Stats update

Back in the Zone

I began my nutritional ketosis journey on a 6-week business trip to Sydney. It was easier to make such a dramatic change to my diet when I wasn't at home. The secondment served as a great "Starting Point". However, for the whole trip I was left guessing if my measurements corresponded to the way I was feeling because hotel rooms always lack scales. As the weeks rolled past, the suspense rose...

Flashback: At the outset, I wrote that I weighed in at just under 100kgs (some days, more!) and a total body fat percentage of 27% (That's a lot of fat!).

No sooner than I had walked through the door of my apartment in London did I jump back on the scale. The results blew me away and validate all of my decisions so far. Without further ado: 

Weight: 92kg (-6kg)
Total body fat: 14.1% (-12.9%)

Thus, in a mere 6 weeks, with very little physical activity, I had lost 6% of my total body mass, but almost 13% of my body fat. Where once I carried around 27kgs of fat, I now carry 12.9kgs (14.1% of 92kg). This also means I've lost more fat mass than total body mass, meaning I've gained muscle. My body feels leaner, lighter and stronger - all without lifting a single weight.

As a T1 diabetic, I have improved my HbA1c to 8.1 (still improving), but my BG averages have been among the best I've ever recorded. I've had fewer lows but retained my hypo sensitivity, and - importantly, I am really enjoying what I'm eating.

What else could I say about this transformation? If you're a T1 diabetic looking to gain a bit more control, or lose weight (or anyone trying to lose weight) - try keto-adaptation. Read up about it (there are some great resources online), clear out those cupboards, and take that first step. It works! 

Some Observations

It's been a month since I decided to follow the path of nutritional ketosis, and in this relatively short space of time I have picked up a few observations. I am convinced that more is yet to come, but happy to report that the experience has been overwhelmingly positive.

Firstly, my blood glucose readings have dramatically improved. Before the switch away from carbohydrates, I had what most would consider to be average control over my BG levels. As soon as I cut out carbs, the numbers dropped. I have tested frequently and the majority of the time I have been pleased with the results. This is what my glucometer tells me:

90 day average: 11.8 ("average" control indeed!) 

30 day average: 10.7

14 day average: 9.4

7 day average: 9.0

This alone is enough incentive to continue the diet, and I have to say it feels great to see these numbers. I am especially pleased because it shows that I have avoided the risk of ketoacidosis.

Secondly, I was prepad for, and indeed experienced the much publicised "withdrawal" effects. As a diabetic, I can assure you that these are nowhere near as significant in effect as a single episode of hypoglycaemia. Don't be out off by reports of feeling sluggish for a day or two. It passes and the ill effect is massively overshadowed by the pleasure of regaining glycemic control.

Thirdly, and finally for this post, I have noticed a visual change in my appearance. Sadly I don't have access to a set of scales, but I am convinced I have lost an appreciable amount of weight. My midsection is looking more toned than it has in a long time! This could also be down to the great sunny weekends I've been enjoying in Sydney though! I look forward to verifying this observation as soon as possible.

As a T1 diabetic, the changes have also sparked some questions specific to my condition...

1) On days when I consume literally no carbohydrates (there have been enough), does a rise in my BG levels between meals mean (indirectly) that I am in ketosis? 

2) Is the ratio of mmol of BG to insulin the same as it was when the glucose was the byproduct of carbohydrate consumption?

3) I have had only 2 episodes of very mild hypoglycaemia so far this month. Does eating high GI carbohydrate food to alleviate the hypo destroy the gains I've made in achieving nutritional ketosis? 

I hope to resolve these queries over time. For now, I am enjoying the journey!

Keto-Acidosis - not good!

Keto Acidosis is a bad thing

I am by no means an expert, or medically qualified in any way. This is just my take on the reading I've done around the difference between nutritional ketosis and keto acidosis. 

As a T1 diabetic, my body does not produce insulin. Without insulin, glucose in my blood stream cannot be utilised by my body. Therefore, I need to inject insulin to bring down my blood glucose levels.

In the short term, without being able to draw energy from glucose, by body will switch to an alternative fuel source by breaking down fat. This breakdown produces ketones in my blood as a by-product.

Now, having elevated levels of ketones present in the blood stream is only good if it indicates that my body has switched from burning carbohydrate to burning fat as its means of accessing stored energy. BUT, having significanlly high levels of ketones could indicate a total absence of insulin in my blood-stream. 

Ketones are acidic and at extreme levels, I can develop what is called diabetic ketoacidosis, which can lead to serious complications, including severe dehydration, coma and swelling of the brain. Clearly this is a state to avoid! 

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What this means, in the paradigm of a T1 diabetic, is that it is crucial to monitor blood glucose throughout the process of accessing nutritional ketosis. To sacrifice blood glucose control in favour of higher ketone levels is foolhardy. As T1's, we all have know people who have horror stories of the side effects of elevated glucose and ketone levels. The key is to play it safe and stay in control.

Read This First

• Type 1 diabetic for 6 years
• 102kg (and rising!)
• Sedentary lifestyle with low energy reserves
• Ambitions of cycling a respectable 200km "Audax"

I was diagnosed with Type 1 diabetes in 2008, at the age of 26. At the time, I was moderately fit, but admittedly too heavy. Like many of us at that age, I had paid a little too much attention to partying and not enough attention to my health...

At the time (in South Africa), standard advice for new T1 diabetics was to go cold turkey on refined carbs and all high GI or hi GL foods. I took this advice and lost 25kgs. I felt and looked great, and when my final weight settled at 95kg, I thought that would be the end of it.

Fast forward 4 years and I found myself living in London, where NHS advice seems more directed at eating freely and injecting insulin to cover one's carbohydrate intake. Carbs are very popular in all their forms here in  England, for reasons I can only guess at. As the carbs gained prominance in my diet, my insulin dosage rose. Gradually I started gaining weight.

While I picked up weight, I was also attempting longer and longer bike rides. I've always used exercise as a means to control my blood glucose (BG) levels, but I found that I had limitations in terms of energy reserves that my friends didn't share. Reading around the issue online, I stumbled on an eye opening video by a renowned long distance cyclist Mike Cotty.

Part of his secret appeared to be a diet skewed away from carbs, towards fat and protein. I wondered if this would work for me, too. I have no aspirations of riding 600km in one go, but have my eye on a few audax rides this summer. 

Calling on my personal experience of weight loss and improved nutrition from my SA days, I bought a book on low carb living for enhanced performance (more on that later). Reading it was like a series of lightbulbs switching on in my mind. This was a concept I could get behind! 

The question was, and it's one I am sure many will share, what are the medical and practical implications of eliminating all carbs from the diet of a type 1, insulin dependant diabetic? Through this blog I hope to share my experiences.