CHAPTER 5 – How a Type 1 diabetic doctor runs half marathons on a ketogenic diet

National guidelines currently cling onto the belief that a healthy, balanced diet must contain a lot of carbohydrate and not a lot of fat. But the evidence is suggesting that this is not the case at all. The reverse is likely to be true, more fats from real food sources and restricted carbohydrates.

Slightly more troubling is the notion that the high carbohydrate model can be extended to diabetes, which is a condition of carbohydrate intolerance. If you have a carbohydrate intolerant body, why on earth would you feed it carbohydrates? Most of the old school would reply with ‘because it is a major food group and is essential’ (which of course it isn’t) as if it was as obvious as the fact that the sun goes round the earth. But now there is new thinking on this which is getting good results. A paradigm shift is imminent. But the old paradigm has dug its heels in. Big time. Some influential scientists have made the age-old mistake of seeing their speciality as a fact, not a current best-fit, and have become high priests of their own quasi-religions. Business has of course moved in to exploit an opportunity. As long as the old paradigm can be propped up, that will be the case. But in the end the new paradigm will replace the old one. It is the order of things.


Unless they have diabetes, or are close to someone who has, clinicians would find it difficult to imagine what us diabetics go through on a daily basis. For example: forgetting if we have taken our insulin doses; running out of supplies; eating out and forgetting insulin, or worse, injecting early and the food arrives late; feeling hypo and having no glucose; just not feeling right and wondering if it is due to glucose or not; being drunk and not knowing if the morning after is a hypo or hangover; re-using needles or injecting through clothes to be discrete. Life as a diabetic is a constant struggle, trying to master the almost impossible dark art of carbohydrate counting and medication balance. Mini-hypos are not uncommon, but dangerous ones are rare. I have had hypos regularly for 20 years, but I’ve only been caught out twice, when I needed help, and both were due to my stupidity.

However, despite some of the best medical care in the world, I was not doing as well as I would have liked. My HbA1c was creeping up and my insulin doses were increasing. The thing was though, it really was not lack of effort. But the nuancing of the advice in my medical consultation made me think it might be. Was I simply not trying hard enough, (or was that just my paranoia)?

Extract from Chapter 5 – Diabetes Unpacked, by Dr Ian Lake

CHAPTER 5 – How a Type 1 diabetic doctor runs half marathons on a ketogenic diet

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