Type 1: Body Coach Plan Ketones?

Jd040767 said:

Hiya,
I'm T1 diabetic and looking to loose weight. I have signed up for the Body Coach 90 day plan which is a low carb very high protein diet.

I've tried out a few initial recipes and have noticed a rise in my blood ketone levels. My kidney function is all normal but am concerned about going ahead with this for fear of DKA.

Has anyone with type 1 done the full diet?

Thanks!

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I'm T2, and can't advise you on your condition, so this post is to bump your thread up the most recent posts lists, and to ask for a little further information experienced T1s may need.

Your concern is fairly common amongst those embarking on low carb for the first time. As I understand things, DKA is usually a risk where ketones are elevated, alongside high blood glucose numbers. In low carb diets, depending upon the amount of carb being consumed, it is possible to enter dietary ketosis, which is harmless.

Could you tell us what your blood glucose scores are like, along with the ketone levels you are actually experiencing? I'm pretty sure that's what someone in the know would like to understand before commenting too much further.

@Jd040767. Haven't heard of or undertaken the diet, but you mention it's very high protein. Are you aware of gluconeogenesis?
A process where the body uses excess protein as fuel which can lead to high blood sugars if you don't make allowances.
Don't know your insulin regime but would strongly advise you do a bit more research regarding this particular diet and being type 1.

therower said:

@Jd040767. Haven't heard of or undertaken the diet, but you mention it's very high protein. Are you aware of gluconeogenesis?
A process where the body uses excess protein as fuel which can lead to high blood sugars if you don't make allowances.
Don't know your insulin regime but would strongly advise you do a bit more research regarding this particular diet and being type 1.

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I'm not sure why he or she would need to do any more research on this particular diet than any other one, but you are right, everyone should do the proper research before embarking on a new dietary change (I assume that's why they've created this thread).

Common sense should dictate whether or not you are at risk of dka:

Step 1: are your blood sugar levels elevated? If no, the chances of dka are extremely low.

Step 2: if yes, did you forget to take your insulin? If yes, take your insulin.

Step 3: If no, how high are your blood sugars and how long have they been high?

Only dietary fat will not cause an insulin response or requirement - eating lean meat to excess would negate the reaction to low carbs of going into breaking down fat and using ketones for energy. Where Humans naturally have a low carb diet and eat fish they also consume fats, and seem to manage perfectly well. They tend not to get diabetes.

Not strictly true for Type 1s:

http://www.joslin.org/news/dietary-fat-can-affect-insulin-requirements-in-type-1-diabetes.html

Even fat is a balancing act.

Aaww - they think that feeding people pizza is a good way to do experiments on the reaction to food types - they must be such trusting souls, believing that carbs are a benign foodstuff just because it gets such publicity for its healthy effects.

Resurgam said:

Aaww - they think that feeding people pizza is a good way to do experiments on the reaction to food types - they must be such trusting souls, believing that carbs are a benign foodstuff just because it gets such publicity for its healthy effects.

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No, the 'pizza effect' is a recognised thing for Type 1s, so I guess they used a common food stuff, but the facts about fat hold true for any fatty food. It's the fat not the carbs that that study is examining.

For Type 1s, fat can alter insulin requirements as the study says.

Maybe they are trying to, but they are introducing the various levels of fat in the meal as a secondary element to a huge wedge of bread - a more focused experiment might have been to feed various ratios of skinned chicken breast and skin on chicken thigh. Varying from 100 percent of one to 100 percent of the other. That would at least give a more honest answer to the reaction to the fat content.

Fat will have an effect after most meals. The carbs were used as a comparison for the insulin calculations:

"Study results showed that participants required more insulin after eating the high-fat dinner than the low-fat dinner (12.6 units compared to 9 units). In contrast, the two breakfast meals required similar insulin doses. Despite the increased insulin, participants had greater hyperglycemia after the high-fat dinner with insulin levels elevated five to ten hours after the meal. The average increase in insulin was 42 percent with significant individual differences.

“These findings highlight the limitations of basing mealtime insulin dosing for type 1 diabetes solely on carbohydrate intake,” says Dr. Wolpert. “We need to consider fat as well as carbohydrates in insulin dosing calculations as well as in nutritional recommendations.”


It was one of a number of studies, and the Joslin Institute knows what it's talking about

Your statement above said that fat didn't cause an insulin requirement. That is untrue for Type 1.

As a very low-carbing type 1 I don't need to bolus for fat.

I don't think conciously about bolusing for fat. But I do think the meals where I know my carb/protein ratios aren't enough to cover the meal and I knock it up a bit from experience of going high after are probably higher fat meals. And perhaps unexpected correction requirements when I've bolused correctly for the carbs/protein can be explained by fat content.

Apart from there are actually a couple of pizza effect meals where I know they need a second bolus. I guess I just don't connect that that is an additional bolus to accommodate the fat. But that is what it is.

Pizza effect is pretty well recognised as the effect that fat has on insulin requirements and timing.

Jd040767 said:

Hiya,
I'm T1 diabetic and looking to loose weight. I have signed up for the Body Coach 90 day plan which is a low carb very high protein diet.

I've tried out a few initial recipes and have noticed a rise in my blood ketone levels. My kidney function is all normal but am concerned about going ahead with this for fear of DKA.

Has anyone with type 1 done the full diet?

Thanks!

Click to expand...

You are unlikely to get DKA as long as you have enough insulin to keep your blood sugars stable. I agree that you will probably have to account for protein converting to glucose if you are eating large amounts, although it's a much slower rise than from carbs. What levels of ketones are you seeing and how are you BG levels?