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Navigating Concerns with Ketogenic Lifestyles in Type 1 Diabetes

The NICE guidelines permit clinicians to collaborate with individuals interested in adopting a ketogenic diet as part of their lifestyle choice. While it’s unfortunate that the current guidelines lack this information, clinicians are empowered to support those inquiring about ketogenic diets.

Your care

It’s your right to be involved in making choices about your care. To make a

decision, you need to know what your options are and what might happen if you don’t want any treatment or care.

Get information on what to do:

  • Before you see your health or care professional
  • When you see your health or care prof
  • When involving other people
  • When you can’t give consent.

Shared decision making

Shared decision-making is when health professionals and patients work together.

It puts you at the centre of decisions about your treatment and care.

This means that:

  • Different choices available to the patient are discussed
  • Care or treatment options are explored in full, along with the risks and benefits
  • Patients decide with their health and social care professional.

Unfortunately, the information has not been made available in the current guideline 

NICE NG17 Appendix C section 1.2.2 2015

The modules on what to eat, supplemented by the patient-oriented site, address concerns about patients’ awareness and transition to real-food ketogenic habits. Individuals with eating disorders or food addiction may require additional support. The course’s methodology for transitioning to keto ensures safety through familiar techniques of carbohydrate counting and insulin estimation.

This common concern is acknowledged, especially regarding insulin management during activities like sports, physical activity, eating out, and dealing with infections. The course outlines a safe transition approach, emphasizing the technique’s commonality among those who have adopted a keto lifestyle. Evidence suggests fewer hypoglycemic episodes overall for individuals on a low carbohydrate diet. The course provides detailed information on transitioning for those with insulin resistance and complications, aligning with the patient-oriented course.

The belief that individuals on a keto diet are at risk of DKA is addressed in the course. Nutritional ketosis resulting from a ketogenic metabolism is not a risk factor for DKA, as explained in detail.

While discouragement from secondary care is decreasing, a survey revealed that 40% of people with Type 1 on a keto lifestyle did not face opposition from their healthcare professionals. Among the remaining 60%, reasons for discouragement often stemmed from bias or personal learning needs. Concerns about long-term evidence, though valid, were primarily related to fat content and the risk of heart disease based on high-carbohydrate diet evidence. The course delves into lipid markers’ behavior in a ketogenic metabolism compared to a carbohydrate-based one, providing insights into successful outcomes. Information on approaching an annual review positively is available for patients on a keto diet, both in the free area for individuals with Type 1 and the professional’s course.

Ready to Enhance Your Expertise?

Register for the Advanced Keto Course and Empower Your Diabetes Management Journey.