Willingness to change
GRIN model , addiction management
Carb Counting Skills
Core skill might need revision
Insulin Carb Ratio
Revise. It might reduce in longer term T1 as sensitivity returns
Insulin protein Ratio
Inform patient of protein effects and delayed glycaemia.
Bolus for protein
Will the insulin choice suit a low carb lifestyle? Would a less rapid insulin be better in very low carb?
Usually accurate but testing it will refine the dose. Twice daily dose a good option
Can the patient use the glucometer and understands the need for frequent testing 4-6 times a day. Does the patient have adequate test strips?
20% of T1 are eligible. With frequent testing a case can be made. It is possibly the single biggest agent to educate the patient.
Plenty of online recipes and a starter fortnight list here. Check the nutrition section
Ketone testing equipment?
Blood ketones are best. Enable patients to get an idea of their personal ketone levels in nutritional ketosis. Urine sticks a minimum and ok for DKA but not ketosis measurement as urine testing may go negative in the presence of higher blood ketones on a keto diet .
Ideas for managing sleep. An important part of a keto lifestlye
Sleep hygiene, no food after 8pm, screen protectors against blue light, etc
Ideas for managing stress. Important in any dietary management of T1
Stress hormones affect blood glucose
Ideas for regular physical activity. Important in T1 and often underestimated
Encourage regular physical activity. Strength, joint flexibility and aerobic training should be included in any recommendation. Increased muscle mass increases insulin sensitivity and glucose handling. There is a practical webinar on this important topic.