Losing Weight with Type 1 Diabetes

amygates said:

So, one of my friend gave me a written advice to start Ketosis. Moreover, I already struggle with heavy breathing and low bp while working out but I want to lose weight.

Ketosis: When u reduce ur carbohydrate considerably, ur metabolism shifts and starts burning fat instead of glucose. After 48h with no carbohydrates, ur insulin lowers, and ur body shifts into ketosis. Ketosis is the state of burning fat.

How to kick-Start Ketosis: eliminate all carbohydrate for 48h. Eat healthy meats, wild fish, free-range eggs, low-glycemic ( below 20) vegetables, food fats from olive and coconut. No fruits or fruit juices.

Should I follow this?

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The problem with a keto diet and type 1 is that if you go low (i.e have a hypo) and take fast acting carbs/sugar to get you out of hypo state, you will be kicked out of ketogenesis.

Personally I'd say have a balanced diet, keep some carbs in but at a reduced rate (<100g a day), have a calorific deficit and do some exercise. In the long run it will also be much more sustainable. A good plan is one which you can stick to and do consistently.

Muneeb said:

The problem with a keto diet and type 1 is that if you go low (i.e have a hypo) and take fast acting carbs/sugar to get you out of hypo state, you will be kicked out of ketogenesis.

Personally I'd say have a balanced diet, keep some carbs in but at a reduced rate (<100g a day), have a calorific deficit and do some exercise. In the long run it will also be much more sustainable. A good plan is one which you can stick to and do consistently.

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I’m type one and have been eating keto for a year now - it works really well for me, not for weight loss, but for normalising my blood sugars, which is why I started it in the first place. You become much more sensitive to carbs, so I can pull myself out of a hypo with two (four if it’s <3mmol) 3g dextrose tablets and turning my pump to 0% for half an hour. That doesn’t kick you out of ketosis, and even if it does, once you’ve established your fat-burning metabolism, it takes very little time to get back there. But as your insulin doses are massively decreased, hypos are much milder and less likely anyway.

amygates said:

Hi, thank you both for reaching out. But it is now becoming a more confusing since both of you are saying different things. I am not sure what to follow. Keto or a Balanced Diet?

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It has got to be something you can do and stick with long term. Personally I don't think keto is a long term solution, others obviously do.

Eating less carbs is no doubt going to help as you have less room for error with the amount of insulin, but that doesn't mean going to keto levels to attain this.

Ok, I do keto because it works well for me - my insulin doses are tiny, but I’m on a pump which makes that possible. My first 8 months of keto were on injections, and I managed that ok, but it’s much easier with a pump.

The trick to any “diet” is to find something you can do long term without feeling you’re depriving yourself.

amygates said:

Hi, thank you both for reaching out. But it is now becoming a more confusing since both of you are saying different things. I am not sure what to follow. Keto or a Balanced Diet?

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Don't get hung up on the word ketosis.
Finding a way that you can eat for the rest of your life and which keeps your bgs in a healthy range is key.
Ketones are not (magic) unicorns they are simply as sign that your body is burning fat preferentially over glucose (what carbs turn into). Whether that fat is what you are eating or from your body stores will be determined by how much fat you are consuming.
The theory is that becoming more of a fat burner decrease the need for insulin a hormone which inhibits use of body fat for fuel and encourages storage of excess carbohydrate (those not used immediately) as fat. So yes you can eat a reduced calories 'balanced diet' including carbs but that will require careful restrictio bence the reason why most diets of this kind fail in the longer term.
Back to the consistency part, eating less carbs and more protein and fat is easier to do than calorie counting for many of us here but as suggested in other posts you don't have to dive off the deep end! And obviously you will need to decrease your bolus doses to avoid hypos (basal should be fine).
Personally I am doing this to keep better blood sugars but find that I have lost weight because I am less hungry. I probably dip in and out of nutritional ketosis but am not strict about it. What I did initially was strip back 1 meal per day of carbs and then gradually increased it until I am doing this way of eating most of the time.

amygates said:

This seems like a good thing to me. However, I am not sure about calorie expenditure because I read it somewhere is is also necessary to track it.

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Calorie's are key to weight loss, if you are not in a calorie deficit you will not lose weight. You need to calculate your maintenance calorie level then drop it by a few hundred to see any results (500 a day will result in ~1 pound of fat loss a week). So regardless of the diet you need a calorie deficit, just because you cut carbs doesn't mean you can eat as much meat or veg as you want...

amygates said:

This seems like a good thing to me. However, I am not sure about calorie expenditure because I read it somewhere is is also necessary to track it.

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NOOO!! Unless you are in an exercise laboratory with a mask on your face, you CAN'T accurately track output.
My original reply was suggesting that the reason most dieters fail is because although it is correct to state that you must take in less calories than you need to lose weight, it is very difficult to count them going in or out. For example a calorie from a carrot does not get stored as easily as a calorie from cola.
So to be clear I'd suggest Priortise Protein, Fill Up on Fat and be Careful about carbs...as a general strategy. Don't count calories. This is the way we ate for centuries when obesity wasn't a widespread thing and we did not have every morsel tracked on My Fitness Pal and every calorie counted as we make ourselves hungry at the gym.
And if you are a type 1 you already have plenty of stuff to think about without the pain of counting calories too!