 10g carbs), but I am finding I have to take 3u! I can verify my ratio works though with say salads, but find when there are proteins involved, it really changes things up very randomly for me. I have read that you sometimes should account for proteins and add bolus, but my question would be how this might affect keto in general, just in regards to more insulin. I didn't have this issue before. It seems different foods are having different affects that previously didn't.

Another issue I find I'm having is my basal is not lasting(?) as long as it did before. I take Levemir every 12 hours, but find that it is falling short. I've worked out that I must take my night dose approximately 15 hours after the morning, or else I will have a huge spike in the night. Displacing the time allows me to have a huge spike in the evening when I'm at least awake to cover with bolus. This also was never a problem before.

In summary I am just going crazy trying to figure out all of these new things out and would like to have a list in mind of possible things that other people have experienced while on keto. Maybe you have seen some of my issues yourself and have worked out resolutions, or maybe you have different issues with resolutions. It would be great to hear them. Keto is something that is working great for me - apart on the most important front, diabetes.

 

[DCUKMod]

Hello! I am a type one diabetic. I have been following keto for almost 3 or 4 months now. At the beginning, I was just doing 'low carb' to reduce my insulin intake but being a bit of a perfectionist I soon found myself going for the deep end on what could be achieved. I have reduced my basal insulin from 32u twice daily to 13u twice daily, and my bolus insulin only 1 to 5u a day. I have lost a good amount of weight and soon will be following keto to just maintain weight. Everything there is going good.

My problems is that on strict keto I find my diabetes, glucose and insulin to be a lot less predictable, and I want to collect information from other diabetics who have had other abnormal issues while on keto. I have a keto shake which has 5g of carbs. For this I would normally take 1u bolus (ratio is 1u for 10g carbs), but I am finding I have to take 3u! I can verify my ratio works though with say salads, but find when there are proteins involved, it really changes things up very randomly for me. I didn't have this issue before. It seems different foods are having different affects that previously didn't.

Another issue I find I'm having is my basal is not lasting(?) as long as it did before. I take Levemir every 12 hours, but find that it is falling short. I've worked out that I must take my night dose approximately 15 hours after the morning, or else I will have a huge spike in the night. Displacing the time allows me to have a huge spike in the evening when I'm at least awake to cover with bolus. This also was never a problem before.

In summary I am just going crazy trying to figure out all of these new things out and would like to have a list in mind of possible things that other people have experienced while on keto. Maybe you have seen some of my issues yourself and have worked out resolutions, or maybe you have different issues with resolutions. It would be great to hear them. Keto is something that is working great for me - apart on the most important front, diabetes.

Hello KetoOptimised, and welcome.

As a matter of interest, how long had you been T1, prior to embarking on LC, then keto, and secondly how long have you been on it?

I'm not T1 myself, so I have no personal wisdom to offer you in this regards, but I'll tag in @Mel dCP and @NicoleC1971 as they are both certainly LC, but may actually be keto too.

Good luck with it all.

 

[Scott-C]

Haven't tried keto myself, @KetoOptimized , but a lot have posted that they've found they need to bolus for protein at generally about half the carb ratio, but it can vary between different meat types, so you may find that you have to "protein count" as well as "carb count".

Protein can end up as glucose through gluconeogenesis, but this can take a while, several hours, so those unexplained spikes might be to do with that, rather than basal. Others have mentioned splitting the bolus and/or adjusting the timing of it.

 

[KetoOptimized]

Hello KetoOptimised, and welcome.

As a matter of interest, how long had you been T1, prior to embarking on LC, then keto, and secondly how long have you been on it?

I'm not T1 myself, so I have no personal wisdom to offer you in this regards, but I'll tag in @Mel dCP and @NicoleC1971 as they are both certainly LC, but may actually be keto too.

Good luck with it all.

I have been a T1 for 15 years, and I was low carb for maybe 1 month before switching to full keto. Thank you for tags and the welcome.

 

[KetoOptimized]

Haven't tried keto myself, @KetoOptimized , but a lot have posted that they've found they need to bolus for protein at generally about half the carb ratio, but it can vary between different meat types, so you may find that you have to "protein count" as well as "carb count".

Protein can end up as glucose through gluconeogenesis, but this can take a while, several hours, so those unexplained spikes might be to do with that, rather than basal. Others have mentioned splitting the bolus and/or adjusting the timing of it.

Sorry I have edited my post. I should have put that. I have heard of this insulin for proteins but I'm wondering how that affects keto in general, if you are taking more insulin? I assume this must happen in non-diabetics as well. Its puzzling that is not mentioned much in keto guides. I suppose its because they always talk in carb terms only.

 

[NicoleC1971]

Hello! I am a type one diabetic. I have been following keto for almost 3 or 4 months now. At the beginning, I was just doing 'low carb' to reduce my insulin intake but being a bit of a perfectionist I soon found myself going for the deep end on what could be achieved. I have reduced my basal insulin from 32u twice daily to 13u twice daily, and my bolus insulin only 1 to 5u a day. I have lost a good amount of weight and soon will be following keto to just maintain weight. Everything there is going good.

My problems is that on strict keto I find my diabetes, glucose and insulin to be a lot less predictable, and I want to collect information from other diabetics who have had other abnormal issues while on keto. I have a keto shake which has 5g of carbs. For this I would normally take 1u bolus (ratio is 1u for 10g carbs), but I am finding I have to take 3u! I can verify my ratio works though with say salads, but find when there are proteins involved, it really changes things up very randomly for me. I didn't have this issue before. It seems different foods are having different affects that previously didn't.

Another issue I find I'm having is my basal is not lasting(?) as long as it did before. I take Levemir every 12 hours, but find that it is falling short. I've worked out that I must take my night dose approximately 15 hours after the morning, or else I will have a huge spike in the night. Displacing the time allows me to have a huge spike in the evening when I'm at least awake to cover with bolus. This also was never a problem before.

In summary I am just going crazy trying to figure out all of these new things out and would like to have a list in mind of possible things that other people have experienced while on keto. Maybe you have seen some of my issues yourself and have worked out resolutions, or maybe you have different issues with resolutions. It would be great to hear them. Keto is something that is working great for me - apart on the most important front, diabetes.

Hello there,
I am sorry to hear that you are struggling with this and would say that it hasn't been smooth sailing for me.
EXPECTATIONS
I have has this thing for 38 years and navively thought that going keto/low carb should produce me a lovely level bg line 'in arget range' however although my hba1c is better I can still get spikes from unexpected quarters.
I know others have found it easier so I am determined to stick at it because the approach makes a lot of sense on paper!
RESULTS
My goal when trying low carb ( I don't know if I am in ketosis ) was to reduce my insulin whilst keeping bgs even so that I didn't become insulin resistant. I use less insulin overall, think I've lost a bit of fat and my hba1c is down 7 points, the latter helped by getting a handle on my basal rates with the help of freestyle libre. You have lost weight and are using less insulin too so that's some kind of result.
basal /bolus
Getting my basal right has been key and the pump has helped in that |I can increase my dose towards dawn when many type 1s get a spike due to the dawn phenomenom. Splitting the dose and taking the evening one later makes sense in that context.
Bolus
I find that the days when I don't eat are the easiest but that's hardly a viable solution!
I have also been surprised by how much glucose my liver/pancreatic alpha cells can churn out in response to minimal carb meals and weight training or hiiT. Other than trying to keep to regular meals (2-3 per day) and doses taken before my BG can spike, I know that I just have to keep on top of it.
Is it worth it?
I like this way of eating because I am weight stable and get to enjoy delicious food without counting calories so for me it is ingrained now and feels easy. It sounds as if you are happy with what you've achieved so far but are frustrated by the unpredictability of your response to foods? Can you regularise what you eat and when you eat it to be able to get a fix on what works? A free style libre would be a great tool if you can get one. Your bgs are not just about the carbs but other factors (exercise, stress,hormones) are going to complicate things too. It is frustrating to have so many variables that we may not be in control of or even be aware of and perhaps you need to get out of the deep end and modify your expectations of yourself as you can on this experiment.

 

[KetoOptimized]

Hello there,
I am sorry to hear that you are struggling with this and would say that it hasn't been smooth sailing for me.
EXPECTATIONS
I have has this thing for 38 years and navively thought that going keto/low carb should produce me a lovely level bg line 'in arget range' however although my hba1c is better I can still get spikes from unexpected quarters.
I know others have found it easier so I am determined to stick at it because the approach makes a lot of sense on paper!
RESULTS
My goal when trying low carb ( I don't know if I am in ketosis ) was to reduce my insulin whilst keeping bgs even so that I didn't become insulin resistant. I use less insulin overall, think I've lost a bit of fat and my hba1c is down 7 points, the latter helped by getting a handle on my basal rates with the help of freestyle libre. You have lost weight and are using less insulin too so that's some kind of result.
basal /bolus
Getting my basal right has been key and the pump has helped in that |I can increase my dose towards dawn when many type 1s get a spike due to the dawn phenomenom. Splitting the dose and taking the evening one later makes sense in that context.
Bolus
I find that the days when I don't eat are the easiest but that's hardly a viable solution!
I have also been surprised by how much glucose my liver/pancreatic alpha cells can churn out in response to minimal carb meals and weight training or hiiT. Other than trying to keep to regular meals (2-3 per day) and doses taken before my BG can spike, I know that I just have to keep on top of it.
Is it worth it?
I like this way of eating because I am weight stable and get to enjoy delicious food without counting calories so for me it is ingrained now and feels easy. It sounds as if you are happy with what you've achieved so far but are frustrated by the unpredictability of your response to foods? Can you regularise what you eat and when you eat it to be able to get a fix on what works? A free style libre would be a great tool if you can get one. Your bgs are not just about the carbs but other factors (exercise, stress,hormones) are going to complicate things too. It is frustrating to have so many variables that we may not be in control of or even be aware of and perhaps you need to get out of the deep end and modify your expectations of yourself as you can on this experiment.

Thanks for you reply. You are right. On paper low carb / keto looks wonderful. My journey actually started when I bought the libre (NHS has yet to prescribe me) and saw all the data and wanted to get that line to be as good as possible. My results from keto are great, too, but you are also correct in my frustration with food. It does seem easier to sometimes not eat to avoid losing great control but thats just too unhealthy. I eat pretty staple keto foods - lots of eggs, avacados, meats, salads, and keto shakes which you can add your own fat too. For the fat I use XV olive avacado oils. So mostly the same stuff everyday.

On a side note, I am also very surprised by the spikes when doing exercise. I am less concerned with this as it should fade/be controllable but always surprising!

 

[DCUKMod]

Thanks for you reply. You are right. On paper low carb / keto looks wonderful. My journey actually started when I bought the libre (NHS has yet to prescribe me) and saw all the data and wanted to get that line to be as good as possible. My results from keto are great, too, but you are also correct in my frustration with food. It does seem easier to sometimes not eat to avoid losing great control but thats just too unhealthy. I eat pretty staple keto foods - lots of eggs, avacados, meats, salads, and keto shakes which you can add your own fat too. For the fat I use XV olive avacado oils. So mostly the same stuff everyday.

On a side note, I am also very surprised by the spikes when doing exercise. I am less concerned with this as it should fade/be controllable but always surprising!

KetoOptimized - I'm not challenging your choices (how could I), I'm curious about what's actually in your keto shake?

 

[KetoOptimized]

KetoOptimized - I'm not challenging your choices (how could I), I'm curious about what's actually in your keto shake?

No worries. We are free to make our own choices. I use a meal replacement shake which contains many nutrients. I was trying to avoid specifically naming it as it is a purchased product. But since you asked, the nutrition information can be found on their website: genesisfoods.co/our-nutrition

 

[NicoleC1971]

No worries. We are free to make our own choices. I use a meal replacement shake which contains many nutrients. I was trying to avoid specifically naming it as it is a purchased product. But since you asked, the nutrition information can be found on their website: genesisfoods.co/our-nutrition

Checked that out and the ketogensisis/glycogenesis pouches make sense but do you now what microgenesis aims to do?! Would love to find a good probiotic mix for my son but the faqs don't answer the question.

 

[KetoOptimized]

Checked that out and the ketogensisis/glycogenesis pouches make sense but do you now what microgenesis aims to do?! Would love to find a good probiotic mix for my son but the faqs don't answer the question.

Not to turn this into a product plug but the guy who runs it is really, really helpful and knows his stuff. I have messaged a few times about different things. Use the contact form there and I'm sure he can answer all of your questions.