The Ketogenic Diet And Type 1 Diabetes: What I Eat
I recently began writing about the ketogenic diet and type 1 diabetes in an attempt to optimize my blood sugar in relationship to athletic performance. This podcast episode can provide some additional perspective about how I arrived at the ketogenic diet for type 1 diabetes. It started with a low-fat plant-based diet and I have recently changed my approach (dramatically) to a Ketogenic diet (low-carb, high-fat). The results have been remarkable and I feel like this dietary approach is a worthwhile consideration for anyone who is in a position to optimize their diabetes management–or who just wants better energy with no “crashes” throughout the day. In case my standpoint isn’t obvious, let me clarify, there is no should or shouldn’t implied in my writing about this or any other diet. Some people eat pizza. Some people drink diet soda. Some never consume either–or do but always feel guilty. Still others know the drawbacks and act in moderation and feel great about it. My goal is to inform those who are interested in trying something new or just knowing what else is out there–not to persuade those who are happy with an already satisfactory approach. I wrote an eBook compiling my experiments with the ketogenic diet and type 1 diabetes which you can check out here: In my last blog I focused on the comparative results between the two diets, and this blog will hopefully answer the one major question I got–‘what do you eat on a daily basis?’ Not all low-carb diets are Ketogenic, but the Ketogenic diet is low-carb. In the coming weeks I will be sharing more about how my transition to this diet came together as well as mistakes I made along the way. I will also probably put up a post along the lines of “What is a Ketogenic diet?” although that is lower pri Continue reading >>
Is The Ketogenic Diet Safe For People With Diabetes?
Is The Ketogenic Diet Safe for People with Diabetes? If you’ve been diagnosed with diabetes, chances are you’re looking for simple yet effective ways to control your blood sugar. And, if at all possible, without the use of daily shots or medications. As I’ve mentioned in earlier blog posts, exercise is one of the best natural ways to manage blood glucose. But perhaps the most obvious way to keep blood sugar at a safe and consistent level without insulin is to pay special attention to what you eat. And, in the case of diabetes, limiting your carbohydrate intake may be the key. What Is the Keto Diet? At first glance the ketogenic (keto) diet may seem like a crazy idea for type 2 diabetics. After all, many patients are put on diets to help them lose weight. The keto diet is high in fat, but it is very low in carbs, and this combination can help change the way your body stores and uses energy. With this diet your body converts fat instead of sugar into energy, which can improve blood glucose levels while reducing the need for insulin. Ketosis VS Ketoacidosis Ketosis and ketoacidosis are two very different things, which are often confused. But it’s very important you understand the difference. What is ketoacidosis? Ketoacidosis (KA) is a life-threatening condition in which your body doesn’t make enough insulin. This causes you to have dangerously high levels of ketones (substances occurring when the body uses fat stores for energy) and blood sugar. The combination of both makes your blood incredibly acidic, and this can, in turn, change the normal functioning of your internal organs such as your liver and kidneys. Patients suffering from ketoacidosis must get treatment immediately or they could slip into a coma and even die. Ketoacidosis can develop in less than 24 Continue reading >>
Type 1 Diabetes: When Doctors’ Good Advice Turns Bad
Here’s a fascinating blog that throws up an ethical dilemma for doctors, nurses and dietitians who dish out orthodox advice for type 1 diabetes. The writer is Lemming Test-Pilot, the alter ego of a British GP who has type 1 diabetes. Last year, Lemming ditched “the almost impossible dark art of carbohydrate counting”, went on a low-carb, high-fat, ketogenic diet and survived. Actually, Lemming hasn’t just survived but has thrived in body and mind. And has been running half marathons faster ever since, even after fasting. Doctors and nurses told Lemming to go on the wrong diet for type 1 diabetes for 20 years. Lemming is understandably miffed about that but says with admirable restraint: “Any other condition managed with the wrong treatment for 20 years would rightly merit a lawsuit. The guideline advisers are getting knighthoods.” Here is Lemming’s remarkable, poignant, real-life story: By Lemming Test-Pilot* I have had type 1 diabetes for 20 years. I got it relatively late, in my 30’s. I’ve managed it the conventional way: 55% carbs, 30% fat mostly unsaturated, basal (long-acting) insulin, and DAFNE (Dose Adjustment For Normal Eating) with carbohydrate counting and injection of rapid acting insulin to balance the glucose. I look after my weight and exercise regularly. I tried three types of statins at various doses but had to stop due to muscle pains and fatigue. My blood pressure is OK and cholesterol reasonable in the 5’s. I have tried hard to manage my condition to the best of my ability and have followed the NICE guidelines and regularly attend for check-ups. My GP or Diabetes Nurse takes my measurements every year, makes some suggestions for improvement (there is always room for improvement) then leaves me to it for another year. My GP team the Continue reading >>
- Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study
- Could going low-carb help you fight off diabetes? The usual advice for Type 2 is to eat plenty. But now a number of patients and doctors are leading a growing rebellion
- Turns Out Type 2 Diabetes Is Reversible, After All
Ketogenic Treatment For Diabetes Type 1
Before the invention of insulin in the 1920's, ketogenic diets were the main treatment for type 1 diabetes (T1D). In 1923, Osler and McCrae in the Principles and Practice of Medicine recommended that a diabetic diet contain about 5% carbohydrate, 20% protein, and 75% fat. The current guidelines call for higher carbohydrate and lower fat intake and this is problematic for adults and children with T1D. As a result of this higher carb intake, blood sugar spikes after meals, which requires a large dose of insulin to bring it down. These higher doses of insulin put T1D patients in danger of severe low blood sugar episodes (hypoglycemia). We call this the blood sugar roller coaster. Switching to a low-carb, fat-burning ketogenic diet stops the blood sugar spike/crash cycle, because when carbohydrate intake is reduced, basal blood sugars stay normal and steady, and less insulin is needed at mealtime. Smaller doses of insulin mean there is less danger of driving blood sugar too low. Coauthored with Dr. Keith Runyan, a physician who successfully treats his own T1D with a ketogenic diet (his average HbA1c is 5.0), The Ketogenic Diet for Type 1 Diabetes provides practical information on: How to adapt and reduce insulin therapy dosage with the diet How a ketogenic diet helps control blood sugar and minimize long term diabetic complications How the diet helps protect against hypoglycemia Special considerations for children with Type 1 diabetes (carbs are NOT essential !) The myths about saturated fat intake and ketoacidosis How to start the diet, monitor progress and treat side effects What foods to choose, which to avoid and how much to eat Tips on cooking, dining out,traveling and where to find recipes The Ketogenic Diet for Type 1 Diabetes eBook is an electronic book in Acrobat P Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Is It Time to Change the Type 2 Diabetes Treatment Paradigm? No! Metformin Should Remain the Foundation Therapy for Type 2 Diabetes
- Does the Ketogenic Diet Work for Type 2 Diabetes?
One Year On An Lchf Diet With Type 1 Diabetes
How does an LCHF diet work with type 1 diabetes? Here’s a one-year update: Today I celebrate 1 year with LCHF, or I could say that I celebrate 1 year in good health! I can certainly endorse the LCHF diet as being good for type 1 diabetics. Besides a more stable blood sugar and a more easily managed diabetes, I’ve gotten rid of pain in my legs, headaches, GI problems, and constant throat infections. Previously, I had recurring yeast infections, but during this past year I haven’t had a single one! I only need one injection daily, instead of the previous 5-9. I eat delicious food, and I don’t miss anything. I have more energy and I’m happier than ever before! During the past year I’ve also gotten to know, and come in contact with, a lot of great people through Instagram and my blog! I could go on about more positive things, but now I’m off to make dinner. A fatty, smoked rainbow trout to honor the day! The whole story on the blog DiabetesType1LCHF (Google translated from Swedish) More Low-Carb to Manage Type 1 Diabetes Continue reading >>
Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?
In this article we will cover what a Ketogenic diet is and if you can manage your diabetes while on this diet. Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject. As a CDE, I have been taught to follow the American Diabetes Association Dietary Guidelines for Americans which is low in carbohydrates, high in fiber, with fresh vegetables, fruits and whole grains. The Ketogenic Diet this article will be discussing is much lower in carbohydrates, in order to promote the state of nutritional ketosis, or the fat burning state for weight loss. What is a Ketogenic Diet? The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up? Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy. The Ketogenic Diet with Diabetes Some precautions must be made clear; this diet is not appropriate for people with any Continue reading >>
Ketogenic Diet And Type 1 Diabetes
What is Type 1 Diabetes? Type 1 diabetes is an autoimmune disease. The immune system is a defence that guards the body against bacteria, fungi or parasites. A combination of genetics and an environmental (viral infection, vaccines, low levels of vitamin D, cow’s milk or increased insulin demand) trigger engages the immune system to attack and destroy the beta cells in the pancreas. After these beta cells are destroyed, the body is unable to produce insulin. Type 1 diabetes is the result of the inability of the pancreas to produce insulin. With type 2 diabetes, the pancreas produces insulin. Who Gets Type 1 Diabetes? Type 1 diabetes can affect all age groups. Although the thought has been that type 1 diabetes appears during childhood, current research has found that adults are just as likely to be diagnosed with type 1 diabetes; half of type 1 diabetics are diagnosed after age 30. (1) Yet, the rate of Type 1 diabetes in children, in the US, has increased by almost 60% in 11 years (2) and approximately 1 in 300 children in the US will be affected by type 1 diabetes by 18 years of age. (3) There are too many children who are effected globally. The highest rates are in northern Europe and in individuals of European decent. Men are more commonly affected in early adult life. (2) Data suggests the incidence of T1D has been increasing by 2–5% worldwide. (5) What Happens When Your Body Does Not Make Enough Insulin? Beta cells in the pancreas are destroyed by your own immune system resulting in too little or no insulin (a hormone released by the pancreas) produced. Without insulin, energy (sugar) from food cannot enter the cells. Instead of fueling the cells, this excess sugar circulates in the blood causing high blood sugar levels (also known as hyperglycemia). If there is Continue reading >>
Why I Chose A Ketogenic Diet For Diabetes Management
Often people use the term “diet” to mean something that is temporary for a specific purpose, usually weight loss. For me, it is a permanent way of eating now. I am a retired physician living with Type 1 diabetes since 1998. I started to exercise regularly in 2007 to help ward off complications, particularly cardiovascular disease. I was unaware at the time that aerobic exercise alone would have little impact on the development of cardiovascular disease. It wasn’t until 2011 when I contemplated doing an ironman distance triathlon, that I discovered diet is the most important determinate in the development of most chronic diseases, including cardiovascular disease. My research led me to begin a very low carbohydrate, ketogenic diet in February 2012. Why I Chose a Low Carb Ketogenic Diet for Diabetes Management Carbohydrate is the macronutrient that raises blood glucose the most, so keeping consumption low is my primary goal. Of next importance is using whole foods that naturally have the necessary micronutrients and enough complete proteins to support my exercise. I had to add fat to my meals to replace calories from the omitted carbohydrates. My protein intake did not change after starting a ketogenic low carb high fat diet. This way of eating has resulted in a significant improvement in my blood glucose control and a 1.2% reduction in HbA1c. Most importantly, the diet supplies my body with the energy, substrates, and nutrients to enable daily resistance and aerobic/endurance exercise, with minimal need for sports nutrition (sugar), or development of hypoglycemia. I completed The Great Floridian Triathlon in October 2012 without any sugar, food, or hypoglycemia thanks to my low carbohydrate ketogenic lifestyle. Nutritional Ketosis My diet keeps me in a state of nut Continue reading >>
Starting Low Carb With Diabetes Medications
So you have diabetes and you want to try a low-carb diet? Congratulations! It may be the single best thing you could ever do for your health. It can start to reverse your type 2 diabetes, and dramatically increase your blood sugar control with type 1 diabetes. However, you need to know what you are doing. Once you start eating low carb you may instantly have to lower any insulin doses, a lot. Avoiding the carbohydrates that raise your blood sugar decreases your need for medication to lower it. Taking the same dose of insulin as you did prior to adopting a low-carb diet might result in hypoglycemia (low blood sugar). You need to test your blood sugar frequently when starting this diet and adapt (lower) your medication. This should ideally be done with the assistance of a knowledgeable physician. No drugs If you have diabetes and you’re treated either by diet alone or just with Metformin there is no risk of low blood sugar on low carb. You can get started right away. Insulin As a general guide you may need to lower your doses by 30-50% or more when starting a strict low-carb diet. Unfortunately there’s no way to know the doses required in advance. You’ll have to test your blood sugar frequently and adapt (lower) insulin doses. This should ideally be done with the assistance of a knowledgeable physician. Note that as a general rule it’s easier to err on the low side, and take more insulin later if needed. That’s fine. If instead you overdose and get low sugar you’ll have to quickly eat or drink more carbohydrates, and that obviously reduces the effect of the low-carb diet. Insulin in type 1 diabetes The advice on insulin above generally applies to type 1 diabetes too. A low-carb, high-fat diet can be fantastic for empowering people with type 1 diabetes to get s Continue reading >>
Tweet Ketogenic diets are very effective at achieving two common aims of diabetes control, lowering blood glucose levels and reducing weight What is the ketogenic diet? A ketogenic diet is a very low-carb diet, considered to be when you eat a level of carbohydrate of around 30g of carbohydrates per day or below. This encourages the body to get its energy from burning body fat which produces an energy source known as ketones. The diet helps to lower the body's demand for insulin which has benefits for people with type 1 and type 2 diabetes. Note that it is important that you speak to your doctor if you are considering following the diet as precautions may need to be taken before starting. How a ketogenic diet works On a ketogenic diet, blood glucose levels are kept at a low but healthy level which encourages the body to break down fat into a fuel source known as ketones. The process of breaking down or ‘burning’ body fat is known as ketosis. People on insulin will typically require smaller doses of insulin which leads to less risk of large dosing errors. The diet helps burn body fat and therefore has particular advantages for those looking to lose weight, including people with prediabetes or those otherwise at risk of type 2 diabetes. How to follow a ketogenic diet Based on the understanding that carbohydrate is the macronutrient that raises blood glucose the most, the primary goal of a ketogenic diet is to keep consumption lower than that of a traditional low carbohydrate diet with moderate protein and a very high fat content. This will determine the nutrient density of the ketogenic diet as well as how to follow it, as different foods will have different effects on insulin and blood sugar levels. Which foods to eat on a ketogenic diet There are a number of differen Continue reading >>
One Man Compares Ketogenic And Vegan Diets For Type 1 Diabetes
Diets that require less insulin are popular among people with type 1 diabetes because less insulin required means a higher likelihood of more easily managed blood sugar levels. To put that more clearly: Each time you give insulin, a certain amount isn’t properly absorbed. This happens to a varying degree each time, whether you inject or use an insulin pump. Each time you give insulin you are also dealing with a different set of variables that may impact the way the insulin works for you. We all deal with these ever-changing variables like stress, digestion, fluctuating hormones, and different levels of activity. The more insulin we give, the more outside our target range we risk being. This is the “law of small numbers” which Dr. Richard Bernstein coined to help explain why low-carb eating equals tighter blood sugar management. A ketogenic diet is a low-carb diet like the one Bernstein follows except it includes a larger amount of fat and a bit less protein. Another popular diet right now is the vegan diet. Those who eat this way while omitting refined or processed foods and grains say doing so leads to high levels of insulin sensitivity which help lower insulin needs and better blood sugar levels. Comparing Ketogenic and Vegan Diets for Type 1 Diabetes Steve Richert is a documentary adventure photographer who also has type 1 diabetes and eats a ketogenic diet. You can visit his website, LivingVertical.org to learn more and read about his latest project–a documentary about insulin access. In a recent post, Steve compares his experience and continuous glucose monitor (CGM) data while eating vegan and ketogenic diets. Two very different ways of eating, both of which appear to work out better than the standard American diet (SAD). There is a clear winner for Steve Continue reading >>
The Ketogenic Diet And Type 1 Diabetes
What is type 1 diabetes? How is it different than type 2? Type 2 diabetes is a condition where the body becomes resistant to insulin, forcing the pancreas to produce ever more insulin, and leading to a downward spiral of metabolic illness. It’s also called “Adult Onset Diabetes”, because the vast majority of people who develop it do so in adulthood, after years of eating a high-carb diet. Type 1 diabetes, also known as “Juvenile Diabetes”, is a disorder where the body’s immune system attacks the cells of the pancreas responsible for producing insulin. Only the pancreas can produce insulin, and insulin is the hormone primarily responsible for shuttling molecules out of the blood and into cells for energy or storage. That means, if the pancreas isn’t producing insulin, a person will starve to death from the inside. Their cells, literally, cannot get any food. They can eat and eat and eat, but there’s no mechanism to transport that food energy into the cells. That’s why they need regular insulin shots. On a regular-carb diet, those insulin shots might be several times per day. On a high-carb diet, those shots will be even more frequent. Type 1 diabetics must keep injecting themselves with insulin in order to deal with all the glucose in their blood stream. They have to keep insulin levels high, if they eat high carbs, because they have a high level of glucose to deal with. Being ketogenic means insulin levels don’t have to be high, because there isn’t a high level of glucose that needs to be shuttled around. And, because there isn’t a big requirement for insulin, the type 1 diabetic can reduce the amount of insulin needed on a daily basis (many reduce this requirement by 80%). The important thing to remember is that someone suffering from type 1 dia Continue reading >>
Does The Ketogenic Diet Work For Type 2 Diabetes?
You’ve probably seen dozens of headlines about the ketogenic diet by now, which has made its way into popular culture largely by celebrities and supermodels giving the long-standing fad diet a repeated stamp of approval. Is this the diet to follow if you have diabetes? Studies suggest the answer isn’t so simple. Some science shows its meal plan may be helpful, while other research, like one study published in September 2016 in Nutrients, highlights the importance of whole grains in the diets of people with diabetes — a restricted food category in the ketogenic diet. While the keto diet can offer many potential benefits for diabetes management, following it requires pretty serious commitment. So take a beat before you take the plunge — and consider these questions that can help you and your medical team determine if it’s right for you: How Does the Ketogenic Diet Work Exactly? There’s a good reason the ketogenic diet is also referred to as a low-carb, high-fat diet. Indeed, following the ketogenic diet means reducing carbohydrate intake to typically less than 50 grams (g) of carbohydrates per day, while increasing fat and protein intake, according to a review published in August 2013 in the European Journal of Clinical Nutrition. To put that into perspective, an individual on an average, non-restricted diet can easily eat more carbohydrates than that in one typical meal — for instance, a turkey, cheese, and veggie sandwich on whole-grain bread with a small, 1 ounce (oz) bag of classic potato chips would come in at around 51 g of carbs. These dietary changes drive down insulin levels, eventually leading your body into a state of ketosis, during which it is burning fat rather than carbohydrates. What Are Some of the Potential Benefits of a Ketogenic Diet for Continue reading >>
Lchf For Type 1 Diabetes
I spend a great deal of time in my clinic dealing with the problems of type 2 diabetes. But occasionally, people ask about type 1 diabetes (T1D) as well. The reason why it is so rare for me is that I treat adult patients where T2D outnumbers T1D by at least 9:1. I was looking at a fascinating study that my friend, Ivor Cummins (The Fat Emperor) had alerted me to a few months ago. Dr. Richard Bernstein is a fascinating character. He had developed T1D as a child of twelve and began to have complications by his 30s. He eventually went to medical school in order to learn better how to treat his own disease. Eventually he decided that the proper treatment was a low carb diet. This was in direct contradiction to the prevailing wisdom of the time (1990s), which included treating patients with insulin and a diet high in carbs. Dr. Bernstein opened up a controversial clinic to treat T1D with a low carb diet and also wrote several best selling books discussing the same topic. Over the years, it has proven to be a safe treatment for T1D. While there are few long-term studies, Dr. Bernstein himself is living proof of the low carb T1D paradigm. In many ways, T1D and T2D are exact opposites of each other. T1D typically affects children who are usually quite skinny. T2D typically affects adults who are usually quite obese. This is not absolute, and we are seeing much more T2D in children as their weights have increased. There are also cases of normal or even underweight patients with T2D. But in general, that is the case. T1D is the severe deficiency of insulin where as T2D is the severe excess of insulin. Nevertheless, people often treat both types of diabetes in the same manner. Both are treated with medications or insulin to keep blood glucose in acceptable levels. Wait, you might Continue reading >>
A Low-carbohydrate, Ketogenic Diet To Treat Type 2 Diabetes
A low-carbohydrate, ketogenic diet to treat type 2 diabetes 1Center for Health Services Research in Primary Care, Department of Veterans' Affairs Medical Center (152), 508 Fulton Street, Durham, NC, USA 27705 2Department of Medicine, Duke University Medical Center, Durham, NC, USA 3Private Bariatric and Family Practice, and Clinical Faculty, University of Kansas School of Medicine, Lawrence, KS, USA William S Yancy, Jr: [email protected] ; Marjorie Foy: [email protected] ; Allison M Chalecki: [email protected] ; Mary C Vernon: [email protected] ; Eric C Westman: [email protected] Received 2005 Aug 10; Accepted 2005 Dec 1. Copyright © 2005 Yancy et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. The low-carbohydrate, ketogenic diet (LCKD) may be effective for improving glycemia and reducing medications in patients with type 2 diabetes. From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A1c. Twenty-one of the 28 participants who were enrolled completed the study. Twenty participants were men; 13 were White, 8 were African-American. The mean [± SD] age was 56.0 ± 7.9 years and BMI was 42.2 ± 5.8 kg/m2. Hemoglobin A1c decr Continue reading >>
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
- A vegan diet could prevent, treat and even reverse type 2 diabetes, say leading experts this Diabetes Week (12-18 June).
- Does the Ketogenic Diet Work for Type 2 Diabetes?