Are there differences in approach to keto between T2 diabetics and non-diabetics

(Bob M) #15

As an example of what fasting does, see 3/4/21, fasting for34 or so hours:

At one time, I was fasting 36 hours twice per week and doing many, many 3.5-5.5 day fasts. Longest was 5.5 days, and I stopped only because when I stood, I got dizzy.

That’s how much my blood pressure decreases with fasting.

(Joey) #16

@ctviggen Ah, yes, thanks for the reminder…

I should have added that, while consuming all this salt, my BP (and that of my wife) are consistently low, comparable to yours.

Neither of us are on any BP meds. But after going keto, my wife was taken OFF of her high blood pressure Rx by our internist.

If anything, we often have to be careful not to get up too quickly and run off somewhere without giving our blood pressure a chance to catch up. It’s called postural hypotension… in layman’s terms: our blood pressure levels are extremely healthy for long term internal plumbing integrity.

'nuff said :wink:

(Cat Onisko) #17

This is all very interesting and encouraging re salt, fasting and blood pressure etc, way to go guys!

I think this is where people who are not on any medications and do not have any health conditions can sometimes get frustrated though. Where my only goal is fat loss (I’m not on any medications, nor do I have any health markers that I need to improve and therefore monitor), and fat loss isn’t really happening, it can become frustrating, and rightly so. I can’t imagine many people wouldn’t be frustrated.

I’m reading so many wonderful stories about people lowering their insulin doses and certain medications in a relatively short amount of time which is really cool and tangible evidence that this WOE is working in their favour, but when fat loss is my only goal, and it’s not happening (I know I’ve lost 4 pounds in a month, but according to my scales, my fat % has not changed), I ineviatably start to question things.

I don’t track my food and I don’t count calories, I just don’t eat carbs except for incidentals in vegetables. Perhaps my protein is too high, perhaps I am actually eating too many carbs and I just don’t realise (I find this to be highly unlikely), perhaps I am just eating too much food for my 5 foot 2 frame, but something definitely has to change in the next couple of weeks. Perhaps I should incorporate longer fasts (I naturally do 16:8 with ease).

So many variables to consider!

I’ve just dug out my old dusty copy of The Obesity Code, perhaps Dr Fung can show me the way :slight_smile:

(Joey) #18

@cateli I can understand with your frustration… your primary motivation for going down this keto rabbit hole is not (yet) being met. That’s hard to deal with for now.

FWIW, I had no interest in losing weight/girth, but lost 25lbs and 4" at my waistline in surprisingly short order (6 mos or so). I was an active, healthy guy - not a “heavy dude” - now being 60+ yrs old, about 5’ 10" who weighs 140lbs with a 31" waist. But to be clear: the weight & waist sort of melted off, this was never my goal. My motivation was (1) to encourage my wife along the path for her health and family history and (2) see if I could feel better in the process.

Well, yes, I began to feel amazing in every respect imaginable - lots of “aging” issues disappeared miraculously. But more importantly, my wife came off her meds (BP and statins) under supervision of our doctor, and she lost about 20 lbs and looks fabulous. But being post-menopausal, it was a LOT slower for her. Also, she is not 100% as keto-diligent as I’ve been, so there’s probably that too.

But women commonly report having a much harder time for keto to produce weight loss - a primary objective for many who frequent this forum - and those in menopause are especially prone to such complaints. Yeah, it works … but slower and more internally long before the external evidence becomes clear.

I hope that a parade of women with personal experiences come to weigh in (sorry, bad pun). Meanwhile, my advice: recognize that everyone’s experience is different (you are your own n=1 experiment) and what works quickly for some may work much more slowly for others. There are lots of reasons for this; there’s no point in expecting to be “average” in anything.

Most importantly, the “How do you feel?” question should remain central to your eating/exercise habits. Stay hydrated and eat foods that really nourish your body. This is your only one and it deserves the best you have to offer. :vulcan_salute:

(Todd Allen) #19

When I started keto to I found I needed to keep carbs very low and protein moderate to achieve good blood glucose, ketones and minimize symptoms I associated with diabetes such as frequent urination, night sweats, etc. My tolerance for protein and carbs improved rapidly over the first couple years and I think has continued to slowly get a bit better since then. My guess is someone who has no issues with T2D or insulin resistance could likely start out eating as much protein as they want without issue and probably double the carbs of T2Ds.

(Michael - When reality fails to meet expectations, the problem is not reality.) #20

What many/most folks don’t realize is that excess fat is a symptom of metabolic disorder. When stored fat exceeds some amount (individually variable, of course - what’s not?) it can become a problem of its own. But long before that, it’s an indication that something’s not working right. A healthy metabolism does not store excess fat. Given that some variation of SAD is prevalent, the most likely suspect of early disorder is insulin resistance. As @PaulL pointed out, Kraft determined that pre-diabetes and even diabetes can be present decades before showing up as elevated glucose and insulin.

Blood Glucose level dipping too low on keto but very low ketone blood concentration. What should I do?
(Butter Withaspoon) #21

I’m a healthy person doing more or less keto. My family get so much cancer so it’s a prevention and health maintenance strategy for me. One thing I’ve found as I go along is that eating more protein seems to help. Women can have a very delicate idea of what adequate protein looks like. I’m eating something like 2 steaks and 4 eggs a day, and some other stuff. I don’t measure, but suffice it to say I eat Twice as much animal protein as expected! Whatever your home scale is saying, hopefully your muscle, bone and connective toss are making good use of the protein, and possibly weighing a bit more.

The calm well being and even energy levels, the smooth skin and long tresses of curly hair (ok not the hair) are worth it you’ll find.

Good luck and stick with, experiment, be confident, enjoy!

(Vic) #22

Did it take more than a year before the pressure kind of stabelized at the low end?

After that it seems to creep up ever so slowly but still low and good today. Why did it creep up?

The change in amplitude is amazing :+1:


No, keto isn’t a diabetic diet. Same results either way. Only the T1D’s have different things they need to do.

You’ll most likely get resistance on that one here, but you’re correct many women feel much better when doing that, with my wife and mother being 2 of them. 50g is still super low carb even by low carb standards, I wouldn’t worry about doing that at all.

It’s normal to be a little under powered at first while you’re adapting. MCTs can help sometimes since they convert to ketones quickly. Exogenous ketones will let you run on those and feel better while they’re in you, but won’t speed up the fat adaptation, they’ll only fix the fuel source issue temporarily. From what you’ve listed as a sample day of eating I’d say you’re pretty severely under eating which probably has a lot more to to with it.

Of course, when you’re insulin sensitive more carbs can come it with less issues. At my start as a 300lb pre-diabetic more than 20g would screw me up huge. I’m 190lbs now, and don’t eat strict keto anymore. More of a modified Targeted keto. I average anywhere from 100-250g carbs a day depending on what I’m doing in the gym and do much better now. I also maintain an A1C of around 5.0.

You broke your fast when you drank a BPC, there super high in calories and fat, they’re very much meals of their own. Also note contrary to keto beleive fat isn’t unlimited and the goal of the WOE isn’t to find creative ways to fat-ify everything at all costs. 2 BPCs, your ommlette cooked in butter, with bacon or avacado, with olive oil, nuts, cheese, it goes on. When I’m loosing if my fat is much of 85-100g a day I won’t loose regardless of any other macro.

People who have a carb based diet can’t eat unlimited carbs, keto eaters can’t eat unlimited fat. Are you tracking macros other than carbs?

(Cat Onisko) #24

Thanks @SomeGuy, that really is a wonderfully inspiring post!

4 weeks of eating this way seems like a long time for me, but I suppose in the grand scheme of things it’s a drop in the ocean isn’t it! A bit of confirmation from my own body that it’s happy with what I’m doing to it would be nice considering I really am doing something quite drastic to it, but I can’t force that, so I’ll keep on doing what I’m doing! It seems to work eventually for everyone so I’ll try to stop questioning it and looking for signs that I’m an anomaly and isn’t working for me.

Thank you! :slight_smile:

(Cat Onisko) #25

Thanks @amwassil, yes you’re quite right, there’s clearly something not quite right if I store high amounts of fat when eating the same diet as my lean boyfriend and doing cardio 5 days as week when he does nothing! I think, as per a lot of keto advocates say, I’ve always beaten myself up thinking I must be eating too much all the time, or I must not be exercising enough, and the really negative emotional state that comes from that way of thinking clouds the rational thoughts of “Hold on a second, you eat the same food as your partner and he’s lean… how is this your fault?!”.
This info on Kraft is incredibly useful, I’m going to change my way of thinking now from “Why am I not losing weight when it’s the only reason I’m doing this” to “It stands a good chance that if I didn’t do this, I’d become diabetic in time for my 40th birthday”.

Many thanks.

(Cat Onisko) #26

That’s interesting re protein @Hallie as I do wonder if I’m eating too much meat! I’m going to reinstall Cronometer today and eat how I have done for the past week or so and see what my macros come back as. I’ll post them in this thread and see what you all think!
Now I think about it, my skin is looking great right now and I’ve suffered from acne since I was 21. I chalked that up to being in lockdown and working from home so no longer wearing makeup, but perhaps keto is also helping!

Thank you for your insights, it’s great to have a female perspective as clearly we are built very differently and are affected very differently by all sorts of things that men don’t tend to have to think about.

(Cat Onisko) #27

That’s really surprising that you think I’m undereating @lfod14! It’s really good to get an opinion on that as I didn’t think I was undereating at all! That’s purely down to me being on a calorie restricted diet for years and years and so my view on how much to eat in a given day has become so so corrupted. I’m going to go right back to basics and reinstall Cronometer and track all my macros now, not just thinking about carbs. I’ll post my macros on this thread and perhaps some of you could take a look and see where I can improve? I’d so appreciate that! I’m still very much a student, and some advice from you wise owls would be wonderful :wink:

(Cat Onisko) #28


I’ve just put what I planned to eat today into Cronometer… I’m undereating! My BMR is around 1450 and I’m eating around 1300. Over a week or so this is quite a bit less than what I should be eating as an absolute minimum. My protein is fine, my fat is fine, but I’m going a bit over on net carbs (about 23g by eating a fair bit of mushrooms and some other slightly carby veg).

Back to the drawing board for me by tracking everything for a bit!

Thanks for all your help ladies and gentlemen.

(Sarah Stultz) #29

So much good advice in this thread. Since most who responded are male, I thought I would give you my perspective as a pre-menopausal 44 year old female. Get rid of your scale. Or hide it or something. The most you should ever weigh yourself is once every 2-4 weeks. As women, we obsess over the numbers on that scale and let it increase our stress when it isn’t moving, or moves backwards, or just doesn’t move down fast enough. Weight fluctuates so much, especially in women with hormone cycles. You just can’t trust the scale. Go by how your clothes fit. Get a belt and wear it with your pants even if not needed; you can tell when your weight is decreasing. And celebrate improved health that has nothing to do with weight. Even if you aren’t diabetic, it’s likely you have some metabolic damage that needs to heal. Some people’s bodies like to really focus on healing before releasing excess fat.

I’m 11 weeks in on my 3rd round of keto, but this time is different; attitude is everything. If you look at this WOE as a temporary change just to lose some pounds, it is very likely to fail. If you look at this WOE as a “restricted diet” or feel deprived, it is likely to fail. You have to want to eat this way the rest of your life. I didn’t start to feel really good until 8 weeks into strict (but lazy) keto this time around. Now I feel like a different person. Like I’ve come alive after 15 years. I haven’t lost much weight according to the scale (doctors’s visit weigh), but I had to add holes to my belt, and buy new bras. I can do hard physical labor for many hours without fatigue. My joints hurt less and I can recover from physical labor much faster; my sleep is dramatically improved and I no longer wake with migraines everyday. And even if I never get any smaller than I am right now, I will continue to eat this way. This is the best medicine I have EVER had.

So keep calm and keto on. Eat until you’re full. Don’t restrict calories. More protein is usually needed for women who have chronically under eaten protein their whole life. Only eat when you’re hungry. And good luck!


We’re of a similar age.

You’ve had some great advice in this thread - the two pieces I will offer are ‘easy to say, difficult to do’, but hopefully they help:

  1. Relax.
  2. Eat.

I am guessing that, like me, you didn’t become overweight overnight. It is difficult emotionally when you overhaul your eating, and you see few results - we are all victims of the diet trap, where we are promised on the front of magazines that you can ‘drop a stone in a month’ or ‘lose 8lbs in 13 days’. Even if we recognise that this is nonsense (or manipulation of water weight), we internalise those messages and when we make drastic changes, we feel as if we’re not receiving appropriate reward for our efforts.

It’s very difficult to trust in the plan if you feel that it isn’t working. I am confident in the approach, and even I have had wobbles where I’ve thought, “I am eating too much? Are my macros incorrect? Should I do x, y, z?”

It’s difficult to let go and trust in your body, but my advice would be to relax and give your body time and space to do what it needs. As many people have said, keto can heal from the inside, so fat loss may not be your body’s first priority.

Secondly, on the topic of internalising messages, we’re all surrounded by traditional thinking. This includes things like, ‘women should eat 1500 calories to lose weight’ or ‘your BMR is calculated as this’ etc. Some people will disagree with me here, but I can only give you my experience - I have lost weight in the past with extreme calorie restriction, but I also put it back on because I was clearly starving myself.

I deliberately raised my calories to 2000 - 2500 when starting keto, because I didn’t want my BMR to drop through the floor. I’ve been eating keto/carnivore for 7 months, and I eat to satiety without counting now (but I have a fair idea of how much I am consuming because I eat similar things each day), and I’ve lost a considerable amount of weight.

It’s very tempting to use calorie restriction as an additional lever to see quick results, but my feeling is that you can hamper yourself moving forward; I much prefer the idea of a life where I can eat 2000 each day, rather than collapsing my BMR and eating 1500 for the rest of my life.

There is a lot of content on this site about people finding that when they eat more, they lose more weight. It doesn’t always happen - your mileage may vary etc - but I agree with the logic of ‘feast’, ‘fast’, ‘famine’ (which basically means that large amounts of keto food can cause the body to realise that it is well fed and can afford to drop fat, whilst meagre amounts of food can cause the body to fear that food is scarce, so won’t drop fat). Again, this flies in the face of so much traditional diet wisdom, it can feel counterintuitive.

The final point I will add is that I feel that traditional diets do not take into account women’s hormones. Your body requires extra nourishment at certain points in your cycle. It takes a lot to be able to trust your body, and to switch off the ‘brain food trigger’ (oh I want something tasty) versus the ‘body food trigger’ (I am hungry).

Someone had advice on the forums previously to consider eating a hard boiled egg when hungry; if that sounds delicious, you’re hungry - if you’re not convinced, you’re not hungry, you’re looking for something ‘nice’. That was very useful for me in determining whether I was hungry or whether I was looking for a treat. If it was the latter, I deliberately found something else to do which was non-food related.

Anyway, on a hormone point, I have eaten 2.5lbs of meat on certain days without pausing for breath - and then, a few days later, struggled to get past 1lb. It’s like being a different person, and if you’re watching your calories, I feel that you wouldn’t provide your body with the nutrition it desires on certain days because you’re scared of going over. Being able to trust yourself is tricky, but it’s been exceptionally helpful for me.

Personally, I would also drop the scale. As is often said here, would you prefer to be 10 stone and wearing XL clothes, or 11 stone and wearing S clothes? With bone density and other factors, weight does not necessarily equate to size; it is fat loss that matters for aesthetics, not weight.

Eat more. Give your body time. Only limit carbs. Good luck.

First post - and me committing to keto

It’s not the best choice for everyone but I surely would have quit keto without chocolate. Chocolate is very low-carb unless one puts sugar or other carby things into it for some reason :slight_smile: I make my own (more like my SO’s as I lost interest after some carnivore days. crazy, I loved chocolate. I had to use less and less sweetener as time passed and reached zero).

To some extent, even coffee works in the place of chocolate for me, very different but still similar and a treat.

But if I keep my carbs super low (especially from plants, I guess) and eat lots of great fatty protein, I don’t even think about sweets. I had several low-carb years before even keto so I had habits and changes in my approach and those helped so you probably will need some time to get used to things… But finding the right woe at the moment can help tremendously, I experienced that, a bit when I did keto and very much on carnivore. I don’t say to go very low with your carbs, it probably wouldn’t help but at some point, it may. Maybe you eat some items which make things harder, who knows?
Stick to the 20g limit if you can, that sounds a great idea. 50g is way too much for ketosis for most of us. My original ketosis carb limit was a bit below, no idea about it now but I definitely function more normal when I am way lower.

You don’t do this long yet, it’s normal if it’s not the best but if you have some ideas, you may tweak things (while doing keto with a quite low carb limit), I know I would do that or else I would quit :slight_smile:

Our salt need is different, it’s quite possible you don’t get enough from cheese and bacon (they don’t even have much from my viewpoint but I eat little from both). Some ketoers are fine without salting their food or using salted things like cheese, some others need a huge amount (the recommended 1 tablespoon of salt a day) and some of us prefers a modest amount since the beginning. A little extra salt can’t hurt, try it if you have a headache or dizziness or cramps. Maybe it’s some other electrolyte or reason but it’s very easy to lick some salt.

Some more weeks sounds great to me as I had my big benefit at 7 weeks (very common time for fat adaptation). Until then, keto was like the previous low-carb woe, just harder.
Unless you feel really unwell, that’s no good and I would quit then (after doing some little easy things I can) and start later, maybe with gradual changes… Except if I was sure I need this. I can even suffer a bit for my health but I believe I don’t need to.


It was very easy for me on extreme low-carb… VERY salty meat sources combined with my small sodium need did the trick. The excess sodium made me feel unwell and I got salt aversion. Unsalted food was so nice :slight_smile:
But it’s not common to use too much sodium on keto, that’s true as far as I know. And it must be hard to go beyond the recommended high amount unless one loves very salty food and eat very much.
It’s amazing to me how many people supplement it and many of them actually need it…

You say people who needs more salt likes salty water? I can imagine that, at least that many people are like this. I hate salty water with a passion and never would consume it, not even if I supplemented salt (I can eat a lot of salt and drink water afterwards, I did that once. it’s not the same feeling at all) - but I don’t need it so maybe that’s why I find it super gross…?


Fat loss was my goal. I was stalling since years when I went keto. It was years ago and I am fattier than before (due to my off times, I almost always maintain on keto and when I don’t, I lose super slowly) - but my life changed for the better (and I got extremely patient regarding my weight. maybe too patient). Low-carb already changed my life, keto doesn’t first but as time passed, I got benefits and more when I did a new step into the right direction. Ketosis itself isn’t the final destination for many of us.
I always felt okay and healthy, I never had problems on HCHF either. But it doesn’t mean my health and well-being couldn’t improve and it’s mostly not related to my weight, I doubt my excess fat is particularly harmful. Sure, less is a smaller burden to my body but it’s still not a very big deal. But I could use more energy (keto never helped but going lower and staying there maybe will, there was a hint once) and I can imagine other improvements. Carbs mess with me, I get compulsions and those are mentally unhealthy but physically too as I overeat. Even if I don’t get unwell just because I eat a bunch of carbs, it’s not good.
Keto may give you surprising benefits. Eventually. Using the right style.

It’s not common to overdo protein but very common to thing 100-150g protein is high for a small woman. Well, it’s unneeded, I think, unless there is some great activity, maybe but it doesn’t usually cause problems. Not losing fat due to high protein sounds weird to me but I don’t say it’s impossible. Just that it sounds very unlikely.
If I don’t lose, I eat too many calories but I am simple like that. It’s possible to eat too much to be able to lose on keto, I experienced that. Even when I lose, it’s so slow that it may be not recognizable for a long time.
And my first 7 weeks were about getting used to keto and grabbing my fat adaptation. No fat-loss was involved, I was hungry and ate just like before and stalled just like before, it’s fine. Losing fat later was/is hard enough, just eating keto wasn’t ever enough for me. I’ve read many stories, some of us need some more specific method and some extra effort. Or just time. Your body changes on keto, your taste, etc.

There are clearly too many variables. I ate way too much on my natural 16/8 :smiley: But it automatically became 19/5 and it was better. But food choices are highly important too. Even the placement of the eating window!

Good luck for both of us…

(Bacon is a many-splendoured thing) #34

Another problem women have is the cultural conditioning that makes the scale number all-important, while totally neglecting body composition. It isn’t the actual number that is important, it’s having strong muscles and bones, and carrying enough fat but not too much.

Dr. Phinney tells of one study participant, a woman who lost half the number of pounds that the other women in the study had lost. I believe they lost about 14 pounds (it was a short study), and she lost only 7. Something like that, anyway. The woman was so upset that Dr. Phinney did a body composition scan on her, and sure enough, she had lost 14 pounds of fat, but had also gained 7 pounds of lean tissue. He hypothesises that she had been on a reduced-calorie diet for so long that when she started the study and was finally getting enough calories, her body took advantage of the opportunity to get stronger.

As a woman on these forums taught me, the question is this: How much do you want to lose? Thirty pounds? Well, would you rather look as though you’ve lost thirty pounds and still weigh the same, or lose those thirty pounds and look as though you haven’t lost anything?

It’s a valid question, even for men. I could stand to lose quite a bit more fat, and the 80 pounds or so I lost aren’t visible to someone who didn’t know me before. But my waist is several inches narrower, I can move better, my arthritis no longer troubles me, my blood pressure is back to normal, my insulin-resistance is gone, and I can do things I couldn’t at the top of my weight. Sure, I’d look better if I lost more fat, but I’m already so much healthier, does it really matter? The same is true of the Dudes: they still look overweight, but metabolically they are so much healthier, having reversed their Type II diabetes.