Insulin dependent diabetic I can't get into ketosis... why?

Davesolves · 2020-01-27 13:45:06 UTC

I am not says this isn’t a good diet but why can I not get into ketosis?
I have been on the diet for 60days and lost 22lbs but I have never been in ketosis
anyone know

Ilana_Rose · 2020-01-27 13:51:45 UTC

@Davesolves Are you measuring blood or urine?

Davesolves · 2020-01-27 14:03:11 UTC

urine

Ilana_Rose · 2020-01-27 14:18:40 UTC

@Davesolves. It’s a poor test. It often won’t show anything even when you are in mild or moderate ketosis. Can you buy a blood meter or is that out of the question?

Also when do you measure? That can make a big difference. Also, do you drink a lot of water? That will really mess up a urine reading.

Davesolves · 2020-01-27 14:30:56 UTC

Don’t know where to find a blood meter …Yes lots of water …and test different times of the day
All I know is if my blood sugar is 300 Ketosis and if it is 140 blood sugar I show 0 ketosis

MarkGossage · 2020-01-27 14:35:05 UTC

Where do you live (Country) someone may be able to help.

Fangs · 2020-01-27 14:39:20 UTC

what are you eating?
food intake is key and if you are Type 1 a whole new diff ballgame.
Type 2 list your food and then we can easily see why ketosis is not happening for you

you joined the site an hr ago, you can’t possibly be one of those veggie trolls are ya :o Please don’t take offense on what I say cause this site is being trolled now I think

Davesolves · 2020-01-27 14:38:02 UTC

Very clean keto …

Fangs · 2020-01-27 14:40:32 UTC

type 1 or 2
what foods?
go there or go home LOL if seeking help one chats a way lot more
personally thinking troll but if I am wrong then I am wrong LOL

Davesolves · 2020-01-27 14:45:50 UTC

Type 1
MCT oil
Grass-fed beef/pasture raised poultry and dairy.
Wild caught/sustainable fish.
Eggs.
Healthy fats, such as coconut oil, grass-fed butter, ghee, olive oil, avocado oil, .

Fangs · 2020-01-27 14:51:00 UTC

Diabetes mellitus type 1 is a form of diabetes mellitus that results from autoimmune destruction of insulin-producing beta cells of the pancreas. The subsequent lack of insulin leads to increased blood and urine glucose.

real medical situation. I can not go there at all cause I do not know the info on ‘what it takes’.

knowledge others will address you, I am out.

still thinking troll on all this of course. On one walks in 1 hr on the forum and just does this post as you have. ugh but others might come and chat. whatever at this point on this post to me and always wish you best of luck if this is the case…bow out

JustMo · 2020-01-27 14:58:15 UTC

I understand your frustration. The trolling on the forum has significantly increased this year and I am hoping the forum owners or moderators do more to control or eliminate this.

I think this forum is very nice and helpful but I sometimes admire the swiftness and ruthlessness with which the keto reddit forums eliminate trolls. The constant influx of “trolls trying not to appear as trolls” does make me want to stay away from the forum.

Fangs · 2020-01-27 15:04:44 UTC

AGREE MO!! never sure to think this real or fake. But some things draw me to fake very fast but if they address something I have no clue in, as type 1 I gotta bow out and I think, WTH? not a normal post from a newbie wanting true help!

yes it is super weird and I hope admin. can see well past those as real people needing help vs. troll posts any forum can get slammed with.

we see it and so they know we are wise and see what might go down on it all. LOL

amwassil · 2020-01-27 20:08:01 UTC

If you consistently eat sub-20 grams of carbs and are not comatose, it’s a good bet you’re in ketosis. Type 1 complicates things, though. Your insulin dose may be sufficient to prevent or interfere with ketosis. But if you’re really eating less than 20 grams of carbs daily, not metabolizing fat would quickly lead to very bad problems, the least of which is being comatose.

PetaMarie · 2020-01-28 01:40:17 UTC

We can’t just assume everyone who confuses us is trolling the site. Let’s give people a chance. If anyone has a concern, please flag the post for admin to have a look.

beccs · 2020-01-28 12:16:05 UTC

Yep, exactly. Not sure how this post is remotely “trollish” but OP I’m sorry that this is your first experience on this site

Anyways, here’s some good info on keto and T1D

http://www.ijcasereportsandimages.com/archive/2014/010-2014-ijcri/CR-10435-10-2014-clemens/ijcri-1043510201435-toth-full-text.php

ncbi.nlm.nih.gov

Management of Type 1 Diabetes With a Very Low-Carbohydrate Diet.

BS Lennerz, A Barton, RK Bernstein, RD Dikeman, C Diulus, S Hallberg, ET Rhodes, CB Ebbeling, EC Westman, WS Yancy and DS Ludwig, Pediatrics, 2018 06

To evaluate glycemic control among children and adults with type 1 diabetes mellitus (T1DM) who consume a very low-carbohydrate diet (VLCD).We conducted an online survey of an international social media group for people with T1DM who follow a VLCD. Respondents included adults and parents of children with T1DM. We assessed current hemoglobin A1c (HbA1c) (primary measure), change in HbA1c after the self-reported beginning of the VLCD, total daily insulin dose, and adverse events. We obtained confirmatory data from diabetes care providers and medical records.Of 316 respondents, 131 (42%) were parents of children with T1DM, and 57% were of female sex. Suggestive evidence of T1DM (based on a 3-tier scoring system in which researchers took into consideration age and weight at diagnosis, pancreatic autoimmunity, insulin requirement, and clinical presentation) was obtained for 273 (86%) respondents. The mean age at diagnosis was 16 ± 14 years, the duration of diabetes was 11 ± 13 years, and the time following a VLCD was 2.2 ± 3.9 years. Participants had a mean daily carbohydrate intake of 36 ± 15 g. Reported mean HbA1c was 5.67% ± 0.66%. Only 7 (2%) respondents reported diabetes-related hospitalizations in the past year, including 4 (1%) for ketoacidosis and 2 (1%) for hypoglycemia.Exceptional glycemic control of T1DM with low rates of adverse events was reported by a community of children and adults who consume a VLCD. The generalizability of these findings requires further studies, including high-quality randomized controlled trials.

ncbi.nlm.nih.gov

Low-carbohydrate diets for type 1 diabetes mellitus: A systematic review.

JL Turton, R Raab and KB Rooney, PloS one, 2018

Type 1 diabetes is an autoimmune condition characterised by pancreatic beta cell destruction and absolute insulin deficiency. The strongest predictor of diabetes complications is glycaemic control and achieving HbA1c ≤ 7.0% is the primary management target. However, standard treatment appears to be lacking and adjunctive strategies require consideration. A systematic review was conducted to examine the effect of low-carbohydrate diets on type 1 diabetes management. Four databases were searched from inception until 28 March 2017: MEDLINE; CINAHL; Cochrane Library; and EMBASE. All primary studies containing a methods section (excluding cross-sectional) were included. Reports had to quantitatively measure the effect(s) of a dietary intervention or observed intake over at least two weeks where carbohydrate is below 45% total energy in adults and/or children with type 1 diabetes. The primary outcome was HbA1c and secondary outcomes were severe hypoglycaemia, total daily insulin, BMI, quality of life and mean daily glucose. Seventy-nine full-text articles were assessed for eligibility and nine were included (two randomised controlled trials, four pre-post interventions, two case-series, one case-report). Eight studies reported a mean change in HbA1c with a low-carbohydrate diet. Of these, four reported a non-significant change (P ≥ 0.05) and three reported statistically significant reductions (P < 0.05). Two studies reported severe hypoglycaemia, five reported total insulin, three reported BMI, and one reported blood glucose. Due to the significant heterogeneity of included studies, an overall effect could not be determined. This review presents all available evidence on low-carbohydrate diets for type 1 diabetes and suggests an urgent need for more primary studies.

Ruina · 2020-01-28 15:04:47 UTC

Thank you beccs

PaulL · 2020-01-28 15:38:12 UTC

The Type I Grit Web site in the UK will probably prove a very useful source of information and support for you. I urge you to check it out. I haven’t read Dr. Bernstein’s book, but he is well-respected, and many people have benefited from his work.

I see a couple of potential problems that might be producing your confusion. First, the urine strips are notoriously unreliable, and in any case, they are measuring wasted ketones only, not the amount that is circulating in your bloodstream. (It is also possible that you have a bad batch of strips.) The main purpose of the strips is to provide advance warning of possible diabetic ketoacidosis, which is a serious (and potentially fatal) risk for Type I diabetics. If you have a serum glucose monitor, it is highly likely that the manufacturer also sells strips that will allow the same meter to measure serum β-hydroxybutyrate, one of the body’s principal ketone bodies. I suspect your liver is in fact producing ketones, and measuring serum β-hydroxybutyrate will indicate this.

The other possible factor is the amount of carbohydrate you are consuming, coupled with your degree of insulin resistance. Ketogenesis in the liver is regulated by our level of carbohydrate intake, which affects the interplay of two hormones: insulin and glucagon. Your pancreas is no longer producing any insulin to speak of, because your body has attacked and killed your beta-cells, but your alpha-cells are most likely still producing glucagon, which is the hormone that stimulates the liver to produce ketone bodies.

Given the standard advice to manage your diabetes by eating a lot of carbohydrate and then whacking your glucose level back down by taking large amounts of insulin, it is entirely possible that your body has become insulin-resistant, and the amount of insulin you need to manage even a small amount of carbohydrate is enough to prevent ketogenesis. The question I would have is (a) how much carbohydrate do you eat in a given day, and (b) how much insulin are you taking? My understanding is that Type I diabetics who eat no or very little carbohydrate can usually dispense with the bolus insulin before meals and rely on a moderate daily dose. This generally puts serum glucose in the true normal range and generally eliminates spikes and hypos. The Type I Grit site explains this far better than I can.

In any case, you should be consulting with your doctor as you embark on a ketogenic diet, because it is highly likely that your insulin prescription will need adjusting. This is serious enough that you probably don’t want to go it alone.