A ketogenic diet (ENGLISH)

Why Konrad eats a ketogenic diet when he has Type 1 diabetes (T1D) and how the diet affects Konrad and his blood sugar.

Konrad has been on the ketogenic diet since january 2015. We – Konrad and Konrads Mom have already learned a lot but we still have so much more to learn about Konrad and his diabetes and him being on this diet.

Vi have met another Danish family this summer with a child on the ketogenic diet. We had time to exchange experiences and learned among other things how different a child can react to different foods – also on a ketogenic diet.

This is the first T1D child we have met on a ketogenic diet other than Konrad. If you have experience being a T1D or parent of a T1D child and have experience with being in a constant state of ketosis please share: KonradsKitchen.dk @ gmail.com

Konrad was diagnosed with T1D when he was 9 years old. That is 3 years ago. Half a year later Konrad got a CGM (continuous glucose monitor) and has had it ever since. With the CGM we can monitor Konrads blood glucose around the clock. For the first 10 months he would do several daily injections of insulin before Konrad got his insulin pump.

After he was diagnosed we learned to count carbs and give the insulin needed. We learned that som foods (eg. 30 gram of wholegrain rice, pasta or bread) would send Konrads glucose level above 22 mmol for around 6 hours and then plummet. We would adjust the basal insulin on his pump and bolus and bolus and bolus. It didn’t seen to matter how much insulin he took the blood sugar didn’t come back down until hours later. Konrad didn’t feel very well when his blood sugar was so high.

It wasn’t worth it. Konrad started avoiding the foods that sent his blood sugar up high. Slowly our diet turned more and more low carb as to the only starchy and high carb food and drink were whole grain rye bread and milk.

January 2015 Konrad decided to try a ketogenic diet with his body being in a constant state of ketosis. We talked to Konrads doctor at the hospital but they can’t help us as they have no experience with children with Type 1 Diabetes on a ketogenic diet. So we have to try as we go. Konrad eats between 20-50 grams of carbs a day.

Konrad has ketones between 0,7 and 3,5 mmol. We are not systematic in checking for ketones. In the beginning we checked more often but now it is rare. Checking for ketones is still an important tool together with keeping an eye on Konrads blood sugar especially in case a insulin pump set is broken and he doesn’t get insulin and he is on his way to ketoacidosis!

We do think it could be interesting to see how ketones develop during a day in relation to blood sugar, food, exercise etc as the CGM does it for his blood sugar. We use the CGM all the time and it is one of our most important tools.

Normal bloodsugar + ketones = Happy Konrad!

High bloodsugar + ketones + Type 1 Diabetes = Bad. We check to make sure Konrad gets insulin as to not end in the life threatening diabetic ketoacidosis.

We often adjust Konrads basal on the pump. Konrads doctors doesn’t like that we do. But it is necessary and it works for us. We have to adjust fast for activity, sport, computer time, a sore throat, a tooth coming out etc. Puberty is also a factor. Some days he takes 12 units of insulin, some days it is 42 units and a few days later its 20 units. It changes so fast we have to keep a close eye to the CGM and on Konrad and be quick to adjust the basal.

The keto diet means that Konrads body uses fat (ketones) as fuel instead of sugar (carbs). When Konrad used to eat a carb diet he needed to eat a lot of rye sandwiches to have energy enough and prevent too low blood sugars.

Now he gets energy from the high fat food (low carb means the body won’t run on carbs but on fat). If he runs out fat from food his body takes from his body fat. But it doesn’t affect his blood sugars. Konrad can do an hour of sports with out having to eat anything for energy. He only has to take into cosideration how exercise will affect his basal.

Konrad still gets low blood sugars. But not as many as before and not as low!

His HbA1c is within what his doctors recomend and it has lowered since he began eating keto.

Most of the time his blood sugars are between 4 and 8 mmol. And some days when we hit just the right basal his blood sugar will be perfect betweek 4,5 and 6 for a few days.

Most importantly Konrad feels great on this diet!!

Mom, updated august 2016

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