Chameleon Ken: The amazing way in which we change to prevailing conditions.
Here is a blog from the patient section of the site.
Ken (not his real name, of course) is a GP.
I had just given a presentation on Type 1 management to a group of GPs’. Ken was the person hosting the session. His job was to introduce the speakers and ensure everything ran on time.
After I had finished, he was naturally keen to get the microphone off me and get me out of the auditorium. He was there for that reason.
‘That was an interesting talk. I have had Type 1 for 20 years. I might give low carb a go.’
It was a nice closing pleasantry and a goodbye. I wished him well, and we parted company. I thought no more of it.
He was in his late middle age and had adult-onset Type 1 for 25 years. His management plan had not served him well. He was portly and so was clearly over-injecting insulin to chase those carbs. The excess insulin was making him fat. Insulin lowers blood glucose by parking the glucose in the muscle, but it also makes glucose into fat. Insulin also causes the body to retain sodium. This leads to high blood pressure and subsequent blood pressure medication prescription. It was highly likely that Ken had iatrogenic Type 2 diabetes caused by the treatment of type 1. For some reason, insulin also interferes with stomach acid production. More of which later.
So, it came as a total surprise that I got this e-mail three weeks to the day after I met him.
“Hi, Ian,bla, bla, bla…..
I immediately started the Ketogenic Diet the following morning, and the results have been staggering: –
HbA1c down from 9.5% to 8.5% in 4 weeks [80-69 mmol/mol]
Weight down by one stone 3 lbs!! [7.5kg] I’ve struggled to lose weight for years.
My long-acting insulin dose is down from 80 units a day to 30 units. (!!)
The fast-acting insulin down from around 40units a day to zero yesterday and on most days.
Also, I am off all acid medications and have no symptoms. Previously I was on a powerful antacid, Lansoprazole 30mg a day and was on a waiting list for anti-reflux surgery. (He had had crippling indigestion for years).
My sleep best it’s ever been.
Also, I am managing the ketogenic diet very well. I have little hunger, and overall, I am feeling great. I’m sure that I will be able to keep this up”.
That was indeed genuinely staggering. This man was medically trained on high dose antacids; he’d had three endoscopies to investigate his acid reflux over two and a half years and was checking in for surgery. He told me that he had cancelled his operation. The rest of the improvement was expected, but the rate of change was incredibly fast.
The changes were worth it for Ken, and he thought he could sustain them.
When people with Type 1 get change from day one, it is hugely motivating. And the most touching part was at the very end of the e-mail:
“I’d sort of come to terms with the fact that my control was as good as it would get, and complications were inevitable. Now I have renewed hope …..”
There is nothing more demoralising than feeling future events are beyond our control. Hope is what often keeps us going. I contacted him four months later, and he proudly told me that he had lost two stones [12.5kg] in weight, and his HbA1c was down to 7.2% [55mmol/mol]. Since changing his diet, Ken had reduced his HbA1c from 80mmol/mol to 55mmol/mol, his insulin volumes had plummeted, and his chances of a healthy old age had increased. He had nurtured his body back to health.
Ken is an excellent example of how the body really does respond to its environment. Change the diet in this case, and the body will change accordingly – it works both ways. But Ken the Chameleon is in a purple patch right now. Good on you, Ken.