Keto diets, type 1 diabetes, and kidney health - Diet Doctor Podcast

Dr. Keith Runyan has used a keto diet to treat his own type 1 diabetes. He wants to share his experience to help others better manage this lifelong condition.
But he doesn’t stop there. Dr. Runyan is a kidney specialist and provides specialized information to help you better understand the role of keto diets and dietary protein levels in kidney disease and kidney stone formation.
Table of content
0:00 Introduction
1:45 Being diagnosed with T1D as an adult
7:20 Controlling Hba1c to prevent a hypoglycemic episode
16:55 Responding to people with T1D about a specific treatment
19:59 Corollary between T1D and T2D
25:23 Ketogenic diets and the concern with kidney health
34:04 Are kidney stones more common for people eating the keto diet?
38:26 Advice for people with history of kidney stones
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[@DrTonyHampton]

As a doctor trained in metabolic health and with a wife whose a pharmacist with Type 1 diabetes, we totally agree that it’s very difficult and at times frustrating to manage Type 1 diabetes. Looking forward to continuing the conversation with your guest on my Protecting Your NEST podcast in the very near future. Just happy that the Type 1 diabetes patients got a little LOVE with this episode.

[@mshklh2099]

I dunno if you’re up to date doctor but there is a device that type1 diabetec wears , functions just like normal pancreas producing insuling throughout the day and you increase the dose by phone before eating or something My neice wears it on her shoulder arm(sorry i’m not english)

[@DrTonyHampton]

@@mshklh2099 Thanks for the heads up. My wife has not used this yet, but it's something we are consideirng

[@ivettesantana4319]

@@mshklh2099 You mean the insulin pump

[@mshklh2099]

@@ivettesantana4319 Something that is stuck to her shoulder

[@NancyEvansUSA]

What 'science' is holding up the standard American Diet as the standard of care? The American Diabetes Association is directly responsible for the massive problems type 1 and type 2 diabetics have experienced over these last 40 years. I have seen the diets they have been promoting and these diets are the DIRECT cause of diabetic complications and progression

[@GregariousAntithesis]

Why isnt using low carb diets for type 1 diabetes the standard is what baffles me. If you eat mostly meat supplemented with vegs you can maintain very optimal blood glucose levels without requiring excessive insulin. I would think maintaining a normal range of 70-140 with meat and vegs.

[@truehealth992]

My husband suffered from terrible gout and had a history of kidney stones. Went on a meat based keto diet (under 30 carbs) and no longer has gout! He eats red meat, bacon, liver, scallops. It’s doesn’t bother him. He doesn’t eat any fruit due to fructose. Amazing watching the uric acid levels go down over time. Now it’s around 6.

[@jsweezey6487]

I'm beyond grateful to Diet Doctor for educating & guiding me to a healthy lifestyle. I'm in shock that an adult can get Type 1 Diabetes... Not one nutritionist told me about this...

[@jgriffin282]

Not enough medical people know this. It’s terrible that approx 10% of adult diabetics are misdiagnosed as Type 2’s simply because of their age.

[@pointshealthcoaching8474]

This is an epic interview and offers astounding information... I hope it can be used by at least the younger doctors... & give ppl choices and best information... thank you so much! Yes, we can be consistent enough to make true changes to our health.

[@jellybeanvinkler4878]

I developed a large kidney stone that the urologist told me would be with me for life. And that it wouldn't cause any issues as it was In a pocket in my kidney far from the urethra (way too big to pass anyway). It did cause discomfort, but he denied it and said it was spinal pain. I think he didn't want to deal with our Tricare insurance. Anyway, I had been on a mostly vegetarian diet with a huge green smoothie every day. Plus, at the suggestion of others, I started calcium supplements in my mid 50's. Fast forward to starting keto/low carb at 63. Three years in, upon retirement, I added an exercise regime as I no longer performed my somewhat active job and gained. I think due to the diet and exercise, I ended up in ER passing a very painful fragment. Scan showed that the stone had broken in two and causing an infection and blood in my urine. 🤦‍♀️ I am also dealing with a possible parathyroid tumor because I've had high blood calcium. I am totally unsure of what caused what... I am going to be seeing an endocrinologist soon. I have my doubts that this doctor will have an opinion, but I will try to get to the bottom of it. My prior Dr never said anything about high blood calcium. I think I may track some of my bloodwork down from previous years.

[@lisagayhart2482]

Wow! Great information and a great interview. Thank you so much

[@GregariousAntithesis]

I dont understand why he didnt say what his basic consistent diet consisted of.

[@donnabronner4837]

Wow! What a great interview.

[@totallifehacker1781]

This is very informative, thank you.

[@k9rescuer934]

Very interesting, thank you!

[@Joro123]

Thank you !

[@paltek149]

amazing. very informative

[@nackyeads2508]

Thank you both! There is so little out there on type 1 diabetes and diet!!

[@johnschlesinger2009]

I'm really glad that Dr Bernstein's book came up. Interestingly, Dr Bernstein says that a ketogenic diet doesn't give people enough protein. This makes sense, as glucose can be generated from protein through gluconeogenesis in the liver. So to use ketones instead of glucose, ketogenesis needs to be induced by high fat, low carb and low protein.

[@krunyanmd]

Not necessarily true John. On page 180 of Dr. Bernstein's book, he recommends a protein intake of 1.0 to 1.2 of protein per kg of body weight per day for most physically active adults and that athletes and children will need more. Dr. Bernstein's diet is a ketogenic diet even though he does not want to call it such. I have been in nutritional ketosis for 10 years while consuming 1.8 grams of protein per kg of body weight per day. In my case, that's about 130 to 135 grams of protein per day. Thus, a ketogenic diet is not necessarily a low protein diet.

[@cireldagagobenitez8618]

@@krunyanmd usted es tipo 1 ??

[@krunyanmd]

Yes. @@cireldagagobenitez8618

[@totallifehacker1781]

Could there be an example of meals regular. Are those times and macros or do you eat the same foods.

[@punkhurst8696]

Could you give a link to a survey mentioned please?

[@Philly1958]

Would like to hear your view of being in ketosis chronically. Dr Saladino just did a video on why it’s not good? I take with he says with a large grain of salt however

[@sigawof]

Most doctors in the field have more than one issue with what Saladino says. Bear in mind he is a psychiatrist, not someone who had been practicing treating physical illnesses in patients for a long time.

[@sigawof]

You can view Bart Kay's videos on him, if you don't mind a bit of a rough speech.

[@sigawof]

@Engelbert Humperdinck, for sure he's not everyone's cup of tea. But as for critiques, he goes straight to the point, and Mastering diabetes guys are doing the opposite of what reason and sane mind suggest you should do, so they definitely deserve it. I don't have diabetes myself, but Dr. Bernstein's Diabetes Solution is highly recommended, do check it out and hope it helps!

[@krunyanmd]

For those with type 1 diabetes who use a ketogenic diet, being in ketosis chronically is a necessary part of the therapy. Being "metabolically flexible" means one is able to utilize both dietary carbohydrates and fats readily, but this does not apply to those with type 1 diabetes who can't make any insulin in response to the carbohydrates. Using dietary carbohydrates from time to time would simply deteriorate their glycemic control and they would be worse off taking that approach.

[@nataliajimenez1870]

​@yoochoooob This is about changing the diet from those that have severe hyperinsulinemia to a maintenance phase when they have reversed it. Using a lot of carbs when you are still very insulin resistant just easily kick you out of ketosis and makes it difficult to get back. But when insulin finally comes down you can introduce 1 or 2 days of slightly higher carbs per week or even get out of ketosis for 1 week every month or 2, because it's easier to get back in ketosis

[@user-nr5he3ic9o]

The interviewer keeps saying that a doctor is more motivated and should be better at controlling Tyoe 1 diabetes than the average person. Any successful T1D will tell you doctors are terrible at insulin. They know hospital insulin but when it comes to real life insulin dosing they no very little. I eat carbs successfully with zero lows below 60. I follow a sugar surfing style that I learned from Stephen Ponder. Insulin dosing is a skill that I’m quite proud of.

[@GregariousAntithesis]

I make my own electrolyte drink using bulk minerals from amazon and drink around 2 quarts daily. Redmonds salt, potassium chloride, magnesium citrate, 1/2 package of real lime limeaide, 1/4 of a actual lime.

[@tym5583]

How do u make it like exact ingredients lol? Can we make something taste like gateraide? That's what I drink mostly, well gateraide zero.

[@GregariousAntithesis]

@@tym5583 i gave the exact ingredients use the amounts LMNT uses listed on their packages/websites. I also use some ground ginger and ground dried lime peel using a coffee grinder.

[@francoisdeleseleuc6201]

Why did your web site go silent? The community is completely gone and there are no more updates at all. Is Diet Doctor shutting down?

[@yelinmanu7204]

How about Fasting?

[@swimfit57]

Did they use the Keto diet to treat Type 1 diabetes before insulin?

[@cireldagagobenitez8618]

Si , así conseguían vivir unos años

[@CarnivoreDMD]

I’m wondering the concentration of PUFA’s etc were in that epilepsy study…bet it was high industrial seed oil.

[@vidalskyociosen3326]

It is well known that PUFA’s are bad that’s why you don’t hear it discussed much anymore, but if you’re knew to Keto to High fat Carnivore, then it’s understandable.

[@chazwyman8951]

I was talking to a 70 year old type 1 diabetic with shocking arthritis. He was unaware that you can live without eating carbs. I told him that glucose is so important that the body makes exactly what it needs. I said, surely of you eat less carb then you would not have to burden yourself with so much insulin everyday. I'm astounded that no doctor ever told him that in the 60 years since his diagnosis. I do not know, I'm no doctor, but maybe shooting up raw insulin everyday is not so great if you have arthritis??? Just a guess!!

[@kaceeboxers3580]

It is unfortunate, but my experience has taught me that allopathic endocrinologists who follow the American Diabetes Association guidelines are only there to Monitor bloodwork and prescribe medications. My functional doctor wanted me to have an endocrinologist on board and I told him there were not any good ones in our city. He opened his iPad and we chose one, out of the blue. It was the most regretful doctor visit I have ever had. His report to my functional doctor made me sound reckless because I followed a ketogenic diet, intermittent fasted and kept a very normal A1C of 5-5.2. My functional doctor agreed to continue treating my T1D even though he is an internist.

[@user-nr5he3ic9o]

Even if you eat zero carbs you still have to shoot yourself up with insulin every day as you have so kindly said. Otherwise you die. If you’re friend has made it to 70 with T 1D he certainly doesn’t need a lecture from a person who has NO IDEA what he’s had to go through.

[@lynnwinston381]

In lieu of randomized controlled trials, how about common sense keto diet recommendations.

[@Philly1958]

Beef the worlds best food.

[@johnniehanceross1198]

wondering if taking exogenous ketones with stage 4 ckd is safe On ketogenic trying for carnivore but hesitant after hearing this as far as carnivore

[@johnniehanceross1198]

thank you for this excellent interview

[@jackieburns5257]

Isn't stage 3 below 60?

[@DK-pr9ny]

Run at x1.25 speed. Dr Keith runs a little slow lol.

[@tuyendo7409]

Họping is not an answer, we need to stand up and pressure i. Take a look at the green environment crowd, the veganism crowd and learn from them

[@Lamz..]

After keto the next step would have to be ketovore/ carnivore., imho The ultimate elimination diet.

[@Lamz..]

@Dust Storm Right? Can't believe this doctor hasn't figured this out yet in regard to his type 1 diabetes. But later on he was also dead wrong about sea food and uric acid causing kidney stones. It's the carbs causing this, doc. And the oxalates in plants.

[@lynnwinston381]

I wonder did his beta cells regenerate?