Type 1's on Keto Diet

Hi Everyone,

I write a lot of posts about my low carb diet. I eat mostly non-starchy veggies, eggs, nuts and moderate amounts of meat. While this diet is definitely low carb, i am not good about carb counting or portion control and these things definitely add up.

I have been reading about Keto diet, which seems to be virtually zero carb but and bit more strict than just low carb, also incorporates more fat. Im not big into meat (as the protein really raises my sugar). So i am looking to get fat from things like olive oil and coconut oil. Trying to avoid nuts as they are way too addicting.

So after really learning the difference between a Keto Diet and a Low Carb Diet, I wanted to reach out to the community and see if anybody has made this transition. And if so, can i see an example of a daily meal plan...and maybe some tips and tricks on how to bolus?

I am weird about bolusing for these foods. I know i need to, as i have read it is still important to pre-meal bolus even if it is just 2 eggs.

I would love to hear all of the advice and experiences that you have for me!


Good morning, Andrea

I switched first to ultra low carb and then to Ketogenic earlier this year. What follows is purely opinion, so you should wait for smarter, wiser people to chime in.

My driver was that I wanted to lose weight and was being unsuccessful, gaining 2-3 lbs a quarter. As I started researching, I found total confusion. CDE's who said avoid fats and CDE's who said they were not a problem. So you have to kind of piece the picture together. Some key resources for me were Gary Taubes book Good Calories, Bad Calories; Dr. Peter Attia,Jimmy Moore's Livin' La Vida Low Carb Blog and SparkPeople Diets. The Calories book is a bit deep but it helped me understand the nutritional confusion in the diabetes world. Spark Recipes is the best tool I have found for finding recipes tailored to you - not just time of day and cuisine but low carb high fat, etc.

At the start I began testing more frequently - the term keto sounded a bit worrisome to a type 1. With that data I was able to more accurately calculate my I:C and ISF. I also bought a Precision Extra ketone meter. My goal was to metabolize fat but keep my ketone to 1 mmol.

This is turning into a lecture, so I will jump to the end. Being ketogenic feels better than any prior time in my life. I have plenty of energy. My A1cs went from 7's to low 6's. I am a MDI but this regimen gives me a very flat BG chart.

I also lost 30 lbs in the first 4 months without changing my calorie intake.

I would suggest that you look at TAG (you can find it on this site). You will need to bolus for the protein and fat but only for 60% of the protein and 10% of the fat grams. They also metabolize (in most people) slower than carbs.


So... I need to lose about 30 lbs. I've avoided the ultra-low carb, or ketogenic diets because I've simply assumed the food won't, ultimately, appeal enough to me to be able to do it.

I'll check out Taub's book, and the other resources you've cited, beechbeard -- thanks!

In addition, anyone here have suggestions for yummy cookbooks for ketogenic diets? Or just ultra low-carb? I need to figure out if and how I can do this. I want to try it, but if it can't satisfy my gastronomic aesthetic needs, I'll almost certainly fail!

Thanks so much for all of this info! I have a few more questions in return..

1) can you give me an example of what you eat on a regular day?

2) do you think there is an advantage in MDI for keto diet. I am currently pumping (less thant 20 units a day), I know Dr. Bernstein suggest MDI and i do think that with a somewhat flat line BG the MDI would be easy.

Do you like bacon? Totally compatible with keto diet. Si is cheese (particularly cream cheese). My wife decided to join me in this endeavor. Initially it was kind of slow and slim pickings. Some of the recipe books call for exotic ingredients that are hard to find and harder to understand. Maries Bleu Cheese salad dressing has 1 carbs! Hallelujah!!! Find anything in your pantry with high fructose corn syrup and take it outside for target shooting (only sane use of that crud).

We bought cookbooks, probably the best we used was a fat fast recipe book that we used to kick our metabolic engines into keto.

Typical day starts with my wife and I splitting a 2 egg omelet with a dash of heavy cream and some cheese (all different types). Also 2 slices of bacon.

Lunch is usually a salad with a protein like chicken or steak. (Pre-cooked in bags from supermarket),. crumbled bleu cheese, hard boiled egg, slices of pickled jalapeno. Sometimes add some onion and/or sliced mushrooms. For me, it is usually Marie's Bleu Cheese Dressing. I use the same plastic containers for the salad and dressing every day so constant portions is a no brainer. I use about 1 cup of spring mix lettuce. For lunch dessert (really) I have a small container of raspberries or strawberries and another container of unsweetened whipped cream. (Got to keep the fat intake up - yeah!!!)

Dinner might be anything, stir fray without noodles, stuffed hamburgers (with cream cheese). We do not eat rice (which I adore), wheat products (bread, noodles, etc.). We do eat high fiber veggies.

For a late snack I often have some berries and more whipped cream. When I am feeling the urge I make a horrible dish instead by slicing and nuking pepperoni to make sort of chips Then I slice some 1" squares of smoked cheese, put them on top of the pre-nuked pepperoni and re-nuke for 90 seconds. Zero carbs (except for the glass of wine).

I have talked to my endo about Dr. Bernstein. He had referred patients to him and they ended up with A1cs in the 5's! That isn't me. I would suggest increasing your testing first to understand what your body is telling you. I founD Bayer's GlucoDeluxe PC program very helpful, particularly the standard day and the standard week charts. I am sure others have the equivalent.

Andrea - It appears that I've been on a similar path as yours. I started a lower carb diet in May 2012. I limited carbs to about 75 grams/day. I lost weight and my BGs improved a lot. I also cut my daily insulin total in half. My weight loss stopped after about 90 days and I've spent the last 15 months or so at a weight plateau. I'd still like to lose 20 more pounds.

I've also looked into trying to further modify my diet so that I can spend more time in ketosis and lose that last 20 pounds. From my reading I believe that carbs don't need to be reduced to zero but below your personal threshold that will trigger ketosis. After experimenting with blood ketone measurements, I've fund that I can do that with a carb limit of 50 grams/day but I had to limit my protein consumption as well. I've calculated based on my weight that I need to limit my protein consumption to 65 grams/day. Many sources says that limiting carbs but not proteins will just lead to a greater portion of protein turning into glucose (gluconeogenesis) and work against dropping into ketosis. I've just started this effort and don't have any results to report.

Here's a recent day in my food log:

Late Breakfast
Cream cheese - 2 oz.
Raspberries - 85 grams
Walnuts - 28 grams
Heavy cream in coffee - 3 oz. over 3 cups

Ground chuck grass fed beef - 4 oz.
Pepperjack cheese - 1 oz. slice
Tomatoes 94 grams
Onions 110 grams sauteed in 2 tbsp. of Kerrygold butter
Ketchup 2 tbsp
Mustard 1 tbsp

Low BG treatment
Applesauce - 1/2 cup (This was not a hard-hitting low and I had the luxury of treating with a slower acting food. I get so tired of the Dex4 tabs.)

Mixed nuts - 1 oz.

I look forward to reading about your experience and others that are further down this path.

thanks! do you limit proteins in meat form? i limit it in that sense but i feel like i do eat a lot of cheese and eggs, they are protein as well but do not seem to raise my BS as much. Any reason for this?

I'm not limiting my meat protein, just total protein. I like meat protein because I've read that its amino acid profile does a good job or repairing muscle and other tissues. I haven't observed a qualitative metabolic difference between the various sources of protein. Maybe the consistency of meat in the gut slows down the metabolism when compare to eggs or cheese. Makes sense but I haven't noticed any big difference. Now that you've raised the issue, I will watch.

I watched a video yesterday from Jimmy Moore's low carb cruise where someone on the expert Q&A panel endorsed eating fish at least once per day. I'm lucky if I eat fish once per week. I'm tempted to try out this idea.

FWIW after testing more often and getting more accurate ISF ICF values, I was able to get to the point in a day that I was BG between 80 - 100 with no insulin left on board.

I take Lantus and Apidra. One thing the numbers showed me was that I was running into gluconeogenesis in late mornings - early afternoon. Si I split my Lantus into a morning shot and an evening shot. What that meant was that if I skipped a meal I could just skip my Apidra and the BG would not move up or down. I finally got to the point where I could fast and just take my Lantus. If you could see a picture of me, you would know that fasting isn't a hobby. lol

But what this did was turn me into a perfect lab rat. Once I got to a point of stable BG and no Apidra left on board, I could experiment on myself. For example, eat 1o grams of whatever and test BG every 30 minutes to measure the magnitude of change and the timing. I did this with various carbs, proteins and fats.

BTW I use my forearms as an alternate site testing area. That's why I do not mind testing so much, it doesn't hurt.