Insulin for keto/low carb

Hi Jim. I will turn 71 at the end of the month. I was dx when I was 8. Yes, I eat close to 275 carbs daily taking only 22 total units of insulin. I can do this because I eat a very low fat diet. Fat causes insulin resistance. I eat a mostly vegan diet with lots of beans, grains, fruits and vegetables.

It sounds like you are doing well keeping your type 2 controlled. I am glad that you enjoy my posts. Thank you for telling me.

T1 and T2 are different ball games. Unless you are one of the 10% of T2 who are misdiagnosed. You won’t be able to duplicate Marilyn’s success. I haven’t seen very low fat and high unrefined carb work for an insulin resistant T2. In fact high carb lower fat, is how most of us became insulin resistant T2.

1 Like

I have to agree, Jack, I struggled to get good control following the dieticians mantra of low fat, high carb. It wasn’t until I read Bernstein’s Diabetic Solution that things got better.

I am not following a very low carb high fat diet, but try to keep my carbs around 100g per day and those are complex carbs.

1 Like

One must still bolus for high fat/protein. I think it is sad that endo’s are still telling patients to bolus only for carbs and ignore the rest. Maybe that’s true when you eat high carb and low everything else.

I am keto and eat generally less than 15 total grams of carb a day. I started with the Warsaw Formula and moderated it to suit me. Here is the simplest explanation of it that I can find: How to Bolus for Fat and Protein! – Young & T1

Instead of 10 grams of “carb” for each FPU, I use 2. And I only stretch my bolus out over three hours, I don’t need more than that. So if you decide to try it (I recommend consulting with your doctor) start conservative.

I concur with other folks in that keto snacks can be used to bridge the gap while you are switching from standard western diet, but in general they are garbage and not remotely healthy. Stick to real, whole foods.


I’ve not seen a reference to the Warsaw Formula before and I’m surprised by the 2009 medical literature that it is based on. I became aware of dosing for fat and protein by posts made by other TuD members many years ago. I used those tactics before I switched to Loop in 2016. They were easy enough to execute and the fat/protein portion of the dosing (using the extended bolus function of my pump) were reliable and easy to adjust.

While this Young and T1 group using the terminology, FPU or fat/protein unit, I called them carb equivalents. Aside from using different semantics, the tactics are essentially the same.

Great advice! Congrats on discovering a way of eating and insulin dosing that produces normal BGs.

Actually Jack if you go to the Mastering Diabetes website, you will see that many type 2’s have success with a very low fat, high carb plant based diet. It definitely depends on what kinds of carbs you eat. My carbs are from beans, lentils, grains, fruit and vegetables including potatoes.

1 Like

The term “carb equivalents” I think, is significantly more user-friendly than FPU’s. I will have to adopt that. :slight_smile:

I was an ethical vegan/vegetarian for decades and rarely chose to eat meat. My cholesterol was always amazing.

Less than 8 months on the low carb approach, and the medical team was going to start adding a script to bring my cholesterol numbers down.

That’s when I made the choice to stop the artificial insulin number chasing and to eat the high carb, whole foods (fruits and veggies) that I had been avoiding on their insistence.

Will be getting new bloodwork in a couple of months. Will report back if my cholesterol numbers went back to their “good” levels or not.


The liver does not release glycogen. The liver breaks down glycogen to glucose and release the glucose. Why would the liver be releasing glucose during periods when it is using glucose to replenish its glycogen stores?

Thanks for that correction, William.

Yeah in addition to the types of carb and plant-based emphasis, I think also people don’t realize the level of low fat you are describing means (I believe) no oils whatsoever, etc. It is way beyond what most people typically consider “low fat” (but often includes some amount of things like olive oil etc).

Both LCHF and HCLF when done at extremes do things (ketosis or increased insulin sensitivity, respectively) that can be useful in terms of diabetes management that neither does when done only to a less extreme level. So you can’t really judge the full effect of the extreme approach by how a more moderate take tends to play out.

Funny, I don’t think of my WOE as being extreme at all. It is different yes, but extreme not in the least. No, I haven’t used oil of any kind in 5 yrs. I find that cooking with a little broth makes a great oil substitute. I do eat a few nuts and always use roasted pumpkin seeds.

I make delicious Chocolate chip cookies using garbanzo beans and usually eat 3 or 4 a day. I don’t feel deprived at all. My husband eats this way too and enjoys it. He loves the frozen banana mixture that he makes for dessert.

I also love being able to eat potatoes and some rice. I find a morning bowl of oatmeal with banana, date, a walnut and a cup of blueberries to be very satisfying and a real treat.

I love not having any threat of gaining weight while eating as much as I want.

1 Like

@Marilyn6 I think it’s extreme in the sense that it’s quite unusual compared to cultural standard WOE and taking low fat to a very far degree and without much flexibility around that (it’s not like, mostly I eat low fat, but a little oil here or there is ok, and if I really want X I make exceptions for those treats in small amounts—I’m guessing if you loosened up like that you wouldn’t see the same benefits re insulin sensitivity), but “extreme” doesn’t mean it’s not working well for you and perfectly enjoyable for you! Same with folks who find LCHF makes them function well and find ways they enjoy eating with that.

Personally, as someone with a lot of restrictions on foods that I have no choice over due to a high number of food sensitivities, I am both less able and unwilling to add any more inflexible restrictions to aid in diabetes control, which puts ketosis-inducing LCHF and insulin sensitivity-increasing HCLF off the table.

1 Like

Same here, although I didn’t know I had food sensitivities until I tried both a plant based and a LCHF diet respectively.

I’ve actually used you as an example of what can work for a T1 over on DD. It is working well for you, to control your BG. You are very stable.

Who knows what the website is putting up. 5-10% of T2 are misdiagnosed anyway.

I can only say that all my years on diabetic forums, I’ve never come across a typical insulin resistant T2 who can handle anywhere near those carb numbers. Even on insulin it is uncontrollable and induces higher A1c, weight gain and higher insulin doses, in an ever increasing feedback loop.

If you ever come across an independent study or trial on T2, I would certainly like to see it.

I eat low fat and high carb too, but I don’t get it as low as Marilyn.
I aim for 20-25%. I cut out most oil which is easier than you might think.
I don’t eat oily things like avocado or nuts.
It has helped me keep a much more steady in range control.
I have gradually increased carbs to about 200 per day. However my insulin requirement is much the same as it’s always been. Trying to drop 10 lbs and see how that effects me.

I still eat small amounts of lean meat which is why I can’t get my fat so low.
The hard part is getting rid of processed carbs. I have to prepare most food myself.

I think eating Whole Foods is really the way to go.
I never go extreme on anything , and the diet the way I do it is quite easy to maintain.

I do miss peanut butter which I’ll eat sometimes just because I want it.
I don’t miss added oil like I would have expected. I really like food better without it.

I used to add oil esp olive oil to everything.

1 Like

As a T1 you can do this. You have a choice of which way you go. What you can’t do is high fat and high carb. you need to pick one.

This thread is about insulin dosing for protein and fats on low carb or keto.

Not really, you can do both. It just may make dosing insulin more challenging, but some people do and achieve good control without either end of diet restriction. For others, the diet restrictions play a key role, because the variability otherwise is untenable or takes too much effort to realistically deal with. YDMV, etc.

1 Like

When I eat what I want and try to match insulin to it, which I did for years, I invariably
gain weight, which I really don’t want to do.

It’s so interesting hearing what everyone does. I don’t eat one particular way. I am low-carb, but I find that my diet has changed, and that I am eating smaller low-carb meals and having carb as snacks to prevent lows. I like keto/paleo recipes as I don’t really like dairy and it raises my blood sugar. I have found that the amount of carb needed to keep the blood sugar steady (within range) is very small. Thanks everyone. Good to hear everyone else’s experience. I find that the stuff I make myself (I make this type of bread with almond flour), I eat half a slice in the morning and it raises my blood very slightly. In fact, I have to eat a fruit (tangelo) with it to keep my blood sugar from dropping. So I have been able to cut down on my insulin by eating this way.

1 Like