Friend is in Desperate Straits, T2 and on Dialysis, Not Sure How to Help

#1

Trying to help a Friend, warning this can get a little graphic.

I have my own issues, been Keto since April, IF since March.

My friend is her mid 50s, always thin (probably TOFI), never a big eater but what she ate was usually pasta and she was always a big grazer. Parents both lived to 85+ and died of heart attacks in their late 80s, early 90s.

She had an accident about 15 years ago and lost a lot of blood was clinically dead. She recovered, lost some minor mobility but cognitively was fine, went back to work in a professional field. Not sure if this accident caused some type of problem that the typical T2 patient does not have.

About 6 years ago she developed diabetes. Went to doctors got “expert” medical care in the USA, has good insurance. After 3 years she developed kidney problems which escalated rapidly. One weird thing, usually kidneys shrink, hers did not. Her eyesight is fortunately ok. About 18 months ago she went on dialysis and disability. In the last year she has lost some toes and a lower leg recently. She has recurrent infections of unknown origins. I have to assume she is on insulin as well as bunches of other medications

Her diet is completely out of control, not because she cares too much about food but because she was never told to control it beyond the standard dietary approaches to T2. If anything she is encouraged to eat everything she can because it will keep up her strength against the infections (supposedly) and because she has trouble keeping weight on. Considering everything her mental outlook is amazing

I obviously want her on a ketogenic diet but is it too late?

Her doctors will of course tell her that it is bad for her.

She is extremely medically fragile so of course and I (who am more than happy to n=1 for me), would not dare do anything without her doctors being aware and being responsible. We have been friends for many years and has seen me go through all sorts of crazy diets, so I think even if I tell her about Keto she will just view it as another of my fad diets that has no real merit.

She really needs help and I am not sure how to help her. While I would love to take her to Fung, we live 800 miles away in the US and she is not very mobile right now and I believe there is a long waiting list.

Does anyone know of anyone who was so medically fragile and was helped by a keto diet?

#2

She will need a doctor who is onboard with keto. Then perhaps she could sign up for the long distance program Dr. Fung provides? Or does that also have a waiting list?

https://intensivedietarymanagement.com/program/

#3

Thank you @carolT. I wish she were well enough for that program. Between her recent losses and the dialysis she is bedridden. I visited recently and got an update. She is on basal and bolus insulin but her insurance will not pay for continuous glucose monitoring. I think those are very pricey, anyone know for sure? She is essentially a Type 1 but with a T2 diagnosis. I am really afraid of her going hypo on keto which she says she has a tendency to do anyway.

Dr. Fung says that “Patients seen in the program will NOT be under the medical care of Dr. Jason Fung in any capacity. Your own physician is responsible to oversee your medications and blood work. It is strongly advised to keep your physician advised of the dietary changes you are making.” Her current endo whom she likes (at least until I visited!) believes that you should eat glucose if you want (not to excess) and match your insulin injections to the glucose you consume (I almost fell out of my chair when I heard that). I doubt he would want her on a keto diet. She is too thin to fast anyway (BMI below 20).

I got her to listen to a podcast and she is interested but was perhaps indulging me. One thing, when she looks at me (my BMI is well over 30) she associates keto with heavier people. I do not think she gets that she has the same problem as a heavy T2, if anything she is worse off because heavier people can store their excess sugar as fat, she cannot. Are there any LC sites or science geared to TOFIs? I did download the TOFI podcast for her and hopefully she listens to it but if anyone has other suggestions. Even the Jason Fung episode that we listened to together was more focused on obesity and not TOFIs. I know he has that one success story from the woman in Texas but I think she is overweight compared to my friend who is literally skin and bones

(stacey kersting) #4

You may want to watch a few videos by Stephanie Keto Girl…Beyond Dr. Fung…she knows her stuff. I study nutrition intensively and was stunned by her. She’s a personal trainer and has coached over 2,000 ppl how to get to ketosis.

#5

Sorry your friend is so sick. Perhaps going in the direction of type-1 treatment is more appropriate for her at this point? You might want to look into the work of Dr. Richard Bernstein, or checkout the Type-1 Grit group on Facebook. https://www.facebook.com/groups/660633730675058/ Perhaps something there will give her endo the information they need.

(Cathrine Helle) #6

I don’t have any advice, as I’m not diabetic myself. But reading this makes me both sad and angry, mostly sad. I cannot believe how medical professionals overlook (or deny) the benefits of controlling BS through diet and/or fasting. It’s unethical, to say the least.

If your friend is bed-ridden, could she still watch some of Jason Fungs videos on Youtube? In stead of going all out and reccomending keto, perhaps you could suggest low glycemic index-foods? Slow carbs? Just some thoughts, I am by no means experienced in this.