The Type 1 Keto Approach
Type 1Keto is about more than reducing carbohydrates. It is an approach to type 1 diabetes that starts with insulin, considers the fuels available to the body, and recognises the wider influences that continually change insulin requirements.
Three connected principles underlie this approach
01
Optimsed Insulin
The right amount
for the body’s needs
02
Metabolic Fuelling
Using the fuels our body
is designed to use
03
Five Foundations of Health
Environmental factors that
influence insulin needs
01
Optimised Insulin
Insulin — as much as needed, as little as possible.
Type 1 diabetes is usually managed through the lens of glucose. We measure glucose, count carbohydrate, calculate insulin and adjust doses in an attempt to keep glucose within range.
There is good reason for this. Most dietary carbohydrate is broken down into glucose, and without our own insulin production that glucose has to be matched with injected insulin. Carbohydrate counting is therefore an essential skill in type 1 diabetes. Protein matters too, particularly on a lower-carbohydrate diet, and learning to account for both carbohydrate and protein can make mealtime insulin considerably more predictable.
But this is only part of the physiology.
Insulin does much more than lower glucose. It is one of the body’s principal metabolic hormones, helping to regulate how energy is stored, released and used.
When insulin levels are higher, the body is encouraged to store energy. When insulin levels are lower, stored energy becomes more accessible. The amount of insulin we need therefore depends not only on the carbohydrate we eat, but on the wider metabolic circumstances in which we find ourselves.
The aim is not to minimise insulin. Insulin is essential. The aim is to understand what is driving insulin requirements and use the amount appropriate to those needs.
That is the beginning of insulin optimisation.
02
Metabolic Fuelling
Not replacing glucose. Expanding the fuels available.
The body does not run on glucose alone. Human metabolism can use several interconnected fuels, including glucose and lactate, fatty acids and ketones. Which fuels predominate changes according to what we eat, what we are doing and the metabolic circumstances in which we find ourselves.
During intense exercise, for example, glucose and lactate become particularly important. During lower-intensity activity or periods of lower carbohydrate availability, fatty acids can make a much greater contribution, while ketones provide another fuel when conditions favour their production.
I think of this as metabolic fuelling: not trying to force the body to run on one particular fuel, but understanding that healthy human metabolism is designed to draw upon different fuels at different times.
Nutritional ketosis is therefore not about eliminating glucose. Glucose remains available from stored glycogen and can also be produced when required. Instead, reducing carbohydrate sufficiently to maintain nutritional ketosis increases access to fatty acids and ketones alongside glucose.
This ability to draw upon different fuels is what I call multifuelling.
03
The 5 Foundations of Health
More than food
Insulin optimisation extends beyond counting the macronutrients in a meal. Carbohydrate and protein still need to be understood and accounted for, but so does the metabolic setting in which that food is being eaten.
A meal after a sedentary day is not metabolically identical to the same meal during a long day’s cycling. A poor night’s sleep can change insulin sensitivity. Stress can change glucose and insulin requirements even when the food on the plate has not changed.
This is why the Type1Keto approach looks beyond nutrition alone.
Nutrition
Food quality and macronutrients balance influences insulin requirements.
Physical activity
Movement changes fuel use and how the body responds to insulin.
Mindset
Stress and emotional state can influence glucose and insulin needs.
Enivironment
Temperature, light and our surroundings can influence metabolism.
Circadian rhythms
Sleep and timing influence hormones, appetite and insulin sensitivity.
As much insulin as needed, as little as possible.
The first half is as important as the second.
Insulin is essential. The aim is not to minimse it, but to use the amount our physiology requires. For me, Optimised Insulin brings insulin, metabolic fuelling and the Five Foundations of Health together.