Ketosis and diabetes are 2 words that instill fear in the hearts of most diabetics. It used to instill fear into me as well, until I started reading about paleo and primal living, and how ketosis doesn’t always mean you’re gonna die. When I started to read about ketosis, and how some diabetics have taken control of their diabetes with it, I began to get excited. I studied and studied for weeks. Trying to understand everything I could about ketosis and paleo, and I was slowly starting to believe that there’s a way to be in ketosis as a type 1 diabetic, without it killing you. I have a lifetime of beliefs, drilled into me by my doctors, that ketosis means death. It does, “IF” you’re in ketosis and you’re blood sugar is over 250 mg/dl. Most diabetics know this as DKA, or Diabetic KetoAcidosis. Your blood literally becomes toxic with acid created by the lack of insulin in your body. This is a life threatening condition, and must be avoided at all costs, by all diabetics.
So why on earth would a type 1 diabetic want to intentionally enter ketosis? What is ketosis?
Let me start by answering the second question. Ketosis occurs when you’re body doesn’t have enough fuel. Your bodies primary fuel comes from carbohydrates that the body turns into glucose to feed the muscle cells and the brain. If you’re body doesn’t have enough glucose, it has to get fuel from somewhere so it starts to burn or break down fat. When a fat cell is broken down, that creates ketone bodies. 3 types to be exact. 2 are used for fuel, and the 3rd is just waste. (Which you can smell on the breath. It’s called Acetone.) The brain and the muscles can run on ketone bodies. Actually, the heart runs close to 30% more efficiently on ketone bodies. When ketone body levels get to high, the body produces insulin, and they are reduced. If no insulin is sent into the bloodstream, the ketone bodies rise, and so does the blood glucose. Since the 2 ketone bodies that are used as fuel are acidid, this combination causes the blood pH to become acidic, and toxic, causing Diabetic Ketoacidosis, or DKA.
I wanted to go on a ketosis diet, because I read story after story of type 1 diabetics that got off the rollercoaster by going low carb (which naturally causes ketosis). By low carb, I mean around 50g or less per day. Low carbs = steady bloodsugar. This means you eat mostly fat and protein. (Hello butter and bacon!) I know, I know, you think I’m going to clog my arteries. Well I’m not, but that’s another story. Anyway, I tried this for a week back in March as an experiment, and it worked great after about 7 days, but for those first 5 days something weird happened. I wasn’t in ketosis continuously. I kept jumping in and out of it. Whenever I’d be in ketosis, my blood sugar would spike, dangerously high, over 250! When I’d bolus, it wouldn’t go down! (I had never been in ketoacidosis in my entire life, so I didn’t know how to treat this.) Tons more research about treating ketoacidosis, and I got it under control. I discovered that if I bolused, AND did a 4 hour temporary basal with my pump, everything worked great and the blood sugar would come down. Perfect! Nothing had I read warned me about this, and when I went looking for answers, I didn’t find any on the big name blogs. Where I found answers was in the forum at Marks Daily Apple. Other T1D’s told me this happens to a select few type 1′s when they start a ketogenic diet (lucky me) and it will go away in a few days. It’s caused by the body being stressed due to what I’m doing to it, and that stress creates cortisol, which tells the liver to dump what little glucose it’s storing, or to convert protein into glucose (called gluconeogenesis). After 5 days, everything was running smoothly.
But then I tried to come out of ketosis. To end the experiment. I increased my carbs back to around 100c per day. Well, that didn’t go so well. If I went for more than 3 hours without carbs, I’d get ketones, and my blood sugar would spike, and I developed dawn syndrome. (Ketones early in the morning because you’ve been without carbs for hours.) So I did a lot of fighting my blood sugar for a while. Adjusted my basal rates, and my carb ratio, and got back to normal (the normal highs and lows I mean), but still had dawn syndrome.
Then I got a Metronic continuous glucose monitor (CGM). I had become even more paleo over the last few months, and even more strict with my food choices. Loving my bacon and butter, and all the steak, burgers, etc. So I decided to do this again, but go even more hardcore into it, and NEVER COME OUT OF IT. The CGM sure makes it easier to do this that’s for sure, because you can see your blood sugar change in almost real time. I went with no carbs for 3 days at the suggestion of 1 particular blog, to effect the conversion from carbs to ketones more quickly. It worked! Smooth transition with no spikes, and my blood sugar hasn’t climbed above 150 for 7 days straight. Most of the week my blood sugar has been around 80-90 mg/dl. I used to be afraid of that low of a number! I’d start eating glucose tabs, afraid of a crash. Now I’m annoyed if it goes above 125! I’ve been in ketosis 100% of the time all week now. It’s been emotionally uplifting too. Not that I have any kind of depression problems, but it just feels good that I’ve found a way to control my diabetes that’s actually working. I keep seeing carbs everywhere, and thinking “No Rich, that will make your blood sugar spike, today, AND tomorrow, and the next day.” Then I just walk away happy that my blood sugars are normal now.
Now, I feel the need to say this . . . . . DON’T TRY THIS AT HOME. There’s a lot of things about starting a ketosis diet that you need to learn, and it can be really dangerous if you don’t do insane amounts of research. I’m a little crazy, and don’t believe mainstream medicine, and this is MY LIFE, but I definitely don’t want you to try this just on a whim because you read my blog. I wanted to tell you my story, so you can see what happens, because I didn’t see this in any of my research, and had no idea that it might happen with all of the hours of research I did before I tried (maybe 50 hours I think).
I hope this article was helpful to you.