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

michita said:

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.

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The Keto section was created for exactly this purpose - so that people could post freely on the subject, exchange information and have open discussions about their experiences.

The Keto section is not restricted to any one type of diabetes, and is open to all but, as with any other section, sometimes people come in and post off topic, or derail. That is why we moderators try to act as herders to nudge threads back on topic. Sometimes we have to delete or move posts to other threads, to allow different subjects a chance to be discussed without smothering the subject at hand.

Everyone is entitled to opinions, and is free to express them (within the forum rules), but for people interested in the subject of a thread, it becomes frustrating if members persistently drag in other topics. Sometimes people try to do this on purpose, if they disagree with the thread subject.

This thread has nearly been derailed twice so far. Both derailments would make useful, interesting threads in their own right, but are off topic for people interested in reading about Dr Ian Lake and Keto.

kokhongw said:

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/

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I've had a look at Dr Runyan's website. In his post #50, there's a table of results. His desired range is 61 - 110, or 3.38 -6.1.

I think that's a ridiculously tight range but let's go with it for the sake of comparison.

For March 2018, he was in range 50% of the time, below 22%, above 28%, based on 153 bg tests, so there'll be big chunks of missed data.

When I set my cgm to that range, in the last 30 days, I get 55% in range, 7% below, 37 above, based on 8419 readings, see pic below. The sd is ok at 32.4, I recall Stephen Ponder saying that around 30 is ok.

So, it looks like I'm in that very tight target range more than he is, significantly less below it than he is, and not much higher than he is, based on more data. I trust the figures my cgm gives me because the estimated a1c of 34 compares well to my last hospital a1c a few months ago of 32. Most cgm overexaggerate lows so the low figure is probably overstated.

When I set my cgm to a more realistic range, I'm generally in range about 80 to 90% of the time, and I've not had any major hypos because the alert facility lets me get some glucose in so it's already starting to act while I'm dropping.

Dr Runyan mentions in his post that he, "avoids restaurants except when travelling."

I remain unconvinced about keto. The plain fact of the matter is that the numbers show that I'm getting better results than he is, and I can still enjoy the simple pleasures of eating out.

I'm quite happy with my numbers and mention them not to show off but just to illustrate that if an ordinary bloke like me can get better results than someone on a keto diet, there's absolutely no reason why any else can't do the same.

Scott-C said:

if an ordinary bloke like me can get better results than someone on a keto diet, there's absolutely no reason why any else can't do the same.

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Perhaps that is the problem...Your assumption is that any one can achieve those excellent numbers with your approach just as you did.

The reality is that few common blokes with T1D and even those with medical training have managed to and do experienced difficulties and challenges despite their best efforts.

What was meaningful from Dr Keith Runyan's detailed blog/video was the significant improvements and lack of hypo events that he experienced. His experience may have no relevance and benefits to you, but it may have life changing impact for those who shared his difficulties in glucose management.

I’ve found it next to impossible to get the timings right with pre-bolusing for carbs - or I find myself not wanting to eat all the food I’ve already injected for, and either forcing it down or going hypo. Waiting after a jab has started working to eat means I often can’t eat at the same time as the rest of my family, it seems to be really variable with me as to how long it takes the Novorapid to work. Mealtimes are really important to us, eating together is crucial. We eat different foods anyway, because I don’t eat meat and dairy and they do, so that’s not an issue.

I’ve found it simpler just to bin the carbs, to be honest. It fits in better with my family and work life, and my sugars are much more stable. I’m seriously impressed that you can control it all so well @Scott-C (mot sarcasm, I really am!) but I don’t have that level of skill, or maybe even the right physiology. Timings and doses notwithstanding, I do actually feel better without them, no postprandial carb comas (I’d be half asleep for quite a while after food) have given me back a couple of hours in my day...

kokhongw said:

Perhaps that is the problem...Your assumption is that any one can achieve those excellent numbers with your approach just as you did.

The reality is that few common blokes with T1D and even those with medical training have managed to and do experienced difficulties and challenges despite their best efforts.

What was meaningful from Dr Keith Runyan's detailed blog/video was the significant improvements and lack of hypo events that he experienced. His experience may have no relevance and benefits to you, but it may have life changing impact for those who shared his difficulties in glucose management.

View attachment 26121

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There's been an encouraging number of posts recently by people saying that they've had their best results ever, turned round what were previously unwanted results, and seen ways of managing situations they previously found difficult, by getting cgm/libre.

I know not everyone has cgm for now - I've been fortunate enough to be able to afford it intially, and, recently, my nhs area has put it on prescription - but things are starting to move slowly in the right direction, and I suspect prescription will become more widespread as time goes by.

I think it's arguable that cgm makes control significantly easier by orders of magnitude for even difficult T1 cases, and that it is a preferable option to one which pretty much involves ruling out an entire food group.

Scott-C said:

There's been an encouraging number of posts recently by people saying that they've had their best results ever, turned round what were previously unwanted results, and seen ways of managing situations they previously found difficult, by getting cgm/libre.

I know not everyone has cgm for now - I've been fortunate enough to be able to afford it intially, and, recently, my nhs area has put it on prescription - but things are starting to move slowly in the right direction, and I suspect prescription will become more widespread as time goes by.

I think it's arguable that cgm makes control significantly easier by orders of magnitude for even difficult T1 cases, and that it is a preferable option to one which pretty much involves ruling out an entire food group.

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Aye. Libre is a game changer. I’m lucky enough to have it on prescription too. My problem with a very carby diet (other than the timings/doses etc) is that I’d be hungry again not long after eating, and was piling on more and more weight. Life was ruled by hunger, cooking and eating. At the moment I have breakfast, and barely even think about food until late afternoon.

There’s many options to manage T1, and finding one that suits (and works) is the holy grail as far as I can see. I’m now in range (4.5-7.5mmol) 73% of the time, and I’m happy with that. And I’m really enjoying the food I’m eating - having followed a low fat, high carb diet for most of my life, it’s wonderful to enjoy food that’s been otherwise denied to me for so long.

Mel dCP said:

I’ve found it next to impossible to get the timings right with pre-bolusing for carbs - or I find myself not wanting to eat all the food I’ve already injected for, and either forcing it down or going hypo. Waiting after a jab has started working to eat means I often can’t eat at the same time as the rest of my family, it seems to be really variable with me as to how long it takes the Novorapid to work. Mealtimes are really important to us, eating together is crucial. We eat different foods anyway, because I don’t eat meat and dairy and they do, so that’s not an issue.

I’ve found it simpler just to bin the carbs, to be honest. It fits in better with my family and work life, and my sugars are much more stable. I’m seriously impressed that you can control it all so well @Scott-C (mot sarcasm, I really am!) but I don’t have that level of skill, or maybe even the right physiology. Timings and doses notwithstanding, I do actually feel better without them, no postprandial carb comas (I’d be half asleep for quite a while after food) have given me back a couple of hours in my day...

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Sure, Mel, I fully accept it is an option and I'm not saying people shouldn't keto, but what can be unfortunate is that it is sometimes presented by ketoists (ketonians?) as the only option.

There was a thread a while back where a few, including a recent convert who'd been ketoing for, oh, a whole six weeks, were saying that anyone who didn't keto was "a fool", "in denial", and, "irresponsible".

A few videos I've watched about it, the presenters come across as scoffing at or mocking folks like me who just enjoy eating a panini or bit of cheesecake now and then. They can be very damaging to their cause.

PS: just saw your later post - nice numbers, you're storming it!

Ketonians sounds like an awesome name. I like it!

I think the big problem is, when someone has found a way of life (diet or religion!) that they believe has changed them for the better, they get really evangelical about it. Probably with good intentions, you want everyone to feel the benefits you believe you have - but it quickly becomes overbearing and gets people’s backs up. I’m possibly been a bit guilty of it myself. And of course the internet makes it much easier to hook up with like-minded people and you can lock yourself into a bit of an echo chamber, reinforcing your belief that your new way is the only right one...

If someone enjoys whatever food they are eating, and it’s not harming them, then crack on, I reckon

Scott-C said:

I think it's arguable that cgm makes control significantly easier by orders of magnitude for even difficult T1 cases, and that it is a preferable option to one which pretty much involves ruling out an entire food group.

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It is arguable...base on data from T1D exchange
https://t1dexchange.org/pages/resources/our-data/t1d-discover/

13,196 of 26,127 or 50.51% meet the criteria you specified above. (on insulin pump)

And those with HbA1c < 6% over 12 months is quite exceptional


And those on MDI

10,912 of 26,127 or 41.77% meet the criteria you specified above.

Let's remember that about 50% of people in the UK has a high level of inslin resistance so have or are on the way towards type2. Having type1 does not protect anyone from this.......

For example @Mel dCP has the same issues with getting hangy shortly after eating carbs then most of us with type2.

ringi said:

For example @Mel dCP has the same issues with getting hangry shortly after eating carbs then most of us with type2.

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I really do. However, I’ve not eaten since my dinner last night (salmon fried in butter with roasted veg), and I’m still not even slightly hungry. Bloods stable in the sixes since I went to bed. I’m happy managing my health like this

A nice video summary of the latest low carb study on the Typeonegrit group

https://www.facebook.com/video.php?v=10156143579381996