Type 2 diabetes meds and keto diet


(Steven Lee Gaber) #1

I have been type 2 diabetic for years and got to the point that I had maxed out dosage of metformin and glimeperide and when my last blood pannel came back A1c 8.6 I was perscribed insulin and told to start at 10 units and test and titrare till I found a good dose. I had bad low sugar episodes and was told to eliminate the glimepiride. That stabilized things but I was on a ton of meds and 60lbs overweight. Also there is NO generic insulin so about $400 foir 3 months supply. That is when I started looking for alternative therapys. I bumped into Keto when I read about “keto flu” and saw just how much it was like narcotic withdrawal. Eureka! Carb withdrawal! About 1 month into ketosis I have lost about 15lbs and my average Ketones test between 1.5 and 2.0 mmlo/L steady. However I am still very much in "keto flu’ in that I have extreme fatigue and brain fog constantly. Also I was expecting to be able to reduce dosages of metformin and insulin but when I do my blood sugar spikes to 140 mg/dl area. I am now thinking that perhaps I am not able to produce enough insulin on my own to handle the residual carbs in the keto diet. Is there some test I can ask the doctor to do to see if I am super insulin resistant or perhaps not able to produce much insulin at all? All suggestions welcome.


(So much bacon . . . so little time . . .) #2


The keto flu is preventable; it’s a symptom of low sodium (the body retains sodium when you eat carbs, so going keto allows the kidneys to start excreting it again). Also, it appears from recent research that more salt than the recommended daily amount is actually healthier for us. So use salt liberally, perhaps add some bone broth to your menu, and drink to thirst to stay hydrated.

BTW, two other electrolytes people sometimes have to manage are potassium and magnesium. Usually we can get enough from leafy green vegetables, but sometimes we have to supplement. YMMV.

(Raj Seth) #3

I’m your twin. I was T2D for 9 yrs before Keto. Max on metformin and glimepiride. A1C stubborn.
Went hard core Keto Halloween, ie target 0 carbs, maximized FAT
2 weeks halved my glimepiride, 4 weeks nixed it
2 months terminated all medications
A1c - 6
3 months off medications: A1c 5.9

Read my story in the public before and after (post #9)

or hear Carl narrate it on 5/13/2018 episode of 2KD.

YMMV, but diabetes is being reversed daily by Keto!

(Raj Seth) #4

Why not cut the residual carbs to zero?

(Steven Lee Gaber) #5

living on neck bones and collard greens and drinking all the broth. Bacon and eggs with lots of salt and mineral supliments. All that it has cures is cramps, the flu is presistant…


Nonsense. For years, I used the insulin from Walmart. Only $24 or so a vial.

A restricted calorie Keto WOE has allowed me to stop both insulin and metformin.

(Steven Lee Gaber) #7

oh, I was perscribed the pen deal. Thanks. My goal is to get off meds

(Steven Lee Gaber) #8

after having fasting blood sugar testing 140-150 mg/dl no meds I took 1000mg metformin and 10 units insulin yesterday morning and tested fasting 82 mg/dl with ketone 1.1 mmol/L. having been in ketosis steady for a month now I get the feeling I am not quite ready to ween myself off meds. Can someone suggest a test to determine if my pancreas is capable of producing insulin?? I am going in to have blood work read and another blood panel perscribed soon. thanks.

rather sure I am under 20grams of carbs but would like to know how to get to 0 carbs and still eat real food.



    June 19

I am now thinking that perhaps I am not able to produce enough insulin on my own to handle the residual carbs in the keto diet.

Why not cut the residual carbs to zero?

(Raj Seth) #9

Steven, if you read and understand the current science, you will understand that insulin is the real culprit. Current standard of medical care is to lower your A1c to below 7. thats BG of 156. When I stopped taking all medications, I asked my endocrinologist what readings I should watch for to realize that I wasnt ready to be off medications - his answer “consistent fasting BG above 150”

If you stop consuming carbs, or at least minimize them to 20gm, 10gm or lower, then you are not dealing with exogenous glucose. The only blood glucose you will have is that which is produced by your liver by gluconeogenesis. My understanding is that process is demand driven, and can sometimes be supply-pushed by excess fat released from the liver. So, I dont try and downregulate it with insulin. High Blood sugar is NOT the evil - high insulin is. Its kinda like my foot hurts - so amputate it!!

I would rather have fasting BG 140-150 with no medications, than take insulin and have it down to 80. Metformin is the one medication that does not raise your insulin - so maybe if you feel compelled to you can have some of that. But no one can make me take any of the insulin rasing medications any more.

(Steven Lee Gaber) #10

So you say that 150 BG is acceptable not the 100 BG that seems to be the bench mark. My last A1c was 8.6 which translated to 200 H. (before starting keto) What you say is consistant with my n=1 tinkering as when I cut all meds I was around 150 BG and with metformin and 10 units insulin I am testing in the 80s. As I am new at this can you refer me to the science that shows that insulin is the root problem not the blood glucose. And a plain language explination for this type of reasoning. I will be seeing the endocrinology clinic in about a month and look forward to seeing the blood panel results of 2 months in ketosis. Also is there some additional test to see if I am in fact capable of producing insulin or a test for “insulin resistance”?


(Raj Seth) #11

Read Jason Fungs blog. Read Obesity code. Read diabetic code. Both by Jason Fung. Hyperinsulinemea is the disease. High BG, CVD, hypertension, obesity, Alzheimer’s etc are symptoms

(Raj Seth) #12

I’d be looking to stop insulin ASAP Metformin is less evil.

(Steven Lee Gaber) #13

Ordered the book


Congrats on helping yourself. Try B12 for brain fog, it cleared mine. A good one a day multi vit can work wonders too. Just make sure its not the sugar coated gummy type lol

(Steven Lee Gaber) #15

In addition to ordering his book I just got done watching his 1 hour video on youtube “insulin toxicty” and now I see exactly where you are coming from. Jason Fung MD seems to be a visionary contrarian, I sure hope his methods work for me. In addition to talking about carb reduction and the elimination of insulin he brought up the benefits of fasting which I had not even considered.


(Steven Lee Gaber) #16

for the first time in over a month on keto I feel the surge of energy but still rather dingy mentaly, guess it will come the so called "clarity’ but not yet. I do take B12.

(Steven Lee Gaber) #17


A1c 8.6

Glucose 135

Weight 192 lbs


A1c 6.2

Glucose 117

Weight 171 lbs

Endrocronoligists reaction:
From: Casaubon, Luis
To: Gaber, Steven L
07/12/2018, 12:26 PM

I sent you the correct order for doing labs in 3 months in a separate portal message. It includes the additional tests that
we discussed. (insulin and hs-CRP). It was great to see you today. Keep up the good work!!! Please call with problems or
Dr. Casaubon


Fantastic! Well done on your new results!

(Steven Lee Gaber) #19

This reflects roughly 2 months on Keto in this quarterly up-date. 52 days to be exact. The doctor said I made his day. In addition that clinic is promoting some sort of lo-carb plan now and they never had in the past. He like my quip: I turned the food pyramid upside down.


Same here, my Doc hugged me, and now I’ve been asked to speak to a group of obese patients with T2D!