Interesting read on the ketogenic diet


#1

#2


#3

Just watched an interesting, controversial show, The Magic Pill on Netflix, related to keto diet.


#4

I’ve used a low-carb, high fat diet for almost seven years now. I’ve lost substantial weight as I dropped from 183 pounds to 156 pounds on my 5’8" frame. I expended little willpower to accomplish this.

That translates from an overweight 27.8 body mass index to a normal BMI of 23.7. Most importantly, my blood glucose control markedly improved. My continuous glucose monitor time-in-range soared to 80%+ and glucose variability as indicated by CGM standard deviation plummeted to well under 30 mg/dL.

The keto diet works like magic for me. I fully understand people’s reluctance to give up their comfort-food carbs as it took me about two years to warm up to the idea enough to give it a try. My success was immediate; it’s one of the best things i have done for my diabetes as well as general health.


#5

Last Saturday, my husband and I spent about six hours de-carbing our kitchen, cleaning, and organizing. We are officially fully keto as of today. I hope we are able to establish this as quickly as the author did. Good read – gives me added hope :slight_smile:


#6

Ditto for me, although I went ultra-low carb (Keto, < 10 gms of carbs/day). I’m only 5’7", and my weight had ballooned from 155lbs to 175lbs six months ago. I began keto in mid-Aug '18, and have dropped 37lbs and presently weigh 138.

My BMI is now down to a normal 21.6. My blood glucose control has never been better in the 55 years I’ve had T1D, nor have my sugars ever been this easy to manage. My time in range is typically 95%, with a SD of less than 18 mg/dl (1.0 mmol/L).

There’s a wealth of keto info on the internet / YouTube. A year ago I was a sceptic, equating “keto” with the feared “ketoacidosis” we all know about. Nowadays I thrive on lower level ketones - they’re a direct measure of body fat burn.

I’d be happy to share my experiences with anyone who has questions.


#7

Excellent! Since last October I have restricted my carb consumption to < 30 grams/day. Since then I have slowly lost seven pounds. My target weight is now set to 150 pounds, a number a I picked since that’s what I weighed at the end of high school. Seeing your numbers makes me consider that I might do better at < 150 pounds.

I see weight loss as a way for me to lower my high blood pressure and hopefully get off of my meds. The one thought that gives me pause is that a sustained health crisis can often consume significant body weight and carrying a few extra pounds offers some insurance against that threat.

@SarahMichelle – Good luck with your keto-diet implementation. The carb cravings will stop after a week or two. Drinking bone broth is a great tactic to minimize these cravings due to the extra sodium it provides. Many people don’t make it past this initial challenge and then don’t accrue the many benefits that a sustained effort will yield. It is so worth the effort; don’t give up!


#8

Terry, it’s funny. When I started 6 months ago, 150lbs was also my target. Secretly, I never thought I’d get there. In the meantime, I’ve relearned everything I know about good nutrition, throwing out numerous “healthy foods” that have been pushed on all of us for years. When I reached 150, I plateaued for 2 months and even put weight back on, but only because I can’t eat much more than 45gms of protein a day (T1D renal issues).

Did I mention I no longer take the 4 BP meds I was on since '96 (Amlodipine, bisoprolol, irbesartan and terazosin)? Or that the severe edema I’ve had for 2 years since being diagnosed with CHF and PH has disappeared (no more compression socks!)?

Keto is magic for me. :grinning:


#9

I have been keto for 6 months and have gone from 160 to 150 lbs on a 5’10” frame. Better is that my blood sugar rarely goes above 150 and lows are seldom and mild (50-60 with a sideways arrow on the CGM). I haven’t had a straight up or down arrow in 6 months and my A1c dropped from 6.5 to 5.5. NOTHING tastes as good a perfect blood sugar feels. Full disclosure I have no other health issues and exercise daily so this works for me, but may not work for everyone.


#10

That is amazing! I’d love to steal that, “Nothing tastes as good as a perfect blood sugar feels.” Nice turn of phrase! Congrats on your diabetes health breakthrough.


#11

Thank you! We are banking on those cravings going away. We are on day four. I saw the endo a couple days ago, and she was able to give me some solid goals for where my insulin resistance and usage should be for our high risk OB to be okay with me getting pregnant!

Pre-four days ago

TDD 275 U average
Average BG 180ish
A1C 6.8

THE LAST FOUR DAYS
TDD 180 U average
almost 100% of the time within range (under 180)

Yeah…I’m excited. Sometimes I don’t feel like I can’t do it anymore (yes, I realize it is only day four…but when you have an emotional and physical attachment to food, it is ROUGH), but these numbers are where they need to be and that gives me the motivation to keep going one…more…day…: ) (okay, sometimes, its just one more minute!)


#12

@SarahMichelle - the first week or 10 days was rough for me as well (cutting out virtually all carbs). If I only knew then what I know now.

I suggest you pick up a bottle of MCT oil to help you slide into ketosis far faster. MCT’s are medium chain triglycerides, which are near-instantly digested and sent to the liver where they produce low levels of ketones (yes, you want ketones in your bloodstream, they are your new fuel now that you’re not consuming carbs).

Once you’re more fully into ketosis, you can back way off on the MCT oil, as all your ketones will be produced from metabolized body fats.

IMPORTANT - There are suggestions all over the internet to “take a tablespoon or 2 of MCT oil”. I’m warning you right now not to do this, as it turns out MCT oil is a far more powerful laxative than anything on the market. Less than a teaspoon (perhaps every morning or evening) is all I’d take. It also can cause severe stomach cramps when taken initially so don’t start too quickly.


#13

I think your drive to start a family is a potent motivational resource for you. Keep up the effort, it will get easier!


#14

This is all so fascinating… but I was reading that as beneficial as ketosis can be for health/weight loss in type 2 diabetics, type 1s aren’t able to process ketones properly. Thoughts on this article? Thanks!

https://www.everydayhealth.com/type-2-diabetes/symptoms/ketosis-diabetic-ketoacidosis-how-they-differ/


#15

Here’s the paragraph that likely informed your comment.

People with type 1 diabetes should not try to achieve ketosis through the ketogenic diet or otherwise. Because people with type 1 diabetes don’t have insulin, they cannot metabolize ketones, which are gradually flushed through urine in people without the disease. For people with type 1 diabetes, ketosis can result in an accumulation of ketone acids in their bloodstream known as diabetic ketoacidosis (DKA), says Dr. Greenfield.

This is nonsense! People with type 1 diabetes can process ketones as energy just like gluco-normals do. I say this because I have successfully utilized a low-carb, high-fat diet for the last 6+ years and spend much time in healthy ketosis.

This Dr. Greenfield embarrassingly suffers a common confusion about ketosis vs. diabetic ketoacidosis. The rest of the cited article makes this distinction between ketosis and DKA very well, more than once. Dr. Greenfield’s quote is not factually correct. Ketones can be metabolized by most tissues in the body and the brain can run quite happily on ketones. Not all ketones are flushed out by the kidneys.

People with T1D do take exogenous insulin. Perhaps the good doctor was talking about DKA that precedes initial diagnosis when T1Ds do not have any native or external insulin added.

As I’ve written before about the difference between ketosis and DKA is like the difference between a light breeze and hurricane force winds. Many medical professionals have historically confused these two different states, especially in the dietitian ranks. I must note that this is improving but Dr. Greenfield reminds me that this confusion is still muddying the waters for many patients.


#16

Thanks for the enlightenment - it did seem odd that a diabetic in good control, and thus with sufficient insulin on board, would for some reason NOT be able to do what a non-diabetic could do, in terms of processing the ketones. =)


#17

I will say something on this.
I did the keto diet when I was first diagnosed.
I lost weight, and kept my BG numbers down (mis-diagnosed as type 2, so no insulin yet.)
I finally got on insulin, but kept at the Keto diet because it was working!
I did have one episode where I was going into DKA with normal BG numbers (I was between 110 to 120 at the time.)
I got myself out of it before I had to go to the emergency room (even though I probably should have went,) by eating carbs and large doses of insulin.
I didn’t have a full grasp on being type 1 yet, and how my body worked. But I was blindly going by my BG numbers to guess how I was doing.
After that I got ketone strips to test with!
I highly recommend testing your ketones to make sure you are in a safe and healthy zone when going on a keto diet. At least until you have a good feel for how your body reacts to this kind of diet.


#18

Greenfield was my doctor for roughly a year. He was excellent at calculating insulin infused thru IV to keep me steady during my stay in the hospital for surgery. I’ve never had such accurate delivery of insulin to balance out the carbs I’d get thru various IV’s. I switched docs when I no longer worked near him, but I have nothing but good to say about him other than he was ALWAYS very late for appointments. Sometimes more than 2.5 hours late. Say what you will, he is one of the best endos in the South Bay.

And I disagree with your statement that Greenfield is incorrect. https://www.healthline.com/health/ketosis-vs-ketoacidosis#diagnosis


#19

After writing my criticism of Dr. Greenfield’s quote in the linked article, I should have raised this point. The doctor may have been misquoted by the journalist. If he was then my criticism may be based on incorrect reportiing.

What point, specifically do you disagree with me?

  • Is it the point that people "with type 1 diabetes should not try to achieve ketosis through the ketogenic diet or otherwise?

  • Do you disagree with my assertion that “people with T1D do have insulin” since they must take it to survive?

  • Do you think that all instances of ketosis lead to DKA?

Your personal experience with Dr. Greenfield paints a much different picture than the article did. If the doctor’s position was mis-portrayed by the article writer, then that left me with a skewed sense of his competence.

I have read many accounts from professional medicos who don’t understand that ketosis is a daily fact of life for almost all people. It’s how our body compensates for lack of food when we sleep for eight hours and don’t eat. The demonizaton of ketosis is often asserted by professionals who support the low-fat and highly processed carb diets, the standard American diet or SAD.


#20

The article, especially the statement “Type 1s aren’t able to process ketones properly” is absolutely false, and there are 100’s if not 1,000’s of keto practicing T1D MD’s that dispel this old fashioned myth. Perhaps as Terry suggested the good doctor was misquoted?

More to the point, T1D’s are more readily able to control their ketone level with proper blood glucose than T2’s, as T1’s can monitor their BG and inject (pump) the lowest possible insulin levels required to maintain target blood sugars. Insulin is effective at doing 3 things: metabolizing glucose, storing excess energy as fat, and lastly putting the brakes on rising ketones.

If insulin is high, ketone production (ketogenesis) is blocked. If insulin is low, ketone production is increased.

http://www.insuliniq.com/insulin-vs-ketones/