Type 1 diabetes and keto

(Jennifer ) #1

I am a type 1 diabetic, on an insulin pump. I started on keto to help regulate my BG and drop a few pounds. Well, my A1C is good but I never lose any weight. Is this normal? Why can’t I lose weight? I’m in ketosis, yet nothing.

(Sheri Knauer) #2

Hi Jennifer. You would need to provide a little more info to help us try to help you. Your age, activity level, when did you start keto, what are your macros, what does a typical day of eating look like for you, are you on any other medications besides insulin, do you have any other health issues, what is your stress level. All these things are pieces to the puzzle

(Joey) #3

Greetings @JCouch and welcome! My understanding (admittedly limited) is that Type 1 diabetics bring unique metabolic challenges to the table. As such, some of the experiences you’ll find throughout the forum are not directly applicable to your health profile. It would be very wise to ensure you’ve got good medical input from keto-smart professional practitioners when considering any adjustments to how you’re approaching a ketogenic lifestyle.

There appears to be those with that special expertise out there in the world, but I’d caution you against assuming that the general population’s reactions and approaches to keto dieting will be the best (and safest) course for you to follow.

Wishing you the best - and please let us know how things progress for you!

(Jennifer ) #4

Unfortunately, keto professionals are hard to come by. Doctors are lazy and would rather you eat carbs to take a bolus than try to figure how how to manage without. Nutritionists frown at keto. My endocrinologist was blown away about the transformation I made happen simply by restricting my carb intake. I went from A1C levels of 10+ to 7.2 at my last visit. Having a continuous glucose monitor helps. I was just wondering if there was a simple answer to why diabetics might not achieve weight loss the same way a normal person would, even though they are in ketosis.

(Jennifer ) #5

Yeah but I’m only trying to figure out if there is a reason specifically, a person could be in ketosis but still not lose weight. All of those other factors should not play that large of a role if ketosis is being achieved. Right? My husband follows the same diet and dropped 35 pounds in 6 weeks where I didn’t lose even a pound. Again, all while in ketosis

(Full Metal KETO AF) #6

Hi Jennifer, I would advise you to work carefully with your doctor to ensure that your insulin requirements are lowered as you progress. Insulin is the key to ketogenic eating and lowered insulin levels are necessary for ketosis to do it’s thing on your body fat %. There’s a whole category for T1 folks and lots of people who’ve had success in controlling their T1 health issues.

https://www.ketogenicforums.com/c/health/T1DM

I wish you the best and a successful keto journey back to health, which will lead to weight loss eventually. Right now your body seems to be focused on metabolic healing, a necessary step to move forward. :cowboy_hat_face::cowboy_hat_face:

(Joey) #7

@JCouch Okay, well, NOT having any certified expertise, my “free guess” may be worth less than it costs :wink: … but I’ll venture this much:

Having been diagnosed as a Type 1 diabetic indicates that your body is not producing sufficient insulation and, as such, you’re supplementing with exogenous insulin (basal and bolus). Doing so prompts your muscles and other tissues to take in glucose - including that which is now being produced through gluconeogenesis in your current state of ketosis. So far, that’s all good - without that process under control you’d have other serious problems, right?

But by having to intervene with your body’s insulin cycle in this manner, it would seem likely that you’re also interfering to some extent with the fat burning process that a ketogenic state would otherwise produce (i.e., in a non-Type 1 diabetic).

More specifically, my guess would be that the insulin you are required to introduce into your system to maintain your general health is also suppressing the muscles, heart, and brain from (more fully) burning fatty acids contained in the ketones as opposed to glucose. So, the insulin is working against your progress in developing a “fat-burning” metabolism.

Frankly, I’m at a loss to suggest what might help change that situation without becoming a dangerous source of ill-advised internet babble to your well-being.

I appreciate that it’s hard to find medical practitioners who are hip to ketogenic eating. It must be all the MORE difficult to find those who also have expertise in Type 1 diabetes. Hopefully others with a deeper grasp of endocrinology and biochemistry should chime in here - especially if what I’m guessing is all wet, please set me straight!

(Michael - When reality fails to meet expectations, the problem is not reality.) #8

Ketosis is no guarantee of weight loss. You still have to have a negative energy balance. Hormonal and other factors are involved. So the other specifics mentioned by @Sheri_Knauer are relevant.

#9

@JCouch, when did you start the insulin pump? (I know someone in the same boat as you, so knowing how long you’ve been on the pump will help frame my input here.)

(You've tried everything else; why not try bacon?) #10

You might consider joining the Type I Grit group on Facebook. They are a great resource and support group. Also, look on YouTube for talks by Dr. Troy Stapleton, a radiologist who was diagnosed with Type I diabetes at the age of 40.

(Jennifer ) #11

I’ve been on a pump for 13 years.

#12

OK, I’m glad I asked. The person I know well just went on it last fall, so I’ll spare you her story as it’s likely apples to oranges and wouldn’t be helpful to you. And you’re certainly a pump expert at this point!

(bulkbiker) #13

I presume you have heard of Dr Bernstein and the TYPE1GRIT facebook family of pretty low carb T1’s?
If not I suggest you get in touch with them too as they will be very familiar with keto and T1.

It’s a closed group so you have to join to see the posts but might help you a lot.

#14

P.S. Thanks for liking my post. I purposely held my tongue on offering my insight because one very helpful thing I’ve learned from the T1D person I mentioned is that there’s nothing worse than being a T1D and getting “advice” from (albeit well-meaning) people who (a) think it’s the same as T2D; (b) think if you just eat everything “sugar-free,” then you’ll be fine; and © simply have no idea what it’s like to worry 24/7 about carbs, boluses, hypos, x-ray machines, “sensor updating” endless loops, lost connections with the CGM, and constantly having something stuck to you.

(Jennifer ) #15

Ughhhh. Thanks for the reminder haha. I’ve gotten to the point where I very directly put those people in their place.

#16

As you should! With all the press/focus on T2D, it’s very hard to be a T1D these days.

(Jennifer ) #17

Which is probably why I have never even thought about reaching out to a diabetic community before. Or even so much as shared a story on my social media. I voice my passion for many, many topics. Never this one. Probably because I have become so used to everyone having some advise for me me. Like, ok Becky I know your 85 year old grandpa has T2 and his doctor told him to stop eating so much butter, but that has nothing to do with me lol.

(You've tried everything else; why not try bacon?) #18

I think you would find Dr. Stapleton’s account of his journey with Type I diabetes on a ketogenic diet very helpful. Several of his presentations were at Low Carb Down Under events and are available on the LCDU YouTube channel.