Ketogenic Lifestyles in Type 1 Diabetes: Addressing Concerns
While the latest NICE guidelines lack mention of ketogenic lifestyles, clinicians are allowed to collaborate with individuals interested in adopting a ketogenic diet as part of their lifestyle choice. Unfortunately, this information is not currently available in the guidelines.
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.
NICE NG17 Appendix C section 1.2.2 2015
Addressing patients’ awareness of ketogenic diets is covered in the modules on what to eat, and it is also duplicated on the patient-oriented site. For those with eating disorders or food addiction, additional help may be needed. The course’s methodology for transitioning to keto is safe, involving techniques of carbohydrate counting and insulin estimation familiar to the patient.
It’s a common concern among clinicians managing Type 1 diabetes. The course outlines a safe transition approach, emphasizing the common techniques used by those who have adopted a keto lifestyle. Evidence indicates fewer hypoglycemic episodes overall for individuals on a low carbohydrate diet. Safety is a priority, and the course provides information on transitioning for those with insulin resistance and complications.
While this concern is commonly expressed, the course explains that people on a keto diet are at risk of DKA not because of the diet. Nutritional ketosis in a ketogenic metabolism is not a risk factor for DKA, detailed in the course.
Discouragement from secondary care is decreasing. In a survey, 40% of people with Type 1 on a keto lifestyle reported their healthcare professionals not being against this diet. The remaining concerns are often based on bias or personal learning needs. There is as yet little evidence on lipid markers in a ketogenic metabolism, but proxy markers point to successful outcomes. Information for patients on approaching an annual review positively is available in the free area for those with Type 1 and included in the professional’s course.