Note: This article is a personal account, and I have written consent from the person whose story this is, to share these details in this article. She hopes it encourages someone. Keep in mind, individual results following a low carb or ketogenic diet vary person-to-person.
At the end of May, a young woman was coming to see me for an assessment appointment, and as I was reviewing her chart in preparation, I noticed that she was taking insulin. It was apparent that she didn’t see the notice on my web page that I don’t treat Type 1 Diabetics or Type 2 Diabetics on insulin, as I am not a CDE (Certified Diabetes Educator).
Discontinuing Insulin
When she arrived, we discussed some of the options she had, and she decided to go and see her endocrinologist and request that they discontinue her insulin and give her 12 weeks to follow a Meal Plan that I would design for her. She then signed and sent me the Confirmation of Non-Insulin Use Form, indicating that with her doctor’s permission and oversight, that she was no longer taking insulin. To support her in being successful, she decided to book weekly 1/2 hour check ins with me for the following 12 weeks.
Note: If you are taking insulin to manage blood glucose in Type 2 Diabetes or other medications do not attempt to discontinue these on your own, as the results can be very serious. Please read this post titled “Don’t Try This at Home – the need for medical supervision” for more information.
Last Friday was her first follow up appointment and she was very excited to show me her blood sugar results, her first week off insulin. Here is the graph;
As can be seen, her fasting blood sugar the first morning was 16.8 mmol (303 mg/dl) which went up to 18.7 mmol/L (337 mg/dl) 2 hours after her low carbohydrate breakfast.
The following morning her fasting blood glucose was 12 mmol/L (216 mg/dl) where it stayed more or less for a few days, then dropped to 9.9 mmol/L (178 mg/dl). This was after only one week.
I asked her to speak to her doctor to see if they would be willing to add a dose of Metformin at bedtime, to help control “dawn phenomenon”; the rise in glucose due to gluconeogenesis of the liver. Her doctor agreed and this week she started that.
This morning was her second follow up appointment and again, she was so excited to show me her blood sugar results.
As can be seen, her fasting blood sugar the first morning of the second week was 10.8 mmol (195 mg/dl) which hardly went up at all to 10.9 mmol/L (196 mg/dl) 2 hours after her low carbohydrate breakfast.
The second morning of the second week, her fasting blood glucose was 9.2 mmol/L (166 mg/dl). The rest of the week, her morning fasting blood sugar ranged from 8.4 mmol/L (151 mg/dl) to 9.6 (173 mg/dl) where it stayed. This was only her second week off insulin.
Moderate Low Carb (not Ketogenic) Diet
Understand, that this young woman (aged 33 years of age) achieved these results eating a moderate low carbohydrate diet of 130 g of carbs per day — which is no where near the level of 25-35 g per day that most women would need to be at in order to be in ketosis, and she has been Type 2 Diabetic since 2017.
Here is the graph of her first two weeks of blood glucose results, tracked at fasting, before a meal, and 2 hours after a meal. The steady, linear drop is quite apparent.
She saw her GP yesterday and he is thrilled with her progress! He agreed to provide her with a requisition to do the fasting insulin that I requested, along with a fasting blood glucose and HbA1C — which we have agreed together to have re-run in 3 months, at the end of the 12 weeks.
For this week, no changes are being made in the number of carbs she is eating, however this may be adjusted in the future in order to achieve clinical outcomes.
These results speak for themselves in terms of the effectiveness of a moderate-low carbohydrate diet to significantly lower blood sugar, as well as the adjunct treatment with Metformin, largely to control early morning gluconeogenesis.
These results also speak to the incredible benefits of her having the support of a healthcare team; me designing and monitoring her Meal Plan and her GP overseeing her care, along with her Endocrinologist.
In two weeks she will see her Endocrinologist again and she (and I!) are looking forward to hearing their response to her progress at that point in time. Given her results the first two weeks, I am confident that she will have much to be proud of!
When I asked her to send me her written consent to share these details in a blog article, I ask her to say a few words about what it was like for her to go from injecting insulin to control her blood sugar, to eating real, whole food to do it — and achieving these types of results.
This is what she wrote;
“I had done so much research into diet and lifestyle changes for Type 2 diabetes as I did not want to go on insulin. Prior to starting on insulin, I was put on Metformin and given the chance from my endocrinologist to change my diet. There was so much information about a low carb diet and its positive effect on blood sugar, so I gave it a try. It could be that I was overwhelmed, but I followed what I believed to be a low carb diet and did not see any significant changes to my blood sugar levels. They were all over the place with huge spikes, even when I would have zero carbs. Clearly something was not right. It gave me no motivation to continue and really made me feel defeated.
I knew I needed help and the only answer my endocrinologist gave me was a prescription for insulin.
I started insulin and was on it for 2 weeks without seeing any significant changes in my blood sugar levels again. This was not working.
So I decided to look for help on the nutrition side of it. Then I found you, Joy Kiddie. I read a little bit about your journey and it inspired me that you have been in my position and therefore would understand my challenges. Your journey gave me hope that there is still something that can be done. Meeting with you was even more of a motivation because you wanted what I wanted; lower A1C and more importantly, no insulin!
These past two weeks, following your guidance and eating a LCHF diet the right way, has been eye opening. I never thought I would get results like this in such a short time.
I used to hate checking my blood sugar levels and poking my poor fingers just to see a discouraging number. Now, I could check all day long because I see numbers that I never thought I would.
Seeing the levels come down and that linear decline in the graph just encourages me to continue down this path and work with you to create a healthier lifestyle.
I cannot wait to see what next week brings!”
For the last 4 years I have been working with those with Type 2 Diabetes and seen so many significantly improve their blood glucose management, and lose weight. Working with this young woman has inspired me to consider learning about insulin management and writing the CDE (Certified Diabetes Educator) certification exam next year while I will continue to partner with people’s GPs and Endocrinologists (as is my current practice) to wean them off insulin while using a well-designed low carbohydrate diet to effectively manage their blood sugar. The literature, including the studies from Virta Health demonstrate it can be done safely and effectively and the American Diabetes Association recognize both a low carbohydrate meal pattern, and a very low carbohydrate (ketogenic) meal pattern as Medical Nutrition Therapy in the management of pre-diabetes, as well as Type 1 and Type 2 Diabetes in adults. For more information on this, please see several articles from April 2019, under the Science Made Simple tab including this one.
My hope is that in the days ahead, Diabetes Canada will arrive at a similar conclusion as the American Diabetes Association, the EASD, Diabetes Australia and others and recognize a low carbohydrate and ketogenic diet as options for those with Diabetes in Canada. Towards that end, I want to be credentialed as a Certified Diabetes Educator in order to be able to support those using insulin.
If you would like more information about my services, please have a look under the Services tab or in the Shop. If you have questions, please feel free to send me a note using the Contact Me form above and I will reply as soon as I can.
To your good health!
Joy
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LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the ”content”) are for information purposes only. The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything you have read or heard in our content.
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