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Question about starting ketogenic diet with type 1

Discussion in 'Ketogenic diet forum' started by Rianne, Sep 6, 2017.

  1. Rianne

    Rianne Type 1 · Well-Known Member

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    Hi all,
    I'm a type 1 diabetic for 38 years and use an insulin pump. Despite low carb, I find it difficult to control blood sugars. Since a week I am trying to eat ketogenic. I experience that my basal insulin needs to be adjusted and am trying to finetune that. Is there anyone with type 1 who wants to tell me his or her experiences in the beginning period of ketogenic and what it did with blood sugars? That would be very helpful, of course considering that effects are personal and different for each person, but any recognition or opening of the eyes would support!
    Thanks!
     
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  2. azure

    azure Type 1 · Expert

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  3. Rianne

    Rianne Type 1 · Well-Known Member

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    Thanks, Azure, for tagging and for the hope giving remark!

    And thanks, Justbe, for your so helpful information. I do have type 1 for decades, but have never taken into account the impact of protein digestion on insulin and blood glucose level. Since starting ketogenic, my night glucoses were fine, I needed less basal insuline. But during the day my blood glucose started rising very very slowly, and did not drop sufficiently despite increasing basal dose and/or physicial activities. If I understand you correctly protein does require insulin. Probably with an extended bolus. That seems to fit with the trend in my bg's so far.
    I feel quite misguided by all the information that is given to me in the past, both by my health care pro's and by most spread info on the internet.... In the question I posted here, I used the words 'eye openers', and I feel you just did that with your explanations. Thanks, Justbe, it does me good to feel taken seriously. I'm gonna indeed keep an eye on research surrounding insulin doses for protein and fat. I did already find the following (not perse scientific) page, that I'm gonna read and that might interest you or others as well: https://optimisingnutrition.com/201...ose-glucagon-and-insulin-response-to-protein/
    I go ahead with finetuning my basal doses with proteins in mind and the further tips you gave. It feels like an interesting path!

    NB. I'm new here on this site and forum system, and my native language is not English. In case my responses are unclear or incorrect, feel free to let me know.
     
  4. robert72

    robert72 Type 1 · Well-Known Member

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    Hi @Rianne

    The first few times I tried to go ketogenic I got the low-carb flu, so I then tried lowering my carbs over a few months which also gave me the chance to adjust basal along the way and figure out how much to bolus for different meals. As @justbe says, you will probably need to bolus for protein but it's a much slower rise and you will need to observe how it affects you personally. Also it will take a while to become fully keto-adapted (several weeks) so don't expect instant results.
     
  5. azure

    azure Type 1 · Expert

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    @Rianne It's usually only in the absence of carbs that you need to bolus for protein. It's one reason why I avoid going too low with carbs.

    Don't feel misled :) Theres nothing magic about the Keto diet for Type 1s. There are a number of possible diet choices for us, and what matters is that you find out what suits you as an individual :)
     
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  6. Rianne

    Rianne Type 1 · Well-Known Member

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    Hi Robert,

    Thank you for your reaction, for sharing your experiences, and for your advice to take enough time. Knowing now what the influence of protein is, it gives me a better understanding of my bg's and stimulates me to further carefully experience what eating keto will do.

    An additional question that I have is: how do you count carbs for vegetables? I used to eat lots of veggies incl. the starchy ones, and fruits, and as a starter I do miss these fresh foods. At various keto sites there are lists with the net carbs for veggies. They very quickly make the total net carbs rise and give me the idea to have to restrict on them more than I would like to. Also I read and see people on youtube, who advocate that the carbs from veggies have less impact on getting in/out-ketosis. I wonder what your opinion/experience is on this. Would you like to share it?
    Thanks!

    Rianne
     
  7. Rianne

    Rianne Type 1 · Well-Known Member

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    Hi Azure,

    Thank you too for your specified information. You write that you avoid going too low with carbs. Are you on a lchf diet? Or on keto with carbs between 25 to 50 grams? I'm curious what your other reasons are for avoiding going too low with carbs. Would you want to share that?

    I guess you sensed it right that I somehow too much praise the ketogenic diet. One of my hopes was, not having to think about and administer boluses as much, when following a keto lifestyle. If protein requires these efforts as well (maybe a bit less than carbs), than keto would not make it as easy as I hoped. I'm glad I found you all here to inform me timely!

    And off course the ultimate motivation stays intact: keeping my bg's on a healthy level and trying to prevent complications.

    Another motivation for me is that I found information that a ketogenic diet would improve diseases caused by inflammation. I have a mild form of arthritis and would very much improve that without medication. Do you, or anyone else here, have experience with that?

    Thanks once more,

    greetings,

    Rianne
     
  8. Kristin251

    Kristin251 LADA · Expert

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    I've been keto for ages. Long before diabetes. It is true in the absense of carbs I have to bolus for about half my protein but the slight increases ( if any) are much lower and slower.
    I take one to two unit if lantus so it's long gone by morning and I rely on humalog through the day. I do eat 4 small fat and protein meals a day so I bolus 4 times. 2.5-3 hours apart and 1/2 unit humalog. I also have a small cheese snack pre dinner with a cocktail and rare,y bolus for that. Though I do bolus 4 times a day my bs stays rock steady. No dips or spikes.

    I eat less than 20c per day and mostly in salad or lettuce wraps, asparagus, avocado, nuts and pumpkin seeds.

    I do keto for numerous reasons. I certainly feel best in ketosis, also less insulin use, disease prevention ( hopefully) and my stomach prefers it. Weight maintenances as well.

    Though one may not have to bolus for protein if carbs are in the meal I prefer protein and fat over carbs. Carbs make me achy, tired and fat haha. I love eating my fat, not wearing it

    Just my experience and personal choice....
     
  9. Rianne

    Rianne Type 1 · Well-Known Member

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    Hi Kristin,

    Great to receive also your story, thanks! I appreciate your detailed description and sharing your personal preferences. I learn a lot from all the various individual ways of eating and handling diabetes. It helps me be more creative. And that, of course, feels like more freedom :). Thanks so much, Kristin. Your reaction, as well as those of others, feels like a great support!
    Have a wonderful day!

    Greetings,

    Rianne
     
  10. azure

    azure Type 1 · Expert

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    We all need to choose a diet that suits us :) The keto diet is very popular at the moment, but it's not a magic bullet for Type 1s. I've come across a number of Type 1 people on keto diets who end up taking just as much if not more insulin eating minimal carbs as they did eating far more carbs. I believe that's because the keto diet causes physiological insulin resistance. Insulin resistance is the last thing I want!

    Many people on keto diet and injections end up injecting 10 or more times a day to control the delayed rise from protein and fat. The high level of fat in the diet can cause insulin resistance too.

    Injecting for protein is harder than injecting for carbs, so I make sure to have carbs with my protein so I can basically ignore it.

    I personally eat approx 180g carbs a day, spread over the day. Over the years, my daily carb amount has varied from around 120g to 220g.

    If you're looking for a diet to help inflammation, there are various Paleo diets that claim to help. These contain a moderate amount of 'safe' carbs and avoid foods linked with inflammation. You could look at those, maybe :)
     
  11. Kristin251

    Kristin251 LADA · Expert

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    Many people choose a ketogenic diet for other reasons than bs control. Even loads of non diabetics. I've been keto for ages as I simple feel much better. Fatigue, insomnia, high BP, aches and pains, brain fog all vanished.

    Though type 1's CAN eat carbs it's not a requirement. Just as a non diabetic. Some people ( myself included) like to keep insulin levels low and believe carbs and higher insulin can lead to cancer, Alzheimer's and a whole host of diseases. Some if us don't digest them well. Some of us prefer fat and protein. Regardless of our reasons nobody is required to eat carbs or eat keto.
    The OP was inquiring how to a embark on a ketogenic diet which
    to me implies she wants a new diet and has had problems controlling bs or even for various other reasons stated above

    Maybe and most likely learning to bolus for protein and time the bolus right is going to make all the difference in the world to her.

    I'm sure in the past she has gone the carb route without good success so lowered her carbs but maybe not quite low enough OR isn't timing her bolus or isnt blousing for protein. Many of us can't get our insulin right when carbs are included.

    Any which way, the OP is looking for experiences and help to go keto as smoothly as possible. Maybe it won't work for her. Maybe it will. Maybe she'll feel oodles better. Maybe not.

    Certianly her choice to try something new.
     
    #11 Kristin251, Sep 7, 2017 at 8:21 PM
    Last edited: Sep 7, 2017
  12. kevio

    kevio Type 1 · Newbie

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    I’ve been eating a keto diet for a while (read years) now and found that i have to keep my protein intake to under 20g per meal or i find that it will cause my bs to rise due to gluconeogenesis but you will have to experiment to find your own tolerance it might be higher or lower than mine and could vary depending on the time of day you are eating.
     
  13. Kristin251

    Kristin251 LADA · Expert

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    I completely agree. I need to keep everything small and fatty in the morning. Lunch can be a bit more and dinner more. Same dose of insulin. Time of day does matter for me
    3 oz is about my limit too.
     
  14. azure

    azure Type 1 · Expert

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    @Kristin251 I was responding to the OP's request above for me to elaborate on why I don't eat very low carb :)
     
  15. Kristin251

    Kristin251 LADA · Expert

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    Sorry :(

    I think we both said the important things for keto. Bolus properly and bolus for protein. I also need the fat in the meal or the protein digests too fast.
     
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  16. Rianne

    Rianne Type 1 · Well-Known Member

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    Hi Azure, Kristin, Kevio,

    Thanks all of you for your so concerned, good intentions to help me as good as possible. I'm really grateful for all your information about your experiences, your thoughts and your results.

    I have searched for more information on keto causing insulin resistance. That would be indeed a terrible result. The information on the internet again is controversial. Some say it's true, some say it's natural under keto circumstances but not chronical, others say that external insulin works differently than internal insulin. I surely keep in mind, Azure, what you described about the experiences you heared from others. I indeed now need a little higher basal insulin. I used to eat pretty low carb, rawfoodish/vegan, with 0.5 IE/hr so far. Total basal 12. Total bolus average 11. My HCP always advised to keep the hourly level as even as possible and manage mainly with boluses. Eating keto now and learning here the effect of protein on bg, I since a few days use 0.33 in the night, 0.9 in the morning, and 0.5 in the afternoon/evening. That gives pretty good results so far. Total basal now: 13. Total bolus is now around 2, with 25-35 carbs a day. Still have to learn/experience how to dose/spread the bolus. With your information I'm sure I'll get it right sooner or later!

    Still also miss the amount of veggies I used to eat as a rawfoodist. Mostly leafy greens is not as enjoyable as the great variety I knew. I will experience further. On the one hand I want to know what it feels like and brings me to be on a keto lifestyle. On the other hand the fresh plant foods are so appealing.

    Time will tell!

    Greetings,

    Rianne
     
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