Tag Archive for: dka

Type 1 Thursday – 5 Lies Your Doctor Tells You About Diabetes

Today, we’re talking about 5 lies your doctor has told you about Diabetes.

It’s not your fault that you’ve been told these lies. Or that you believed them, either! Do these sound familiar to you? Do you need carbs? “Eat and cover for it with insulin”? DKA? Complications? A cure for Type 1 Diabetes?

Check out this episode of Type 1 Thursday and see what is really going on with these lame excuses!

Which ones have you believed? Are there any you still believe? Or have you been told other ones? Share in the comments and let’s talk about it!


If you prefer to read, here’s the whole (pretty much unedited) text:

Hello, and welcome to this week’s episode of Type 1 Thursday with me Hanna Boëthius, one of the founders of The Low Carb Universe, as well as a type one diabetic for the past at least 34 years. I have a few years of experience with this chronic disease, and I am now happy to share some of my knowledge with you all in this series that we call Type 1 Thursday. I have a whole thing planned for you guys, and it’s a presentation that I have done in the past but I thought it’s very important information and so that you should know it as well.

This is the five lies that your doctor has told you about diabetes. And I cannot wait to get started. Because these are quite fundamental things that a lot of medical professionals or even doctors have troubles realizing and that I’m quite sure that you have been told as well. So let me know in the comments which lies you believed or which ones you’ve been told, so that we can get those straight and maybe not believe them anymore.

My number one lie that your doctor has told you about diabetes is you have to have carbs. This sounds very, very silly to me now, after eight years of low carbing my way through life, as a healthier, happier, better human being. So that sounds really weird to me now, but it didn’t sound weird to me then, which is when I believe this and I was told it that, yes, your body needs carbs.

This is partially true, your body does need some carbs and some sugar. But your body’s also clever enough so that it can sort that mess out on its own and you don’t actually have to add any, if very, very few carbs from the outside to maintain that equilibrium of carbs versus rest of stuff in the body.

The carbs and insulin are not a match made in heaven. injected insulin is first of all, not by any means as precise as endogenous insulin so if a human being produces insulin on his or her own, that is a lot more effective than the injected insulin that you as a type 1 diabetic will have to inject. And, of course, the disparity between these, you can never chase a lot of carbs with a lot of insulin because the equation very rarely will match. This goes back to apparently my favorite topic in this, which is the law of small numbers. So if you work with small numbers, small levels of sugar, and work with small levels of insulin, they are easier to make happen and make that into an equation that actually adds up.

Also, of course, this makes me wonder why the official recommendations are still 45 to 60 grams of carbs per meal for diabetics? I think that is ludicrous, I don’t understand why because clearly, clearly, clearly, you can survive on almost none carbs because your body is so beautifully clever in that way, so you don’t need carbs is the conclusion for line number one. And there are alternative fuel sources for your body to function.

Lie number two, hey, just eat what you want and come in for it with insulin, that will work. Right?

Well, it does work for some, it just doesn’t work for myself, and many, many, many other type 1 diabetics out there. It is, as I already mentioned, too difficult to match a lot of sugar with a lot of insulin. So it isn’t the ideal treatment. I mean, it is the best treatment we have out there but it’s not the ideal treatment because it doesn’t work with injected insulin and with carbs. So don’t be fooled that you can just eat anything and just cover for it with insulin because in very many cases it doesn’t even work.

Hyperinsulinemia has been shown also to cause an array of crazy things in the body. It has been linked to certain cancers, to coronary heart disease, to Alzheimer’s, it’s been linked to a lot of things. So if you can help it, maybe it’s not the best idea to put a lot of insulin into your system if you don’t have to, what is the point of that. Also, insulin toxicity is of course, another thing to mention here. That is something that we need to of course, have a lot more research on but for now, I don’t want to jinx anything and I don’t want to be playing with uncertainties, when I have another way of doing it.

It also of course, when you eat whatever you want and cover for it with insulin, it does make the margin of error way to big for comfort, and that is one of my main points of eating low carb as a type 1 diabetic, it is the margin of error or just too large to handle for me. This sends your blood sugar on a roller coaster rocket ride, it goes up and it goes down and you have to treat with insulin, you have to treat with sugar you have to treat treat, treat. You still have to have a normal life. But all you’re going to do if you are on that roller coaster is to manage diabetes, and that is not what I want for you. That’s not what I want for myself. That’s not what I want for any type 1 diabetic. This is why I call it a lie because it’s not sustainable for very, very many of us. For those who it is sustainable for, yay, good for you! Awesome that you found what works for you. But for us that it doesn’t work for I want you guys to know that there is another way of managing diabetes. So conclusion for number two; too much insulin isn’t good, either.

All right, and then I have a sneaky lie, number two and a half. Without masses of insulin in your body, you’re gonna go into diabetic ketoacidosis (DKA). I did a whole video about this a couple of weeks ago, and I think I, well, at least I aimed at trying to explain to you that this was not the case. This has nothing to do with how much insulin you have in your body, it has to do with that you have enough insulin in your body, but it doesn’t mean that you need masses of it.

There are many, many factors that that are needed for a diabetic ketoacidosis to happen. High blood sugars, dehydration, there are large ketones and not like the large ketones that they mentioned in these nutritional ketosis graphs. No, no, like really high ketones like 10 mmol/l and upwards for it to be a DKA.

A DKA requires, what did we learn a couple weeks ago, we learned that it requires a lack of insulin in the body and nothing else. Nothing else can actually push you into DKA apart from the lack of insulin or being dehydrated.

There are very many ways that you can avoid a decay even if you’re a type 1 on a ketogenic diet. Normal glycemia (normal blood sguars) has been shown to actually have less occurrence of DKA. If your blood sugars are normal, stable, healthy blood sugars that all diabetics deserve and should aim for, the risk of going into a DKA is pretty small.

This is leads me shamelessly onto my third lie, which is all ketones are bad. Even trace ketones are bad for every single diabetic.

It feels like I also did the video a couple weeks ago on this topic, because this is of course, when diabetic ketoacidosis isn’t at all the same as nutritional ketosis. They’re two completely different things. And what’s needed in between is of course, the lack of insulin we come back to this again. So, trace ketones may be a danger if you are a sugar burning diabetic, who is not receiving in either way, the insulin that the body is needing or that you actually just don’t have control of your diabetes that then trace ketones can be bad. Yes, absolutely. But if you are a controlled fat burning machine of a diabetic, there won’t be a DKA. As long as you keep taking the insulin the body’s needing, you keep hydrated and you keep an eagle eye on your blood sugars, it’s not harder than that. So keep at it.

Ketones are a great fuel, if you know how to use them. So the conclusion for line number two and a half and three is DKA is easy to avoid even as a type one on a ketogenic diet.

Lie number four, complications are a natural progression of diabetes. This one actually really annoys me because not only is this said widely and freely and by everyone who is educating diabetics around the world, but it also comes with the terrible advice of eating 45 to 60 grams of carbs per meal, how is that possible? Those two things are absolutely are correlated, because high HbA1c, above the normal, healthy level and ranges, has been shown to cause more diabetic complications.

I know I don’t have to, but I’m going to anyway, diabetic complications are things like retinopathy, potentially blindness, amputations, nerve damage, renal failure, heart problems, high blood pressure, all of these things that can be correlated with high blood sugars, and of course, you get high blood sugar if you keep eating all that sugar!

Furthermore, a healthy A1c is nax 5.5%, which I think is very interesting because for a diabetic is anything between 6.5 to 8% of HbA1c. Why is that? Why do they think that diabetics are going to be healthier at a higher level than normally healthy people? That is an equation that I can’t make work in my mind. So that is why I also call this a lie because, of course, when the goal is set so high for diabetics, they are more prone to complications. Then it becomes a natural progression.

Stable, normal, happy, healthy blood sugars are the leading cause of absolutely nothing. Then you can live a healthy happy life with both type 1 and type 2 diabetes, and all the other types as well. But that does have the prerequisite that you do get the chance to get the information that this is a possibility, which of course a lot of people don’t today. That makes me sad.

Conclusion from lie number quatro is stable, low blood sugars will keep you safer from complications, then the high blood sugars that are set as the goal for us today.

Lie number five is a cure is just around the corner. And I bet if you do live with Type 1 Diabetes, you have heard this at least a gazillion times. Every time I went to my endocrinologist as a child, every time, and I can’t even imagine how many times my parents have heard this too.

Back in the day, and it’s always in five to ten years. Yeah, listen up people. It’s been 34 years, and I’m still waiting for this cure to happen. So, I’m sorry, but I’ve lost a bit of faith in this statement, which is what is causing me to also call it a lie.

There have been fantastically promising advancements made in terms of managing diabetes. We have, we have insulin pumps, we have continuous blood glucose monitors, we have got blood glucose monitors that need a lot less blood, they’re a lot less invasive. We have so many treatment options now and especially super exciting with the closed and open loops that are coming out on the market. And that is going to be fantastic. But I have to be a little bit pessimistic when it comes to cure because I don’t think that that is actually even on the horizon, although there are a lot of attempts going on. But there’s not that much progress being made. So the conclusion from why number five is, there’s going to be a lot more done for diabetes management, but maybe not as much as we hope for a cure in the foreseeable future. At least, I hope someone proves me wrong. I really, really do hope someone proves me wrong, but from what I can see right now, this is not the case.

Which one’s of these lies have you believed? Have you been told maybe or have you been told any other lies that I didn’t have time to bring up in today’s live session? Let me know in a comment, and I will be happy to discuss it. There. have fantastic rest of the day. And I will see you next week with a new episode of Type 1 Thursday. Bye!

Type 1 Thursday – DKA vs Ketosis: are they the same?

This is one hot potato (ha!) in the diabetes world: ketosis and DKA.

How do you get DKA, diabetic ketoacidosis? what is it, what’s dangerous? And ketosis, what is that? How do you get there, and is it dangerous, even for a Type 1 Diabetic? Check out the latest episode of Type 1 Thursday to find out:

  • Please note: This information is based on my personal experience and should not be understood as medical advice.

Andrew Koutnik is a fantastic researcher and T1D, who has summarized the difference between DKA and ketosis in a handy chart:

Physiological Differences Between Ketoacidosis and Very-Low Carbohydrate Diet.
Source: https://www.andrewkoutnik.com/blog/2018/9/8/part-3-optimal-blood-glucose-control

Andrew writes:

Ketoacidosis involves dangerously low or absent insulin which causes glucose and ketone levels to rise. A VLCKD has low to moderate insulin which is sufficient to control blood glucose in the homeostatic range while allow low to moderate elevations in ketone bodies. This pathological (ketoacidosis) versus nonpathological (VLCKD) physiological states are vastly different.

Andrew Koutnik, “Part 3: Can you Achieve Optimal Blood Glucose Control as a Type-1 Diabetic?”

I highly suggest you read the rest of Andrew’s blog post here, there is a magnitude of great information in there!

Jon us for more discussions like this at diabetes. by The Low Carb Universe in Sweden in June 2019!

What are your experiences with ketosis or DKA? Leave a comment!