What Others Are Saying
Here is what people are saying about their experience of working with Dr Lake
Dr. Lake writes not only as a physician but also as someone who has lived with the daily reality of Type 1 diabetes for decades. That dual perspective gives this book a rare authenticity.
His willingness to question assumptions — while remaining grounded in science — carries forward the spirit of pioneers such as Richard K. Bernstein and Keith Runyan. What Dr Lake offers in these pages is not a rejection of established care but an expansion of it, encouraging deeper metabolic thinking while remaining practical and grounded in lived experience
“Dr. Lake is a cyclist and experienced clinician who takes us through his meticulous travel journal in Shifting Gears. With disarming wit and humor, he teaches you exactly how to optimise insulin therapy.
Dr Lake demonstrates with brutal honesty, innovation and self-awareness how his 5 foundations process allows for the lowest and safest insulin doses. This book is a must read for anyone interested in understanding insulin, because Dr Lake’s experiments bring us a wealth of knowledge and scientific data that inform us of a better way of delivering healthcare.”
All Book Reviews
The new Bernstein for T1D
What an amazing feat! I enjoyed it immensely and found it hugely informative, really like the way you weave the narrative with the science.
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It should be compulsory reading for all clinicians working with people who have type 1.
This is a must buy book for any type 1 diabetic. It’s also very informative for anyone with type 2 diabetes or anyone interested in metabolic health.
Written by a doctor who has type 1 diabetes, it explains the condition so well. The reader is taken on the long cycle ride with Dr Lake and learns along the way. What impacts blood glucose levels and insulin? What impact does exercise have? Food? Fasting? Sleep etc.
It’s really well written – an interesting and easy read – and it’s really encouraging. If you are someone struggling with blood glucose control, or know someone who is, this is going to be so helpful and positive.
ZVH, United Kingdom
New Insights
I’m halfway through your book – what a wonderful, delightful book you have written. I’m enjoying it so much and it’s giving me new insights.
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The way you alternate descriptions of your journey with your personal experiences and professional insights makes for a truly enjoyable read. And what a beautiful journey that was—in true Ithaca style! Many thanks
TK, The Netherlands
A rare clarity and courage
Dr Lake brings rare clarity and courage to the management of T1 diabetes. Weaving his cycling journey across Europe with the equally demanding terrain of B/G management
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he combines lived experience with medical precision to transform daily guesswork into thoughtful, strategic care — showing what is truly possible.
JHM, United Kingdom
1 to 1 Coaching
I've halved my insulin
I wanted to update you, as it’s been 4 weeks since starting a ketogenic diet. I had my first appt with my consultant today. In 4 weeks, I’ve halved my TDD of insulin, reduce my weight by 4kg,
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BGs have been 100% in target range and I can run for greater distances, (…). Anyway, I feel great and I going to keep working hard to manage my T1DM using your approach.
NS, United States
Headline News!
I am baffled why this is not headline news. Utterly baffled. Thank you for trumpeting the message!
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In the US control is horrible. Physicians see me with non-diabetic numbers and look at me as if I am a unicorn that just stepped off of a space ship. Ha!! The sad thing for me is knowing I went over 50 years with such unhealthy numbers. Water under the bridge I guess.
RK United States
Huge contribution to change
I want to share with you that my medical treatment team in the hospital is making a change in their view and guidance of type 1-diabetes.
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There it was so very difficult to get them to agree with the view of a low carb/ketogenic lifestyle, this change is happening. (…). I want to thank you for your sharing of knowledge (also online) and experience in a way that I could keep trust has made a huge contribution to this.
TK, United Kingdom
Type 1 Keto Courses
Feb 2024 Course
My experience of going keto has been nothing short of life changing. Before, I tried all the conventional advice — a (relatively) good diet, regular exercise, carb counting, and the pump. None made any significant difference.
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BWith keto, I’ve gained both control and freedom. Previously my HbA1c was typically mid to low 60s (8%). Now it’s in the non-diabetic range at 40 mmol/mol (6%). Thanks to the work of Dr Ian Lake and his team, I am in the best health possible.
CG, United Kingdom
June 2024 Course
I have so much positive news on my metabolic and T1 health. My lack of energy seems to have gone. My brain fog is no more.
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My dynamic ‘get things done’ energy has gone up 200-fold. To the point where my partner is looking at me askance, wondering where the old Emma has gone. I think he is genuinely worried that I have become a new person.
EC United Kingdom
2025 Attendee
I just wanted to take a moment to say a huge thank you for the incredible programme you’ve run this past week. It has truly been a life-changing experience for me
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Not just in terms of the invaluable advice and knowledge you’ve shared about managing type 1 diabetes, but also because of the amazing people I’ve met along the way. I feel like I’ve gained lifelong friends and a newfound confidence in handling my condition
PG, United Kingdom
Discover Shifting Gears
A practical, evidence-informed guide to insulin, nutrition and living well with Type 1 Diabetes.
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