Managing Type One Diabetes With Keto, Episode 9

So welcome everyone, I'm joined here today by Courtney. Courtney is a wonderful lady that I have been following for a while on Instagram and she utilizes the keto lifestyle to help manage her type 1 diabetes. So welcome Courtney.

Hi, thank you.

Thanks for joining me. If you can maybe just start out by— obviously if people are listening to this on the audio version, I read your bio and so they already know a little bit about you, but can you say kind of in your own words a little bit about your background and how you came to start eating in this way?

So I'm type 1 diabetic and I've been insulin dependent since I was 3, so now I'm 38, so it's been quite a while. And because I'm, I'm very active, I do bodybuilding and boxing and all kinds of workouts and exercise, exercises. So that sounds great, like, oh, you're so— you're going to be so healthy, but it's hard to manage the blood sugar levels. They go up and down, up and down, and so, you know, our doc— my doctor, my endocrinologist, has always had a hard time with me in particular. My A1C levels haven't been great, and then I also have a coach for my bodybuilding competitions, And I did competitions probably for 4 or 5 years, and then my body just was like, okay, I'm done, I'm done with it for a while. So I still, I kept, you know, I still have a coach, and my body just wasn't responding to the usual diet and workout regimen that typical bodybuilders use, like with carbs. Um, and the diabetes I think is part of that too. So he just said, probably in like 2019, I'd never even like really heard of keto before. I'd heard of it, but in my head it was like, oh, all you do is eat almonds and like butter, fat, like just bad stuff like that. And I was like, I would never want to do that ever. But then he mentioned it and he said, hey, have you heard of keto? Let's, we should just try it out. And I, you know, I read more about it, and it's not a— like I said, it's not a typical bodybuilder's diet. So I said, why not? Let's just try it. And then I realized it was good for blood sugars, and I kind of just— I really— it was really hard. It was really hard to switch over, but I'm super focused and dedicated if I'm trying to do something. So I was on it for like a year and it helped my blood sugar levels and I was able to lose some weight on it. And yeah, that's how I kind of fell into it.

That's awesome. Well, so just to give some people background, so maybe some people listening to this aren't as— I mean, I think everybody at this point is pretty familiar with type 2 diabetes, which is an adult onset process usually brought on by poor metabolic health and sometimes is a result of years of abusing your body with like a lot processed foods and a lot of sugar, but type 1 is quite different because it's really considered an autoimmune disease, correct?

Yeah, yeah.

So, so at some point your body basically had attacked your pancreas and your body is no longer able to make any insulin at all. So is that how you would characterize the difference?

Yeah, so when I tell people, because people that aren't familiar with like the two different types, uh, they say, but you look so healthy, like you don't look like you're diabetic. But that's the problem, you could be super healthy, but if it's an autoimmune disease, it's still attacking the pancreas, and no matter what, you're never going to start having that insulin ever again. So, unless there's some kind of cure, which of course I'm always hoping for, it's pretty much— I don't know anything else because I've had it for so long. So I have to have it, I have an insulin pump, and also a continuous glucose monitor, which is kind of a recent development in the past few years. So, but I always have to have the insulin attached to me. I can't make any whatsoever.

So, and because this is also a new idea to some people, I've done some reading of the research, and seeing as you have a background, you have a doctorate degree in, was it— remind me again, it's, uh, physical therapy, right?

Yeah, I have a doctorate in physical therapy and then my undergrad's in athletic training, and then I got a certification in strength and conditioning.

So obviously you've had a lot of education in how the body works, how physiology works, right? And yet for some reason it wasn't until the last couple year or two that you heard about, you know, possibly using a diet like to manage your blood sugar. So I'd be really interested to hear what your experiences was as you transition into keto and how managing your blood sugar has changed since you changed your diet.

Well, the level— again, I'm not like— my A1C still is not perfect because I still work out a ton and we're— yeah, it's always a process for me. Um, but I noticed with the keto, like when I first, first started it, The first week, like, my blood sugar levels were like perfect, and they didn't like go up and down and up and down, and it's just because you basically take those carbs out, because when you have the carbs, it spikes the body to have the insulin, and then things kind of go all over the place. But my A1c level did go down initially, and then my body just wasn't responding. After, I was on keto for like a year, so my coach said, well, let's go off it for for a while, do the carbs, and then I noticed everything was spiking again, like the second I stopped keto. So I went off of keto probably for like 4 or 5 months at the beginning of 2020, and I said, hey, I want to go back on, I want to go back on keto. I want to see if maybe I just needed to be off it for a little bit. And so I've been back on it for 8 weeks now, and I lost like 5 pounds, and then my A1C level went down.

So, and also just in case, I think probably people that are listening to this are pretty familiar with A1C, but that's actually your average blood sugars over the last 3 months, right?

Yeah.

And so what would be typical in trying to manage your diabetes before? Like, what was your A1C before you really started to get a good handle on it?

Um, well, I, I, it's very high still, so, but it just going So I had spiked up when I went back on carbs, so it was at 8.9, which is very, very high. Um, but then after only 7 weeks on keto, it went down to 8-ish. So that's a big, like, that's a big jump down, decrease, just in 7 weeks. And my doctor wants me around like 7.0, but non-diabetics are probably 5 to 6.0.

Yeah, actually I think I have to look at the reference range and maybe I can like put that in text here on the video, but I think mine has been in the 4s since I've been on keto. But I'm not, I'm not type 1 diabetic though, so that's a little easier for my body to accomplish. Um, but I think you actually start getting out of the reference range maybe in the high 5s. I, I know 6 is definitely like diabetic or pre-diabetic, so for most people they want some kind of range between between maybe like 4.5 and 5.5, something like that. So because you don't have a pancreas, obviously your body has more of a challenge in maintaining that level.

Yeah, that is all my other, like, all my other lab work, blood work, everything else is perfect, but it's always that A1C that— because I'm diabetic, so I'm always trying, trying to control it but still do the workouts and everything I love to do. So Hopefully, hopefully it keeps going lower and lower if I stick to the keto.

Yeah, and it'll be interesting to follow up with you because I think before— how long had you been on it the first time that you tried it? Because you initially tried it more for the bodybuilding than for blood sugar management, right?

Yeah, yeah, and then I just happened to see how good it did go on the keto. And I mean, nothing against my endocrinologist, but no one had ever mentioned keto to me for diabetes management, right? And, but it was my coach that actually was the one that brought it up, and I'm like, oh my God, this is helping both. So that's how I, that's why I liked it. It was like two things in one.

Yeah, no, that's pretty amazing. Um, and just for other background information on managing diabetes, so you have, I think you told me you have an insulin pump, correct? That's like basically kind of installed in your body at this point. Um, and then use the continuous glucose monitor. So For those that aren't familiar with the continuous glucose monitor, it's something that goes— I've had one too, you probably saw that, just for fun or for purposes of what I write about, I tried one. It goes on the back of your arm. It actually has a little teeny— it doesn't hurt to put it on, but it has a teeny little pin that goes into your interstitial fluid, which is actually a proxy for your blood sugar. It's not a direct measure, but it basically shows trends throughout the day. So maybe— did you have the glucose monitor? Glucose monitor, um, prior to trying keto, or no?

Prior to keto, I had just started it. Um, I had just started it, so I haven't had the CGM— the glucose monitor— CGM, I haven't had it that long. Okay, but the ins— like, this is the insulin pump.

Oh, nice.

So that— this is, this is what gives me my insulin. I've had this for a long time.

And so does it Does that kind of monitor your blood sugar as well, or you just release that when you need it?

Well, the CGM, the glucose monitor, talks to that insulin pump now, which is what makes it so great. It talks to the insulin pump and it kind of adjusts the insulin levels for me, and you know, that's something else that's been kind of helping with my blood sugar levels along with the keto.

So that's a more, kind of a more automatic thing somewhat now than it used to be, having it attached to the continuous. And so what did you notice, if anything, with the continuous glucose monitor? What were some things that you were surprised about? I think like most people get kind of freaked out when they test their blood sugars because they don't know that exercise increases your blood sugar level, right? Which is maybe one of the challenges that you have with your A1C because you do work out a lot. Um, so maybe you could talk about that relationship and what you noticed on the monitor.

Well, what I was noticing was that I would do cardio, and you can see like the graph of your blood sugar, and it would start like dropping. And I didn't even know this before I had the glucose monitor, but then I noticed when I started lifting weights, because I'll do cardio, then I'll go lift some weights. When you lift weights, it makes the body release the glycogen out of the muscle, and and which starts increasing your, your levels. So, so it really helped me to be like, okay, my blood sugar is dropping, maybe I should stop the cardio right now and switch over to lifting the weights so that I don't have to eat something instead, right? And make things— yeah, so I'm trying to do it without eating and spiking any more insulin.

Now that's a very interesting application of that, like probably something most people wouldn't think about. No. And you also did some, when you were saying like bodybuilding, I also noticed you did bikini contests at one time. Is that something you're still doing?

So yeah, it was a bikini division that I did. Gosh, I did a ton of different shows and it requires a lot of working out and diet and you count your macros and it's very specific and I kind of fell in love with it. So I did a lot of those shows, but the last one I did was in 2018. And I said, well, I like, I did them for years in a row. So I said, I gotta, I gotta take a break. So I took a break, but I'm still doing all the crazy workouts and the dieting too. I'm hoping at some point I might be able to go back, but for now it's just the workouts. Yeah.

And how was that when you would do the shows with having the insulin pump, and did you notice that the stress of doing a show had any impact on how you were feeling and blood sugars and that sort of thing?

Oh yeah, especially on show day because you're just really stressed out. And so my blood— I didn't have the CGM at that time, so I would just take my blood sugar level like with a finger prick, and it would be like in the 300s, like when I'm about to walk out on the stage and It's just, it was crazy because you didn't want it to be super low because if you get low, then you know, you get foggy and dizzy and you can't, you might fall on stage. You don't want to do that. So you're like eating candy on the side just to make sure you're fine. And yeah, it's very stressful. Like, and then once you're done with the show, of course, all the bodybuilders, the first thing they want to do is eat donuts and go get a hamburger. My thing was nachos, so I would try to take a ton of insulin after my show and try to counterreact everything that my body hadn't been eating for months, right? And it just like the roller coaster was with the blood sugar levels was— it was difficult.

Well, yeah, more challenging for you than somebody that is not diabetic, obviously, but I think it's something that's underappreciated by people is the, you know, the effect of stress and sleep on blood sugar management. And I think that becomes more apparent when you wear a continuous glucose monitor, whether you're diabetic or not, because you can see how individual situations affect your blood sugar outside of food, you know.

Well, and then like, have you heard of like the dawn phenomenon? Yes, when you first wake up. Yeah, so I didn't even, you know, I was just like, I don't pay attention, I wasn't paying attention to that, but because is the CGM, it was kind of showing me when I first wake up it would go up, and I was like, oh wow, that's— I just didn't realize this stuff was happening. And I work out really early in the morning, so that kind of helped. If it would go up a little bit and then I do my cardio, and that would kind of lower it a little bit, you know. It's just a bunch of trial and error with what little things that could affect your blood sugar level that people don't realize because especially if they're not diabetic because their body just kind of reacts to it, right? So, and it's like I have to every day— I think there's— I read something that diabetics have to make like 300 decisions a day or something based on what they're eating, how much they're eating, the insulin they have to take, what's affecting it, right?

So yeah, and I will say, I think especially at least for, you know, type 2 diabetics, they still make insulin, so it's a little different. So once they start really evening out their blood sugar throughout the day, that takes away a lot of decision-making, at least in the Type 2s' case, because yeah, you no longer— when you don't have those spikes, you don't have those hangry episodes anymore, you don't have that, you know, funny woozy feeling like you're getting hypoglycemic, and it's just like everything is very easy and it makes decisions a lot, a lot easier.

And then sometimes people like for food, people like I I stay away, well, definitely because of keto, I don't eat pasta, like real pasta kind of stuff, but before keto, like I stayed away from bread and the starchy stuff anyways because it wasn't worth it because it would just like spike the blood sugar up so high that I didn't know really how to do it, so I just learned to stay away from some of it, or you know, portion control it, so I'm not even a big fan of bread anyways, which works for keto.

Yeah, absolutely. I know, I wish, probably everybody wishes they could say that because that's the one thing that I think people have trouble giving— well, many things that they have trouble giving up when they go keto, but you know, they're like, oh, what do I do for a sandwich? Or what do I do about, you know, whatever. Um, so since you've done this for so long, and I know you haven't been like fully keto, but you have monitored your food for various reasons, whether it's the bodybuilding competitions or whether it's, you know, trying to control your blood sugar. Like, you realized even without him telling you keto, that obviously that bread might not be worth it because it just sends your blood sugar so high. Do you have any practical advice for people that are, you know, just starting to get the idea that, hey, maybe this reducing carbs and sugar is a good idea and how they might go about, you know, doing that in the beginning, like some things that you learned along the way?

Oh, if they're just starting out like on keto?

Yes.

Practical stuff. So I count my macros. So I know, like my coach gave me certain amounts to eat. But if people aren't really kind of monitoring in the beginning, sometimes they have no idea if they're really eating enough percentage of the fats versus a little tiny bit of carbs and then the protein. Because I've read up on some people, they'll just, or it seems like they just eat everything they can that has to do with fat, but yes, keto is high fats, but you need to make sure it's good fats. It can't just be the disgusting like oil and, you know, it's really— I like to do my research with all the foods and stuff that I put in my body, so I had to really figure out what kind of fats were good fats versus not, you know, not good fats, and I didn't want my cholesterol to be really bad either because of the types of fats I was eating. Because initially it did spike up my cholesterol, and then I started monitoring the types of fats I ate. And it sounds annoying in the beginning, but then you get used to it and you know which ones are the healthier kind.

Right. And I think just to follow up on that point, for people that are new, the two things that I would recommend that you avoid like the plague, and there's some other— you would like this since you like research— there's some other evidence right now that stearic acid versus linoleic acid, it has to do with polyunsaturated fats. So for— if anybody doesn't know about polyunsaturated fats, it's basically like anything that they're making into an oil that should have never been oil to start with, like soybeans or corn. Those are the two— soybean, corn, canola— avoid those like the plague, basically. They're just— they really affect you on a cellular level. They actually tell your fat cells, like, not to release fat. It's kind of what it boils down to, to put it in layman's terms. But there's some interesting science around that. So I love the fact that you're focused on finding, you know, really healthy fats to use as energy in your diet because basically fat and carbs are both energy and you're just kind of replacing one with the other basically once you go keto.

Yeah, yeah, and then, um, for like when my, my fat, my HDL/LDL, like initially when I first started keto it spiked up super high and then my doctor was like, well, I don't know if keto is good for you because look how high I And I said, well, if you look at the research, it's going to go up a little bit, but it depends on the— like, I had to teach her about it. But then it was kind of a little bit higher than I wanted, so once I focused in on the types of fats, it lowered back down. And she— my doctor, the next appointment, she's like, uh, did you stop keto? What did you do? And I was like, no, I just paid attention to what the heck I was eating, right?

Well, I think people don't realize that Uh, cholesterol is, is very transient marker. And there's actually this guy, Dave Feldman, that talks a lot on keto podcasts and stuff, and he does a lot of research on cholesterol. And he can manipulate cholesterol as much as 200 points in either direction just by what he eats and by fasting. It's really, really interesting. So I would just say to cons— like, for everybody, consider about cholesterol. It's like, well, is it— it's a It's a snapshot in time. And so especially if you're making a big change like keto, for example, you might find that those numbers change quite a bit, but then your experience, it kind of all settled back down. And particularly when you were even more focused on, okay, I'm going to eat these better kinds of fats for me. And it, and it seemed to, you know, make things be more in line after a while.

Yeah. Yeah.

That's a good one. Um, any particular favorite, like keto substitute kind of— so, you know, because you've been around my page and stuff, that I'm really about whole foods keto and clean keto and all that. But in the beginning, when people are transitioning, it can be challenging, right? So were there any products that you found that are kind of like little replacement kind of things, or treats or something, that helped it make it easier for you to transition back? I know you said you're a super focused person, so it might be easier for you, but just like for other people that might—

oh no, I'm very— sweets, but I've had to find the keto sweets instead. So not to talk bad about like the keto companies, but you know, there's a lot— just because it says keto on the bag doesn't mean it's like good for you.

Yes.

And I learned— I had to learn that too because I— because now I look at the ingredients and I'm like, oh, that's not good, that's not good, that's not good. And it was just kind of— it just wasn't good. But I do like making like the cheesecake kind of keto versions of cheesecakes, and those are kind of the sweets, the treats that I eat. But I use like the Swerve loaf and the Splenda kind of sweetener, sugar things, because those didn't spike my blood sugar. But something— I don't know if other diabetics have noticed this or not that do keto— soluble corn fiber. Have you heard about that?

Yeah, it's Well, it's not good in multiple ways. A lot of people have GI issues with it. Did you have the GI or did you have the blood sugar?

No, it tastes like some of the stuff— I won't name the people, but, or the company, but it tasted so good, this chocolate. But then I noticed it would like just spike my blood sugars up like no other. And I kept like, what is it that's in this stuff? And so then I, you know, because I did my research more, and I found out it was the soluble corn fiber that was in it, and I had no idea that it affected me like that, like so bad. And come to find out, I guess like 5% of people, it spikes up their blood sugar.

Mm, it happened to me once.

Whether you're diabetic or not, it just like spikes it up, and it's just a really— you know, if it doesn't spike it, then great. But man, so every time I see soluble corn fiber in the ingredients of sweets and stuff, I get so bummed, especially if it tastes good.

Yeah, and I can't figure out if it's more prevalent because it's a texture thing, particularly with chocolate like you mentioned. I think it's in a lot of ice creams as well, or if it's more about adding that fiber to the product so that they can then lower the net carbs, which is probably what it is.

But yeah, that's all about corn fiber. Man, it was just like such an eye-opening— like, I was like, oh no, this is my favorite chocolate. So now I have to be really— I still eat some of the chocolate, but I have to be really careful.

Yeah, so good reminder to people, like, even if you are going to try a partelia packaged keto treat, that there are some extra ingredients and everyone's a little bit different, everyone's a little bit bioindividual. So if you really want to know if it spikes your blood sugar, which, you know, depending on what your goals are and depending on if you're diabetic at all or not, that may or may not be that much of an issue for some people. But obviously for you it is because it affects like how much insulin you're going to need to use and how you feel and, and all of those things. So it just depends on people's goals, I think, whether they need to know if that spikes their blood sugar a lot, you know.

Yeah, yeah.

Um, yeah. Any final other last thoughts on keto? Anything that we haven't talked about or, um, just that you would want to add that might give some value to people that are trying to, you know, figure out how to make this lifestyle sustainable?

Well, I think you have to kind of go all in. Like, if you're going to do it, you have to do your research, you know, educate yourself on the good foods, the bad foods, you know, ask people that know about it, like people like you, and you have all the good tips, and make sure you account for what you're eating for. Maybe, you know, talk to someone about the amounts you should be eating, and like really, really put your effort into it to see how it is in the beginning, And if you put 100% into it and you don't end up liking it, that's fine, it's just not for you, but who knows, you could really like it, like it could benefit you like it did with me. I've had friends that, you know, they see the difference in me and what I do, and they're not diabetic at all, but they're like in my boxing class or boot camps or whatever, and so they want to try the keto, or just other people want to try it, and they're like, "Oh, let me try it, I'll try it," and then they only do it like for like a week and they're like, "I couldn't do it," and I was like, "Well, did you see any benefit?" "Well, yeah, but then I wanted to eat the bread." So then they eat it and then they're eating the carbs and the fat, and I'm like, "No, you can't do that." So my advice would be put yourself 100% into it if you do want to try it and educate yourself first. Don't just wing it.

Yeah, totally agree. It makes it easier when you at least have some background. And one of the other, one of the other interviews that I had, we were talking about how it makes it a little easier when you figure out your why for doing this, because it, because it is a big lifestyle change. And so obviously now you, that you know that it can help manage your blood sugars, I mean, I'd imagine that's a pretty big why for you. Any other things that it, you've noticed it affects that You would say why?

Well, you know, my focus is a lot on like the bodybuilding and the workouts, and I just didn't want to keep gaining weight. I wanted to lose a little bit of weight for bodybuilding kind of stuff, not because I thought I was fat or anything, right? But so that was the other reason that I went on it. So that was good. Do I miss like my Cinnamon Toast Crunch and stuff? Yes, of course I do, but You know, there'll be another time when I can have that. That's always going to be around. Yeah.

Actually, just on that note, I one time somebody sent me this thing called Catalina Crunch that I think was pretty similar to—

Yeah, I eat that. Okay. Yeah.

And that one doesn't mess with your sugars?

No.

Good. Awesome. That shows you how everybody's a little bit different though, because I'm not even diabetic and I had some, and for whatever reason, for me, it messed with mine. Like, I got a pretty big— yeah, I got a pretty big increase.

So, yeah, I don't remember if there's soluble corn fiber in there, but yeah, I just found that at Sprouts like a month or two ago. Yeah, and one of them was cinnamon toast, like cinnamon toast or something, and I was like, hmm, all right, let me try it. Like, I looked at the ingredients, it wasn't like too horrible, and then I was like, wow, this isn't bad.

Yeah, no, that's— and that is the thing, like there's a catch-22 with all the products because as you mentioned, they're not all good just because they say keto-friendly. But I do think the beauty of it is if there's something particular like you just mentioned that you really miss like that, yeah, if you can find a substitute, even if it's not perfect, even if it's kind of, you know, a little dirty or whatever, it still helps people transition or it helps them that occasional craving that they're like, oh, I just really would love to have that again, but they know it's you know, not really in line with their goals, so they could pick something that's a little substitute instead.

Well, one of the hard things in the beginning when I was doing it was, you know, you go out with people and you want to eat with people too, and it was kind of hard because people don't— a lot of people, they haven't done keto before, they have like, I don't know, kind of a bad— I don't know what the word is— they just, "Oh, you're doing keto?" And I'm like, "Yes, yes I am!" So I always try to look ahead of time wherever we would go out to eat and like look at the menu. I mean, it's not that hard to order stuff that doesn't have that much carbs in it. So you just have to think about it ahead of time too.

Yeah, that's another great tip is look at the menu ahead of time. That way the decision is kind of already made, you don't have the temptations. Know that it's going to work for you and just move on.

Keto is a lot more popular in these past few years, right? Yeah, so even like restaurants and stuff, they have keto options too.

So yeah, actually I was shocked. So last, uh, January of 2020, right before the whole COVID business went down, I was in Banff snowboarding and we went somewhere for breakfast and they had like 2 or 3 like fully like keto section that said keto meal. And I was just like, leave it to Canada, right? They always, they always do it right up there. But I was like, that was so amazing to just see keto on a menu without any modifications. Didn't have to, you know, order. And it came, it was like bacon and avocado, um, maybe a couple berry— I don't know, it was an amazing breakfast. Eggs, of course. Um, and it's like, how hard is that? It's not hard at all.

Well, how hard is it Just order an omelet, like, without the hash browns.

Right, or without toast.

That's hard.

Yeah, yeah, it's totally not that hard. Well, um, thank you so much for joining us today. I'm so happy to have finally gotten to talk to you in person instead of just on Instagram. And, um, let me know if you have any final little thought here that you want to share with people, but other than that, I think we've had a great little chat.

Yeah, I mean, if anybody has any questions as far as like Working out and diabetes and keto.

Yes, and obviously where can they find you? All of the social media, all of the websites, all of that stuff.

I'm not a doctor or anything, but I can tell you my experiences. So just on Instagram, it's @cornut34. It's C-O-R-N-U-T-3-4.

Okay, and that'll be obviously in the show notes as well. And so that's the best way for people to contact you if they have questions?

Yes.

Okay, awesome. Well, thank you so much again. I really appreciate you joining us.

Yeah, thank you.