Might be interesting for Type 1's and keto Dr Ian Lake

Thanks BB! Good interview. I am type 1 doing keto and taking it seriously now by using cronometer to track it all as they have a keto diet setting.
Now watching a review of UK Keto subscription boxes Low Carb Loot (not recommended) and Ketogenius (sourced from outside the UK too).
Not that I can afford fancy keto 'junk' but am interested to see what's out there\!
https://www.ketogenius.co.uk/shop
£32.99
Quite new to this so apologies if you are all familiar with this...

bulkbiker said:

https://ketogeek.com/blogs/news/diabetes-care-management-type-one-ian-lake

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I've listened to it.

Dr Lake seems to have a lot of issues with his own T1 management which he needs to sort out before he starts giving advice to impressionable newly dx'd T1s.

I note there's an article on this website about his approach:

https://www.diabetes.co.uk/in-depth/ian-lake-normal-glucose-type-1/

The telling point is that, "He has had type 1 diabetes for 22 years, spending most of that time with poor control."

He then says that, oh, hallejulah, he got good control as soon as he started keto.

He's kind of missing the point. Many of us have had good control for decades, and will continue to do so without the enormous restrictions of keto.

Dr Lake needs to explain why his control was so poor for so long before he starts driving newly dx'd into extreme eating regimes.

For newly dx'd, the methods he advocates, based on repairing, it would seem, his own, "poor control", poses a huge risk of developing needless eating disorders.

He should learn how to use insulin properly, instead of spreading that sound-bite nonsense about the, "law of small numbers". Anyone who talks about having found a law in this area is a charlatan.

I hate to think of the number of young newly dx'd T1s who have been psychologically damaged by the artificial restrictions thrust on them by these people.

Scott-C said:

I've listened to it.

Dr Lake seems to have a lot of issues with his own T1 management which he needs to sort out before he starts giving advice to impressionable newly dx'd T1s.

I note there's an article on this website about his approach:

https://www.diabetes.co.uk/in-depth/ian-lake-normal-glucose-type-1/

The telling point is that, "He has had type 1 diabetes for 22 years, spending most of that time with poor control."

He then says that, oh, hallejulah, he got good control as soon as he started keto.

He's kind of missing the point. Many of us have had good control for decades, and will continue to do so without the enormous restrictions of keto.

Dr Lake needs to explain why his control was so poor for so long before he starts driving newly dx'd into extreme eating regimes.

For newly dx'd, the methods he advocates, based on repairing, it would seem, his own, "poor control", poses a huge risk of developing needless eating disorders.

He should learn how to use insulin properly, instead of spreading that sound-bite nonsense about the, "law of small numbers". Anyone who talks about having found a law in this area is a charlatan.

I hate to think of the number of young newly dx'd T1s who have been psychologically damaged by the artificial restrictions thrust on them by these people.

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But he is not giving advice to newly diagnosed, just sharing his experience to anyone interested.

What you say is probably true for some but at the same time there will be some other type 1s who are struggling with their bs control hugely even with the best advices and would appreciate the info like this on type 1s (and type 1 doctor ) on a low carb diet.

I for one would like to know all options available and decide myself which one suites me the best, rather than one way pushed on to me.

bulkbiker said:

slight exaggeration?

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No, I don't think it's an exaggeration at all.

One doesn't need to look very far on this site to find posts from recently dx'd T1s who have developed serious eating disorders because they have read that, "carbs are bad", "you'll be on a constant roller-coaster if you look at carbs", "insulin makes you fat", "you'll have really bad hypos if you eat carbs".

There's been a few recent posts where newbies have said they would actually like to eat more carbs, but feel they can't because, erm, well, they're carbs and it might affect their levels because keto people have said so.

And people who seem to be eating either barely anything at all, or things which they don't want to eat but feel they need to because they're not carbs, when they would prefer to eat something more like their old pre-T1 life.

These people are likely candidates for eating disorders. It is unnecessary.

One has to bear in mind that the T2 population is 90% and the T1 one is only 10%. So there's numerically bound to be more posts advocating low carb/keto.

Newbies, by definition, are new to this, they likely know f all about diabetes in general, and if they come on to a site like this, they're bound to read lots of posts about low carb, and probably don't appreciate the differences in biology between the conditions, and then think that when a T2 says limit carbs as a necessity, it applies to them too. Which is why we end up with T1s terrified of eating carbs, even though they can if they use insulin properly.

We're not actually that far apart on this issue.

It's sometimes assumed that people who don't low carb must therefore be constantly binging on junk food. Maybe some do.

I don't. I eat generally healthy food in moderation. Where we differ, though, is in what healthy food means. I'm quite fond of Baxter's Soups - a typical tin of their, say, Highlander's Broth or Scotch Broth, is cutting around the 28 g mark, I'll maybe have a slice of toast to dip in, 12 g, then a punnet of raspberries, 10 g, so call it 50 g.

That's technically a low carb meal which I consider tasty and nutritious, and doesn't do anything dramatic to my bg, and there's no reason at all why any T1 can't learn some simple skills to do just that in terms of matching insulin and food absorption patterns. But...

But, that meal contains barley, wheat, some underground vegetables, more than a few raspberries - a whole damned punnet! - so it'll be written off as a travesty, a threat, food of the devil, by ketonians.

Even though it's perfectly manageable. But newly dx'd will read posts saying, oh, steer clear of that sort of stuff and that's the point they start needlessly restricting their food options.

I can perfectly understand why T2s limit those foods, but the biology is different with T1 - these are still options for us.

One of things I'm curious about is for how long T1s who have recently started keto actually maintain it. I can see how attractive it seems to a newly dx'd T1 to read here's a keto solution. But when being T1 means being T1 forever, have they considered whether they are still going to be as enthusiastic about it in 10, 20, 30 years time once the initual enthusiasm wears off?

That's not an abstract, theoretical question. It boils down to the intensely practical, real world issue of how confident the person is that in 25 years time, they'll still be ok with leaving out the hash brown, tattie scone, toast, probably the black pudding too, when they pop out for brunch on a Sunday.

T2s, sure, they'll maybe have to because of the different biology, T1s not, because it can be bolused for. That distinction is often not clear to newly dx'd T1s.

bulkbiker said:

I think that you too are a "lowish" carb eater by the sounds of it so again I do think you are exaggerating a little about causing eating disorders ( and I would question whether the disordered eating is a result of the info on the forum or whether there may have been some triggers already).

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There is at least one example within the last few weeks which springs to mind of a T1 who was given the carbs rhetoric shortly after diagnosis on a forum (unclear if it was this same forum but it was brought up here so not too much of a leap). They took it seriously and have struggled since.

I too remember similar messages shortly after joining (amongst similar helpful ones advising to try and continue as normal for stability) though I was able to work out I could continue to live as before diagnosis and take appropriate amounts of insulin for what I was eating after I figured out my doses and got settled. What Scott says is happening and we don't know at what scale it could be affecting those who don't post but read through the forum as it's public.

I get the website runs a low carb program. I get the benefits of reducing carbs for some people (whether diabetic or not) for specific purposes. I just think it needs conveying in a way that lets people know that it is one of many options.

bulkbiker said:

Ok so you don't like keto but many others do and if it can assist them then I feel it should be shown as an option.

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Thanks for posting this @bulkbiker .
Dr. Lake is one of the medical advisers on this platform (Diabetes.co.uk) so it's interesting to hear his take on this. It is also the approach used Dr. Bernstein and - for him at least - it has been sustainable. He has been following a low carbohydrate diet for 49 years and remains passionate about its benefits.

Let's just shake hands on this, and agree there's aspects of this we'll likely not agree on, @bulkbiker !

My take on it is that I'm a T1 on MDI with a small amount of knowledge about cgm and that's the extent of my skill set.

As such, I don't comment or offer views on T1s on pumps, reactive hypoglycaemia, gestational diabetes, lada, or T2, except when those areas do some Venn diagram stuff which intersects with what I know about.

But what happens all too often on this site, in my view, is that people step way out of their experience area.

We see that all the time when a newly dx'd T1 asks for some basic advice on how they'll deal with a simple thing like a 50g panini, and then it soon becomes an argument with non-T1s who say they shouldn't even be thinking about a panini.

Or some weird stuff about how they should scrape the filling off the panini, wrap it in lettuce and throw the bun away.

There's an extraordinary amount of hypocrisy going on with T2 advice to T1s. Lots of threads where T2s admit to having a sneaky fish'n'chips even when they're telling T1s on other threads to avoid those things.

I know nothing about T2, so I don't comment on it. Why do T2s think it's ok to persistently tell T1s on T1 threads how they should manage T1?

Biggles2 said:

Thanks for posting this @bulkbiker .
Dr. Lake is one of the medical advisers on this platform (Diabetes.co.uk) so it's interesting to hear his take on this. It is also the approach used Dr. Bernstein and - for him at least - it has been sustainable. He has been following a low carbohydrate diet for 49 years and remains passionate about its benefits.

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Seeing as he's involved with this site, could we ask Dr Lake to post here about how he would deal with perfectly manageable T1 situations like eating a full fry-up including the hash-browns and toast, or just going out to an Italian cafe and having a panini or lasagne, and, while we're at it, maybe ask Dr Bernstein what his take on cgm is, seeing as proper use of it makes his, "law of small numbers" belong in the Stone Age?

I agree that it would be great if Dr Ian Lake and Dr Bernstein had a presence on the forum, but fortunately, they both have plenty of information available elsewhere for those who are interested.

This link goes to youtube where there are some videos of talks given by Dr Ian Lake at conferences
https://www.youtube.com/results?search_query=dr+ian+lake
Apparently he can also be found on Twitter.

And Dr Bernstein has his own series of videos here
https://www.youtube.com/playlist?list=PLs_TA02I6IvV6-1s2pL4BPhvMo0Ck_lcY
covering a wide range of subjects, which will probably answer most of the questions people are likely to ask.

NicoleC1971 said:

Thanks BB! Good interview. I am type 1 doing keto and taking it seriously now by using cronometer to track it all as they have a keto diet setting.
Now watching a review of UK Keto subscription boxes Low Carb Loot (not recommended) and Ketogenius (sourced from outside the UK too).
Not that I can afford fancy keto 'junk' but am interested to see what's out there\!
https://www.ketogenius.co.uk/shop
£32.99
Quite new to this so apologies if you are all familiar with this...

Click to expand...

Check out fatforweightloss - Low Carb Recipies and Common Sense Keto both on facebook or look at online websites. Pinterest has lots of recipes. I've been keto since 4th Jan my hbA1c has gone from 10.2 to 6.7 yay and I've lost 30lbs. There is lots of free info out there.

The lack of long term safety information for ketogenic diet is often an initial concern. So my consideration was to look towards those who have adopted it as a lifelong perspective...

Beside RD Dikeman/Dr B (Typeonegrit), here are 2 other T1D experiences that I have found helpful...
Troy Stapleton 2014

And more recently
Dr Keith Runyan 2017

Dr Keith Runyan blog provides regular and detailed updates of his glucose management data.
https://ketogenicdiabeticathlete.wordpress.com/

Scott-C said:

I've listened to it.

Dr Lake seems to have a lot of issues with his own T1 management which he needs to sort out before he starts giving advice to impressionable newly dx'd T1s.

I note there's an article on this website about his approach:

https://www.diabetes.co.uk/in-depth/ian-lake-normal-glucose-type-1/

The telling point is that, "He has had type 1 diabetes for 22 years, spending most of that time with poor control."

He then says that, oh, hallejulah, he got good control as soon as he started keto.

He's kind of missing the point. Many of us have had good control for decades, and will continue to do so without the enormous restrictions of keto.

Dr Lake needs to explain why his control was so poor for so long before he starts driving newly dx'd into extreme eating regimes.

For newly dx'd, the methods he advocates, based on repairing, it would seem, his own, "poor control", poses a huge risk of developing needless eating disorders.

He should learn how to use insulin properly, instead of spreading that sound-bite nonsense about the, "law of small numbers". Anyone who talks about having found a law in this area is a charlatan.

I hate to think of the number of young newly dx'd T1s who have been psychologically damaged by the artificial restrictions thrust on them by these people.

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I don't know about damaged, but I certainly struggled with reconciling some of the 'advice' on this forum with my personal experience when I was first diagnosed...

The cynic in me is always suspicious of anyone who stands to gain from any 'discovery', eurika moment or dogma. The problem is, how do you separate the genuine from the snake oil salesman?

At the risk of incurring the wrath of moderators and my question being deleted again for being too controversial, it would be very interesting to hear real life experiences from real life people on low, medium and high carb diets and their success or otherwise of managing their condition.

Regards,

DCUKMod said:

I would suggest if you would like to do that you are very welcome to start a new thread with that as the subject matter. This thread is in the Keto diet forum, so your potential thread wouldn't likely be the best fit.

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But in the context of this thread title and the general discussion on this thread I suggest this is a very appropriate place to pose the question.

DCUKMod said:

I would suggest if you would like to do that you are very welcome to start a new thread with that as the subject matter. This thread is in the Keto diet forum, so your potential thread wouldn't likely be the best fit.

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Hello @ DCUKMod,

To be fair it's a bit difficult to post a low carb topic under type 1 thread when some very experienced T1 members get offended and think the info will confuse newly diagnosed and damage them which no one wants to do.

Maybe you can create new sub-category for type 1 on a low carb diet somewhere with a warning to newly diagnosed. I know we are a minority but it would be nice to have a designated supportive section for low carbing type 1s where we can exchange info without worrying about offending other members.