"Managing Type 1 Diabetes Mellitus with a Ketogenic Diet" (Gardemann et al., 2023)

Dr. Lee Next, the second paper is "Managing Type 1 Diabetes Mellitus with a Ketogenic Diet" (Gardemann et al., 2023). This study presents the case of a German man in his twenties who was diagnosed with type 1 diabetes. He weighed 61 kg and was 175 cm tall. He drank no alcohol and did not smoke. Each day he ate about 140 g of carbohydrate — roughly 23 g at breakfast, 55 g at lunch, 12 g as a snack, and 50 g at dinner. Then his blood-sugar control suddenly broke down, and he had to start receiving insulin.

Grace That sounds like a type 1 case — the pancreas may have been damaged so that insulin itself was no longer being made.

Dr. Lee Yes. The damage may have been from a toxin or from any number of other causes, but the pancreas appears to have been suddenly injured. Over the course of a year, the hospital had this patient gradually reduce his daily carbohydrate intake from 140 g down to 25 g, while gradually raising the protein and fat. Like most ketogenic protocols this used animal foods — fresh vegetables along with meat, eggs, cheese, butter, and fish. Of course, as I have mentioned, replacing animal sources with nuts, seeds, and beans while still raising the share of fat and lowering the share of carbohydrate yields, in my view, even better outcomes.