I promise that this is the next to last blog post about dietary stuff for a while. I just wanted to conclude this series with some pointers on things to avoid if you should find yourself curious about implementing a dietary shift, away from carbs and towards fat as an energy source. There is, of course, plenty of information available courtesy of my good friend Mr. Google, but I want to highlight the pitfalls I experienced in hopes that you can learn or be entertained by my failures–or possibly even both. I’d like to remind you that I am not a doctor or dietician. The following statements have not been approved by anyone other than myself, and likely reflect significant gaps in objective factuality!

I wrote an eBook compiling my experiments with the ketogenic diet and type 1 diabetes which you can check out here:

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  • Low-carb and Ketogenic are not synonymous. A ketogenic diet is by definition “low-carb” but unless you are consistently bringing your carb intake below 50 grams (ideally below 30 grams) daily, your body will maintain glucose as a fuel source. This may still be useful for managing blood sugar, but athletic efforts will still require higher loads of carbs with corresponding higher doses of insulin. The benefit of ketosis requires commitment and some time to fully achieve.
  • Keto acidosis or DKA and Ketosis are not the same things. DKA is an extremely high level of ketones which lead to a shift in the pH level of the blood–it is not the ketones themselves as much as the acidic condition that is dangerous. Ketones are a natural byproduct of metabolizing fat and are no more a cause for alarm (in small quantities) than glucose in the blood. When any chemical in the blood accumulates too rapidly, bad things happen. Ketosis is not a drastic “dump” of ketones that causes the blood to become acidic (DKA). Nutritional Ketosis is very much controlled and regulated by insulin in the bloodstream. Elevated blood sugar levels need to be treated with caution (sickness, stress etc) but if blood glucose levels are in range then I learned not to fret about a moderate level of ketones.
  • Less protein, more fat. One thing that the Keto crowd and the Vegans can agree on (generally) is that we have been oversold the need for protein in our diets. I made this mistake for years–swapping carbs for protein and then wondering why I never seemed to go into ketosis and would always experience slow upward creeping of my blood sugar. Protein, beyond “maintenance doses” gets converted into glucose through gluconeogenesis which can ultimately sabotage Ketosis. If you’ve ever eaten a big steak with no carbs and seen your blood sugar inexplicably rise hours later, you probably have experienced this phenomenon. I never knew this and it wasn’t until I backed off the protein and increased the fat that I saw Ketosis occur–and when it did, the light went on in my head–my blood sugar levels stopped creeping up and my energy levels went through the roof!
  • Not enough electrolytes. Ditching the carbs makes you pee. This makes it a little more intuitive to hydrate (which actually helped me completely get rid of diet soda cravings!) but it also flushes out minerals and salts that your body needs. When I was transitioning into the Keto diet I failed to replenish these electrolytes and felt, quite predictably, like I had the flu. This is actually a pretty common occurrence (google “Keto flu”) that can be rectified with a concerted effort to get enough electrolytes. There are several powdered drinks that can help with this–as well as beef and vegetable broth and pickle juice. Once I restored my electrolytes levels to normal I felt much better and my energy returned–with dividends!
  • Exercising too hard, too quickly. Overall it took me about a month to adapt “fully” where I had a good sense for meals, insulin dosing and response, fluid and electrolyte balances and athletic performance. Exercise–or just staying moving–is really important to me. I tried to immediately return to the same level of intensity as I was starting the Keto diet and it was really difficult. I felt depleted and weak. This almost made me give up on the diet. In retrospect, taking it slow is advisable; if I were doing it again I would simply do the lowest intensity of exercise possible until at least week two or three–by which point the Keto-adaptation should be more or less complete and the corresponding surplus of energy would almost certainly necessitate more intense outlets.

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Self experimentation is as challenging as it is rewarding. It’s hard to know if you’re doing everything right. I am not a professional and so I can’t say that my way is right for everyone–but I can say that it has been beneficial for me. I know that the failures along the way were really discouraging and even scary at times–which is why I share them. “Extreme” diets are not trivial and should not be approached lightly–even without the challenges and complicating variables of type 1 diabetes in the mix. The more you know up front, the better equipped you can be to make decisions.

In closing, I want to thank you all for bearing with me on this summer’s diet-heavy focus in the blog. It is interesting in a way, but this isn’t a diet/food blog. I believe that I (personally) will benefit a lot from the lessons I have learned with all this experimentation. I believe this new information can help me take my climbing to the next level–which ultimately is what this is all about. Diets and blood sugar and devices and numbers–are only as good as the places they enable us to go. As I turn my attention back to more creative pursuits and the big move that my family is about to take on, please feel to reach out via email (steve@livingvertical.org) out if you have questions about my dietary experiments that aren’t covered in these blog posts.

LivingVertical thrives because of YOU. I (Steve) personally appreciate the fact that you are part of our growing community of active and adventurous people with diabetes. I will be offering diabetes coaching services beginning October 1st–and I have space for 5 people who are looking to improve their lifestyle, diabetes control, goal setting and adapt their management to unique, active pursuits. Email me for more info steve@livingvertical.org!