Type 1 and keto diet

[Sharnanike]

Good morning
I’m type 1 diabetic. I’ve heard lots about the keto diet helping diabetics but this seems to be mainly type 2 diabetics.
I’m wondering if any type 1 diabetics have tried the keto diet? I know your body goes into a state of ketosis (not ketoacidosis which I know to be dangerous). There are tablets which can help your body go into a ketosis stage, the tablets have been on dragons den and are safe to take, but I don’t know about diabetics.
I am speaking with my consultant in a couple of weeks so I will ask her about all of this, I was just wondering if anyone could give me their advice on this beforehand if they’ve tried it and how it helped.
Many thanks
Sharna

 

[NicoleC1971]

Hello @Sharnanika ! I am type 1 and take a big interest in diet mainly because I help type 2s but also because as a type 1 I've always found it hard to get my bolus doses right for the amount of carbs I eat in spite of doing carb counting courses and having a pump.
You will be told that there is no reason not to eat carbs because your pancreas is already busted and that beyond the considerations of eating healthily in general, you should simply tweak your dosing to those carbs. Or that the keto dit implies high fat (it does) and that as a dibetic you may be putting your heart health at risk when you are already at increased risk due to having higher blood sugars.
My experience is that the less carbs I eat the easier it is the manage my blood sugars so I have gradually dropped them over the years. I exercise a lot (job is as a trainer) and have found there are no problems with my energy levels. This works really well with my pump and dexcom sensor system (I am lucky to have this) which can make corrections for small highs and lows.
The flip side is that I love bread and chocolate so rather than being massively strict I've opted for low carb (under 120g carbs daily) but generally have much less than that and don't fret about being in ketosis or not. This works for me.
If I am trying to drop body fat then I'd be stricter btu generally I know I've lost fat without trying and I attribute this to the low carb lifestyle.
So I'd say it depends on what you are doing this for? Your own food preferences and lifestyle play a big part. I started this gradually and its got a lot easier with practice and I do think the benefits are worth it.
ps having read the research on eating fat causing heart disease, I am even more convinced that to protet my arteries the best strategy is to keep my blood sugars in check NOT to avoid fats!

 

[In Response]

Why do you want to try keto diet?
Do you want to do it to lose weight or do you want to do it because you think it will make your diabetes easier to manage?

I have not tried keto but I have tried low carb. I found low carb harder than "normal carb". The dosing of insulin is more complex because you need to bolus for protein at a different insulin to protein ratio for different type of protein and at different timings.
Having to keep track of the different insulin to protein ratios for eggs, salmon, prawns, cheese, nuts, ... became too much for me and I don't eat meat so didn't have to worry about the different ratios for beef, ham, chicken, ...

I eat less crabs than my (non-diabetic) partner but not "low" carb. This is the approach I have taken since my initial diagnosis nearly 20 years ago: I have a HBA1C below the type 2 "cut off" and no complications.

 

[EllieM]

I go low carb but not keto mainly because I can't be bothered to start counting carbs for protein ( a step too far for me) and low carb works well enough for me. (I have a fair amount of insulin resistance so low carb keeps my insulin doses down.)

I believe the typeonegrit facebook group is dedicated to T1 and keto, so you could look there if you are interested. Or read the books by Dr Bernstein, a T1 who has achieved fantastic results by cutting the carbs.

As for the tablets. Do you mean the ones on this thread?
https://www.diabetes.co.uk/forum/threads/raspberry-ketone-supplements.186816/
I'd be a bit skeptical as to their efficacy and safety. Have they had medical studies done on them? (Genuine question, I have no idea.)

Just be aware that many diabetic specialists don't approve of keto because they worry that if your blood sugars go up (eg when ill) you won't be able to distinguish between a DKA and nutritional ketosis.

I find it fascinating to read the different approaches taken by different T1s on diet, reflecting our different metabolisms and food choices.

 

[NicoleC1971]

Further to @eilliem s link to Dr Bernstein (patron saint of low carb for type 1s but not ketosis per se) here is a take on it from Dr I an Lake, a UK Gp with type 1 who discusses the insulin resistance question (double D is just a bra size it seems)

 

[ert]

I'm a type 1 on a keto diet eating less than 30 grams of carbohydrates a day. I follow Dr Bernstein's Diabetes Solution.

 

[Patch13]

Hi. I am presuming I am keto (I haven’t actually tested my ketone levels) because of what I eat (no grains etc, some protein, some veg, odd apple and fat).

Previously my blood sugar was up and down rapidly after meals. Now my blood sugar is flatter (less highs, less lows). Obviously I do sometimes mess up and it is higher/lower than I would like. It’s a work in progress.

I have never taken any ketone supplements as I am relying on my diet to put me into ketosis (although as I said at present I am not testing for ketones).

Dr Richard Bernsteins book is a good place to start to get to low carb. Also watch his videos on YouTube.