Keto and Type 1 Diabetes

Type 1 diabetes cannot be cured, unfortunately, but there are ways to significantly improve your quality of life! Nutrition is the best tool for this, as it can greatly reduce your symptoms. In this article, I will explain everything to you about it.

Table of Contents:

What is type 1 diabetes
Medication is necessary
Reduce the amount of insulin
The benefits of a ketogenic lifestyle in type 1 diabetes
Don’t start immediately!

What is type 1 diabetes?

This form of diabetes is congenital and is not caused by anything you’ve done “wrong.” In type 1 diabetes, your body does not produce (or in some cases, produces too little) insulin. Insulin is a hormone responsible for regulating glucose metabolism.
After eating a carbohydrate-rich meal, glucose (sugar) is released in your body, causing your blood sugar levels to rise, which then triggers the production of insulin. Insulin acts like a key, allowing your cells to open up so that glucose can enter and be converted into energy. In essence, you can think of insulin as a key.

Life-threatening
Without this “key,” sugars cannot be absorbed, resulting in elevated blood sugar levels. This can lead to life-threatening situations, which is why administering insulin is necessary in type 1 diabetes (since your body cannot produce it).

Medication is necessary

As explained above, medication is necessary for type 1 diabetes. In the past, this was primarily in the form of injections containing insulin, which helps sugars in your blood to be absorbed. Nowadays, there are also insulin pumps, which are medical devices implanted under the skin. These pumps make it easier to administer insulin medication, and they can be more accurately adjusted in terms of dosages.

How do you determine the amount of insulin you need?

Reduce the amount of insulin you need and stabilize your blood sugar

Earlier in this article, you learned what type 1 diabetes entails and why it is necessary to administer insulin in this form of diabetes.
Now we come to the (almost) magical part of this article, which is reducing the amount of insulin you need to administer, and more importantly, how to keep your blood sugar much more stable! The benefits of a stable blood sugar level are enormous, with the most important being a reduced risk of health issues such as heart disease, hypoglycemia (low blood sugar), hyperglycemia (high blood sugar), and more…

How do you achieve this?

Insulin is closely related to blood sugar, and blood sugar levels rise due to carbohydrates (sugars). If you drastically reduce the number of carbohydrates (thus sugar) you consume, you will need much less insulin. That, in itself, is fantastic, isn’t it? But there’s more to it!
Your blood sugar level also remains much more stable when you consume fewer carbohydrates. This means you have much less chance of experiencing hypoglycemia or hyperglycemia.

Why don’t doctors and diabetes nurses prescribe this as standard practice?
Medical professionals understand the effect of carbohydrates and, based on that, conclude that you need to take insulin. However, people with type 1 diabetes often receive the same advice as most people, namely: Eat according to the guidelines of the nutrition center (the “Schijf van 5,” which includes a lot of carbohydrates and little fat). Unfortunately, this advice often includes the additional note that you can continue to eat what you’re used to, as long as you ensure you inject the right amount of insulin before each meal.

Is that really sound advice?
It sounds rather illogical and contradictory, doesn’t it? Your body can’t produce insulin to process carbohydrates (and sugars), so we advise you to eat a lot of carbohydrates! And to process these carbohydrates, you need to take more insulin… Do you see the logic in this?

Fortunately, there is slowly but surely a shift away from this old advice. More and more studies are showing how bad this advice is, and more specialists are delving into this and adjusting their recommendations accordingly.

The benefits of a ketogenic lifestyle in type 1 diabetes

A More Stable Blood Sugar Level
One of the benefits of a ketogenic lifestyle is that it leads to a highly stable blood sugar level, which is ideal for individuals with type 1 diabetes.

I have seen the results from many people who have never had such stable blood sugar levels before! They feel so much better, experience significantly more energy (which makes sense, as their bodies are less shocked by frequent blood sugar fluctuations), have a much lower risk of hypoglycemia (low blood sugar), and require much less insulin.

Reduced Risk of Hypoglycemia
Research has shown that the risk of hypoglycemia can be reduced by 90% with a ketogenic lifestyle. Given that hypoglycemia can be life-threatening, isn’t that reason enough to consider a ketogenic way of life?

Lower Risk of Type 2 Diabetes
Despite having type 1 diabetes, it’s possible to develop type 2 diabetes (with all its consequences). Therefore, managing your diet and lifestyle, including a ketogenic approach, can help reduce the risk of developing type 2 diabetes on top of type 1.
Learn more about diabetes type 2.

Positive Effects on Your Weight
Many people with diabetes type 1 (and 2) tend to gain weight and may also find it more challenging to lose weight. This is because insulin promotes the storage of glucose (sugar), and if your body doesn’t need that glucose for immediate energy, it gets stored as fat. Since estimating the required insulin dose can be tricky, sometimes your body ends up with too much insulin, making it easier to store fat.

With a ketogenic lifestyle, you require much less insulin and consume far fewer sugars, leaving little for your body to store as body fat. Additionally, by using fat as your primary fuel source, you provide your body with the opportunity to tap into stored fat for energy more easily.

Alleviate Physical Symptoms
Many people with type 1 diabetes often experience symptoms such as dizziness, stiff muscles, blurred vision, mental fogginess (a feeling of having a clouded mind), and stiff or painful joints. A ketogenic lifestyle often helps alleviate these symptoms within a few weeks.

Don’t Start Immediately!

Please, don’t!

Despite the strong recommendation for a ketogenic lifestyle for both forms of diabetes, it’s not wise to adopt it immediately. Type 1 diabetes can indeed have life-threatening consequences if not managed carefully.

So, before making any dietary adjustments,
Always consult your diabetes nurse, and inquire if they are familiar with a ketogenic (or low-carb) lifestyle. If necessary, consider switching to a different diabetes nurse who specializes in this approach. A ketogenic lifestyle has a significant impact on the amount of insulin you need, right from the start!

Are you finding it challenging to discuss this with your healthcare provider?
It would be ideal if your current diabetes nurse is already knowledgeable about or open to learning more about this approach. Who knows, it might open up new possibilities, and they can help more people with both type 1 and type 2 diabetes.

However, if this isn’t the case, do not hesitate to switch to a healthcare provider who will thoroughly assess your situation and provide guidance from a knowledgeable standpoint.

Key Points to Consider
(The following recommendations are typically provided by diabetes nurses who specialize in a ketogenic dietary approach, but always consult with your primary healthcare provider first):

More Frequent Monitoring
Hypoglycemia (low blood sugar) doesn’t always show clear symptoms. Often, individuals experiencing hypoglycemia aren’t aware of it themselves, but those around them may notice. Therefore, it’s a good idea to monitor your blood sugar levels more frequently if you don’t have a continuous glucose monitor.

Protein Counts Too
Proteins also influence blood sugar levels. In a ketogenic lifestyle, you generally consume a higher proportion of protein compared to a “normal” diet, and these proteins also affect the amount of insulin you need. Consider delaying the injection of short-acting insulin until 30 minutes after the meal and use a ratio of 10:6 (protein: slow-acting carbohydrates).

Ketoacidosis May Be Less Noticeable
In ketoacidosis during keto, blood sugar levels are not always elevated. If you feel unwell, measure your ketone levels. If they are too high (above 5), consume 5 to 10 grams of slow-acting carbohydrates every hour until you feel better. If this occurs, be sure to inform your diabetes nurse.

What Is Ketoacidosis?
During the transition to using fat as a fuel source, your body produces ketones (hence the name “ketogenic”). This process releases breakdown products that can literally acidify the blood (especially in people with type 1 diabetes).
Symptoms you might experience include rapid and deep breathing, vomiting, and breath that smells like acetone. Ketoacidosis can be life-threatening if neglected, so treat it seriously!

Before Exercising
Exercising with type 1 diabetes is highly encouraged (even recommended!). However, remember to consume extra protein before exercising, as opposed to the “normal” recommendation of consuming additional carbohydrates before exercising with type 1 diabetes.