Peter Attia· MD
CGM is essential and then in the toolbox there's a few other key thing but the the most important thing is information so you gotta have Bernstein's book you should be following type 1 grit which is this Facebook group which I'm again which is a wonderful place to learn about low-carb but there are wonderful podcasts and also some terrific YouTube videos talking about the intersection between low carb and type 1 I want to put in a plug for an organization called low carb Down Under ok which is really a wonderful group of people at dr. roger Taylor in Australia in Australia yeah dr. rod Taylor is an amazing character he's an anesthesiologist in Melbourne and a passion passionate advocate and supporter of all things low carb and his organization goes around the world doing AV capture of low carb talks and so on YouTube they have a YouTube channel with over 8 million views on various low carb things including some terrific talks on low carb by for instance dr. Troy Stapleton who's a radiologist who got type 1 diabetes himself and figured out how to hack it using low carb where does he live he is in Brisbane ok he's an amazing person very nice so there's this growing community of low carb nerds who are trying to help people with type 1 and again there's a bunch of different places where it's happening there another really nice resources Adam Browns book which is called bright spots and land mines and he works for close concerns and he wrote this book essentially as the manual for diabetes that he wish he had been given and it contains lots of tips and tricks about how to think about living with type 1 and it's from wellness to exercise to sleep all the way to very practical tips around low carb and nutrition and type 1 how careful does someone with type 1 diabetes need to be if they go on a ketogenic diet obviously in patients with a normal pancreas even those who are somewhat compromised by type-2 diabetes I'm not aware of any case of ketoacidosis right diabetic ketoacidosis but in patients with type 1 who have no insulin production that would have to be a real concern wouldn't it well I think that there are some interesting intersections in between hardcore I'm not talking about generic low carb or low carb high protein all of the Bernstein method but let's talk about the people who were trying to get into nutritional ketosis with a beta hydroxy butyrate that hovers around one to two well those people have a couple of unique problems and and one is diabetic ketoacidosis as you mentioned again for the folks to understand why that's the case in you or me even when I'm fasting you know and I fast for a week at a time my beta hydroxy butyrate level will reach six or seven millimolar right but it's not gonna reach 10 millimolar it's certainly not gonna reach 12 or 14 which is where we start to see the acidotic changes because eventually that ketone is going to get elicit some response from insulin right in the person who has no beta cell reserve that