i’ve always been on a low carb diet…at least as far as i can remember. not for my health or anything, just felt enough satisfaction with the amount i was eating. however i dont think i ever got into ketosis. recently, ive had trouble eating bread (anything with wheat or rye) so i stopped eating bread to see what happens. then i started thinking about the Keto diet and had a lot of questions about it bc i swim and i didnt know if it was dangerous or not.
Eric has always believed in carbs and encourages me to eat them constantly for my swimming. i am NOT any kind of Elite Athlete by any stretch of the imagination. i just like to swim, and i swim between 90-120 minutes at a time, usually 5 days a week.
back when my husband was an elite marathon runner, he consumed plenty of carbs throughout the day, into the night, in the morning, etc. then he had a full hip replacement and could not run anymore (he works out, still, just different exercises). he still eats carbs, but bc of the nature of his exercise and his lack of cutting back the carbs, he has gained quite a bit of weight. i dont want to gain any more weight. in fact, i would like to lose about 5 pounds to get back to my ideal weight. (i’d love for my jeans to fit by the Fall season!!!)
i want to emphasize that this is not something i want to do for better BG control. i’ve already got that down patt. my A1cs are between 4.8% and 5.2% consistantly. and my average BGs are between 70 and 120.
You absolutely eat vegetables on Keto, if you get all of your carbs most days from vegetables you can actually eat quite a lot of them. However, eating low carb is easier since you get most of the hunger reduction benefits without having to be in ketosis or track everything.
i am starting to believe that sticking with my low carb diet is the way to go. recently i’ve been having trouble with eating Rye bread. terrible cramps and bloating. i looked up breads that cause this, and sure enough, Rye & Wheat were the nightmare foods. so i stopped eating my Rye bread (which i have been eating without a problem for years). its almost 2 weeks now, and i am still having this problem. i was told that it can take about 2 weeks to notice that i will be feeling better. i am trying to be patient, but so far, nothing. absolutely no relief. i also cut out my beloved freshly ground peanut butter. the next thing i will cut out is cottage cheese, which i eat EVERY morning for bfast.
but i see my GI doctor next week, and we’ll hopefully find out if i have some gluten problem. i really hope not. but in any case, this was one of the reasons i started looking into Keto. there is no way in hell that i am going to start eating gluten free bread
I wonder if this would change once a person’s attained ketosis?
Also, DM, about the rye and wheat - yes ask about a gluten issue when you’re in the doctor’s office. But please also ask to be tested for SIBO. I’ve had it, and it was treated with antibiotics successfully.
This hasn’t been my experience. Even in ketosis I need to bolus for protein (and as always, make additional adjustments depending on how much fat you eat).
My I:C ratio is 1:15, and I typically use the same ratio when bolus’ing for protein + fat (I keep my calories from protein / fat at 25% (protein) 75% (fat). In other words, if I eat 15 grams protein, I’d eat 20 grams of fat and take 1 unit of insulin.
If I eat in excess of 45-50 grams of protein, additional insulin is required for glucose (glycogen) my body produces converting unneeded protein (Gluconeogenesis). This is often the reason people gain weight on keto (eating too much protein).
this is facinating. what is the reason that someone might gain weight eating “too much protein?” i never knew that protein could cause weight gain. i mean, i know that there are calories in protein, but how much is too much?
How much protein your body requires depends on many different things, but for adults who aren’t olympic athletes or trying to build muscle (body-builders), males require only 0.8-1.0 gram of protein per kg of body weight. Females slightly less (0.7 grams per kg body weight).
I’ve eaten strictly protein (+ fat) for 3-4 months and have found for me, 0.8 grams per kg is adequate under most circumstances. If I work out for 3 hours a day vs only 2, my body can use an additional 10-15 grams. Anything in excess my body converts to glucose, and spikes my BG, then ultimately gets stored as fat (you gain weight).
To convert this to the imperial system,
Males: 0.8 grams/kg = 0.36 grams per lb body weight
Females: 0.7 grams/kg = 0.32 grams per lb body weight
Calories themselves aren’t as important as what food substrates the calories come from. I’m a firm disbeliever in the American (Canadian) Dietary Guidelines.
I don’t know; I thought it meant zero carb, but the whole thing is very confusing. The various web sites I found put the maximum carb level at between 20g and 50g, but my understanding from other discussions on forum.fudiabetes.org is that “Low Carb” means less than 30g/day, so “keto” is just another word for LCHF, right?
Everyone does, but I think most T1Ds handle it in the basal. I don’t; my basal is set to my fasting level requirements, so I take extra insulin. I don’t use a bolus; either I use an Omnipod “extended bolus”, typically 6 hours for protein, or I use an Omnipod “temp basal”, up to twice my normal basal (0.5IU/hour hence 1IU/hour) for maybe 8 hours. This article seems reasonably informative:
The conclusions accord with my own experience; when I reduce my carb intake towards low carb levels I need to take a lot more care over the (temporary) adjustments to my basal, but I’m still not having to handle carb spikes and this is the benefit for me.
I’ve never had particular concerns about fats. The glucose available from a triglyceride is, if I understand correctly, only one to four molecules per molecule, so that is not a whole lot by weight particularly for heavy molecular weight fats. It’s difficult to find a source of fat that doesn’t have either a lot of protein or significant carbohydrates included and I suspect that tends to mask or even prevent any gluconeogensis from the fat itself.
I don’t bolus much DM, perhaps 3-4 units over 24 hours (depending on what I eat or other aberrations such as DP, site issues).
Pre-keto my TDD of Humalog was 36+ units a day. Now it’s usually < 18 units (FiASP) a day.
Non diabetics on keto would also secrete the equivalent in real Pancreas® insulin to handle their basal needs.
So in answer to your question, while “loads” of insulin tends to put the brakes on ketosis - as do carbs, I never take loads of insulin. When doing 48-72 hour fasts my basal (12 units / day) declined to approx 9 units, and I din’t bolus at all. Normal ketones rose from roughly 1.0 to between 3 and 7 mmol/L, still safely under the 10-20 with DKA. And I felt great.
I’ve been in ketosis for over 365 days now (have a meter and check every morning).
Even when my doc threatened me for having too low an A1C and instructed me to eat carbs I was still in ketosis (I had a pizza for a month or 2 to bring A1C up to 5 for her). That even surprised me, as one night I had to have eaten 60 grams of carbs
how is that even possible? everything i’ve read suggested (only a suggestion) that over-doing the carbs will ruin your ketosis.
also, what is your typical A1c like? i eat low-carb and my A1c is between 4.9 and 5.2 and my BGs are generally a flat line. (i am also very strict with myself)
Reality is often quite different than much of what’s written. It’s a journey - I hope others that have gone down this road can give us their perspective on what their keto reality is.
My A1C’s since beginning keto have been 4.7 (Nov 18), 4.6 (Apr 19) and most recently 5.1 (which I intentionally drove up to stop my doctor threatening to have my driver’s license suspended).
DM - IF is a subset of keto, and yes I practiced it extensively for 3-4 months.
Since I only eat one meal a deal (OMAD), technically I’m doing intermittent fasting now. IF helps you lose weight, and more importantly improves a wide variety of health issues.
As mentioned, earlier this year I regularly did 48 and 72 hours fasts (no food at all, only water). Obviously a T1D needs to be very careful with basals, which for me decreased from 12 to 9 units a day. Ketone levels rose from roughly 1.5 mmol/L to 6 or 7 mmol/L, but otherwise I felt fine.
Jim, is there a reason that you put yourself through all of this dieting? i understand that you say it makes you feel better, but my goodness, IMHO, food is such a wonderful, enjoyable part of life
DM - Like so many of us, in addition to T1D I’ve got 2 other (inflammatory) auto-immune diseases. I’ve also been dx’d with a pulmonary disease, and my quality of life most of the past 3 years was nil.
The keto, IF and carnivore diets have dramatically improved many issues I’ve had for decades, not to mention make me feel a lot better. My inflammatory processes are all much improved, I’ve cut the number of meds I take. With any luck, I’ll get an additional year or two out of this body.
And isn’t that the goal of all of us? Die of something other than T1 or its complications?
gosh Jim, this sounds challenging. i have Grave’s disease and had to go through radiation treatment; in and out of remission (currently been in remission for about 10 years.)
i also live with terrible OCD and Paranoid Schizophrenia. i also have Diabetic Gastroparesis, bi-lateral osteoarthritis in my spine and lower back.the list goes on and on.
instead of dieting to help all these issues, i find,for myself, that food is one of my pleasures and that there is no way i plan to give up something so pleasurable.
i am so happy to hear you have found something that does work for you. i cant imagine myself having such fortitude and commitment. God Bless.
PS: needless to say, bc of my own illnesses, i take handfuls of meds. it stinks. there are all the side effects of all these meds, which i am certain you’ve been familiar with.
