DrCarney.com Discussion Forum

Forum for DrCarney.com Discussions, Questions, & Answers
  1. Sean Carney
  2. Support Questions
  3. July 7, 2017
  4.  Subscribe via email

The story about Ken Thomas entitled Ken's Engineered Type 1 Diabetes Whole Food Plant Based Low Fat Lifestyle proved to be extremely popular, generating many questions and comments to the point that we decided it might be easier for people to find this information if it was included in a forum dicussion. Hence the creation of this post. Feel free to join the conversation here. 

Comment
There are no comments made yet.
Ken Thomas Accepted Answer Pending Moderation
1
Votes
Undo

This is an answer to KM Idamari's question on the interview page:

Hi KM Idamari,

Yes, I have routine lab work and no, I'm definitely not in ketosis. Not even once since 1989. To be passing ketones, one must be very insulin resistant. I'm not losing weight or fatigued and it's been this way since 1989.

Blood-sugar control of a T1D is open-loop due to the absence of insulin producing beta cells. Therefore, the diabetic, his/herself, must close the control loop. Thus, the resulting blood-sugars are dependent on their control. Whatever a T1D's blood-sugar is - they put it there (whether they realize it or not). My goal is 80 mg/dl with a 70-100 mg/dl limit window. I don't always meet that, but I purposely lean it to the low side. I just take more insulin to keep it that way. My insulin doses are set by the blood-sugar, not the other way around. It's important to note that a healthy non-diabetic's blood-sugar is normally below 90, so that is where I adjust things to keep it there. It has been my goal, from the start, to match or beat normal, non-diabetic blood-sugars.

I have had doctors tell me that blood-sugars spiking over 130 mg/dl (even into the 200's) is not harmful, but I don't believe that. The same doctors also tell me that even with the best possible control, T1 diabetic will still suffer diabetic induced complications, but I realize that is because their control method allow and promote such spikes.

My diet consists of about 5-6% fat, 6-8% protein and the rest is all carbohydrates. A major element of my control is keeping insulin resistance as low as possible. In that effort, I am an obsessive low-fat fanatic. I won't eat anything that contains any ingredient (not even a sprinkle) that has greater than 10% fat calories. No nuts, seeds, avocado, not even oatmeal that has 25% fat. This is to keep insulin resistance down. And it's working. My health and vitality has been on a steady ascent for the past three decades.

Best Regards,

Ken

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 1
Trey Venters Accepted Answer Pending Moderation
0
Votes
Undo

Ken - Thanks so much for all of your efforts. What you are doing is very intriguing and impressive. Would you mind (if you haven't done so already) sharing a sample meal plan for a week. I'm curious what you eat on a day to day basis.

Thanks again!

Trey

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 2
Rien Hofman Accepted Answer Pending Moderation
1
Votes
Undo

Hi Ken et al.

I have been following your blood sugar control method for a week now. The software for my Abbott Freestyle Libre glucose monitor has a forecast HbA1c function. It was 5.8% before, but over the last week the estimate dropped to 5.2%! Usually the estimate is pretty close to the actual Lab number.

I have copied and modified your log for Australian units of measure, exercise and my personal insulin types. It is quite valuable.

Slowly I'm getting the hang of correctly estimating rapid insulin quantities, catching lows early enough, and taking just enough snacks. It is easy to overdo it, and go high ?.

I have tried flattening the post-breakfast spike with insulin. While I can do it, I think it's safer to skip breakfast rapid insulin. Straight after breakfast I ride my bicycle 40kms, and I need enough fuel in the tank. Yesterday I injected 5 units, had no spike, but 20km into the ride my sugar was down to 4.0 mmol/L (72 mg/dl). Not enough to get home. I snacked, and then again at the 30km mark, and again when I arrived home. All up I consumed an extra 300 calories, just to keep up with the injected insulin.

This morning I did not inject. At 20km my glucose was 7.9 mmol/L (142 mg/dl), on its way down after peaking at about 10 mmol/L (180 mg/dl). At 40km it was 4.6 mmol/L (73 mg/dl). No snacking required, and no anxiety about whether I was going to make it without crashing my numbers. I hope the brief spike is not too damaging.

Thanks again for all the work you have done to document and publicise your method.

Rien

  Machans Beach QLD 4878, Australia
Visit 
Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 3
Ken Thomas Accepted Answer Pending Moderation
1
Votes
Undo

Hi Rien,

Thanks for your progress update!

I suppose you found the Excel version of the log on the Log Blog?

I have been doing this for so many years that it is second nature and I often don't realize that it is indeed quite a learning curve for someone just starting. Additionally, I believe that only the method can be conveyed, but the specifics of the insulins, foods and timing cannot. I believe it is all extremely personal and dynamic. My personal doses are always changing as life changes (not referring to age). In fact, the sample log I placed on the Log Blog is not really a good example because that was taken during a "contaminated" period and is not my best. Still getting over that. (FYI; it took a while to figure this one out, but the contaminate, of all things, turned out to be body lotion! No, I wasn't eating it, but I found that the oil in the lotion absorbs through the skin and induces insulin resistance just as if I had eaten it! Live-and-learn!)

Personally, I do fear spikes and believe they are harmful. Do be patient! The snacks are "medicine" that is a major element of this control method and since there is always a delay, you have to learn, by experience, how to predict and precede the snack type and dose. It took me a few years to figure it out, so don't think a week is being slow! You will have to learn what each fruit's onset, amplitude, ramp-rate and duration is. I believe it is probably different per individual, because there are a zillion different variables that affect each of those specifications which is dependent on what's going on in one's life at the time. It varies with me as my life takes different turns; activity, stress levels, weather, just too many to list. The general characteristic of each fruit remains the same, but the fine-tuning details change and are what's needed to sync the timing and amplitudes.

Every morning, I inject fast insulin (Humalog) first thing out of bed. This counters the "wake-up" glycogen that is output by the liver and expected to be matched by insulin from the pancreas to ramp up metabolism for the wake-up process. That is typically 1 to 3 units. I skip it only if my wake-up BS is below 70 mg/dl.

Breakfast is my largest meal, typically sweet potatoes (largest portions), greens (spinach, etc.), steamed fresh beets, mixed beans and an orange. I take a large Humalog dose about 10 minutes before the breakfast. This sets BS level for about an hour then starts down ramping, which I fill in with a fruit snack (before I actually get low).

Yes! It is easy to overshoot with the fruit snacks! It will take time to learn the timings and doses. Keeping insulin sensitivity as high as possible is important because it shortens the delay of everything. The longer the delays, the harder it is to predict and synchronize everything. If the delay is too long, it will never sync. I have found that fats are the greatest killer of insulin sensitivity. I believe that is rarely known because the slow onset and long duration obscures the connection.

I never worry about calories (carbohydrates) - except to get enough. With the "both-ends" method, I no-longer count calories. And, as far as weight gain is concerned, I have learned by experience and observation that Dr. McDougall is absolutely correct that "The fat you eat is the fat you wear". Regardless how many calories I consume and regardless how much insulin I inject, I never gain an ounce in weight. It is only the fat that gets stored as fat, which I avoid like the plague. I have conducted may experiments to that effect. The latest was at the McDougall Hawaii Adventure where the food was provided. For five days, I stuffed myself miserably full of potatoes, rice, etc., every meal every day. After the end of the week, I had lost 1/2 ounce. In reality - no change. Also, no loss of insulin sensitivity.

I suppose one could say that the "both-ends" method is more tedious than traditional, but I don't feel that way, probably because I have been doing it for so long.  I do however, believe it works. I believe the effort of preventing spikes is what has prevented me from suffering any diabetic complications after all these 30 years. Besides, I find the spikes feel bad - feel damaging.

Please keep us posted on your journey!

Ken

 

  12301 Farnish Cove, Austin, TX 78753, USA
Visit 
Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 4
Sean Carney Accepted Answer Pending Moderation
0
Votes
Undo

Rien,

I am thrilled to read your response to Ken and his response to you.

Thank you for translating his log into the non-USA measurements.

I am not sure if you noticed below the editing window that there is the ability to add an attachment. I wonder if there are others out there that might like to download your translated version. You could put it in a .zip archive that somebody could download and unpack. :-)

Sean

  1760 FM 967, Buda, TX 78610, USA
Visit 
Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 5
Ken Thomas Accepted Answer Pending Moderation
1
Votes
Undo

Ken - Thanks so much for all of your efforts. What you are doing is very intriguing and impressive. Would you mind (if you haven't done so already) sharing a sample meal plan for a week. I'm curious what you eat on a day to day basis.

Thanks again!

Trey

Hi Trey,

Here is a sample of my meals and snacks:

BREAKFAST is basically always the same.
sweet potatoes (largest portions)
greens (spinach, collard greens, broccoli, etc. Sometimes a mix.)
steamed fresh beets
mixed beans
an orange

LUNCH is basically always the same.
2-1/2 cups steamed brown and wild rice mix
Cup or two of berries, cherries, strawberries, melon, grapes, banana, etc.

DINNER is the variable of the day. It is always starch based. I take my Lantus insulin before bed time. I find the response curve of the Lantus is the flattest throughout the next day, however, there is a response spike (BS dip) between midnight and 2AM that a starchy dinner fills, keeping me flat through the night - and the next day.

My wife, Heidi, cycles through about 100 recipes that she has cataloged in a library style index box. These recipes are a collection from books, websites and friends. All have been edited to remove or substitute any ingredient that exceeds 10% fat calories. 
Each of these dishes are served with various greens and fresh fruit.
Here are what we had last week:
TWICE BAKES POTATO SKINS:
Large russet potatoes
Red bell peppers
Yellow onion
Chopped spinach
Yellow corn
Nutritional yeast
BBQ sauce
Smoked paprika
Black pepper

LIME-MANGO BEAN SALAD:
Cannellini beans
Fresh mango
Diced red onion
Fresh cilantro
Fresh lime juice

BARBECUE PINTO-PORTOBELLO OVER RICE:
Pinto beans
White rice
Minced onion
Minced garlic
Cubed Portobello mushrooms
Tomato sauce
Chopped green chilis
Yellow mustard
Molasses
Agave
Chili powder
Liquid smoke
Smoked paprika

BAKED VEGGIES OVER RICE:
Onion
Green pepper
Sweet potato
Broccoli
Mushrooms
Cherry tomatoes
Yellow squash
Red cabbage
Brown rice

Shepherd's Pot Pie:
LARGE russet potatoes
Black pepper
Yellow onions
Large carrots
Froze peas
Broccoli florets
Arrowroot powder
Suzie's unsweetened quinoa milk (fat calories <10% - no oil)
Nutritional yeast
Fresh chives
Mushrooms

SNACKS: (Snack, Onset, Ramp Rate, Amplitude, Duration)
Medjool dates, 20-30 min, Medium fast, high, short Grapes, 20-30 min, Medium fast, medium high, short ~ 2 hrs.
Oranges, 10-20 min, fast, high, short ~ 1 hour.
rice cakes, 25-35 min, medium fast, high, long >3 hrs.
air-fried potato wedges, 20-30 min, medium fast, low, long ~ 3 hrs.
raisins, 20-30 min, medium fast, high, medium, ~ 2 hrs.
cherries, 25-40 min, slow, low, < 2 hrs.
Apples, 25-40 min, slow, low, < 2hrs.
Banana, 25-35 min, medium fast, high, long ~ 3 hrs.
Apple Juice ~ 5 min, fast, high, short. Use only when caught low (Raw Carrot, NA, NA, NA, NA used for a munchie snack. Glucose effect too low to notate.
This is a general list. Snacks are not limited to the above.

I stopped logging snacks years ago. My current daily insulin dose is about the normal 40 units per day for the average T1 diabetic. Before I started the "both ends" method, it was almost half that. As typical, I would experience occasional lows, so I started carrying snacks with me to prevent any emergencies. I used to carry a small grocery bag with me at all times, then that evolved into small box raisins in my pockets, then that evolved to glucose tablets then, currently, I carry medjool dates. It did not start as a conscious plan, but carrying snacks on my person evolved into the "both-ends" method where I learned to purposefully increase insulin to force a constant downward blood-sugar trend and keep it pushed up with snacks. I then found I had even more energy due to the extra insulin pumping extra glucose from the snacks into the cells producing more energy. It also eliminated calorie counting requirements or any need for matching calories to insulin.

The above listing is and approximation, because the onset, rate, amplitude and duration varies by your current insulin sensitivity level and metabolic rate (activity) is never exactly the same.

YESTERDAY; Breakfast at 6:30 AM. Then, an apple plus 1/2 peach about 8:30 AM, 6 cherries and half a rice cake at 10:00 AM, lunch at 12:00 noon, a banana at 1:00 PM at the start of my 1-hour walk/jog, two medjool dates half way through the walk, 1 large carrot at 2 PM, 7 grapes plus a rice cake at 3:30 PM then dinner at 6:00 PM and 1/2 rice cake and pumpkin cookie at bed time (to help fill the midnight dip). This was yesterday's snacks, but it varies each day. Wakeup BS was 83 mg/dl.

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 6
Rien Hofman Accepted Answer Pending Moderation
0
Votes
Undo

Hi Ken,

Thank you for describing in detail what you eat and why. The snacks information is also quite useful. 

How do you take care of your omega-3 needs? I take flaxseed meal and chia seeds.

I've modified my exercise routine in order to achieve a better A1c. I still walk 6km (one hour) before breakfast every morning. It is lovely to watch the new day break over the Coral Sea. I used to eat some bread before the walk, but that spikes much more than a banana. A banana is a mere pimple on my Freestyle Libre graph. 

The post breakfast bike ride I've had to halve. I used to ride about 2 hours at high intensity. Now I do just over half the distance at a more leisurely pace. Now that I inject rapid insulin to take care of the breakfast spike, I will go much too low mid-ride. In addition, after injecingt rapid to take care of the lunch spike, I get the mother of all hypos mid afternoon. This is well after the rapid action should be finished. I figure it is the so-called post exercise late onset hypoglycaemia phenomenon, where the liver scavenges all available glucose to replenish the stores that I so inconsiderately depleted during the ride.

Before starting the 'both ends' method I was injecting 6 units of slow acting Levemir once a day, no rapid at all. The bike ride would take care of the 500gm of carbs I eat every day, and give me an A1c of 5.8%. But, that requires high blood sugars after breakfast before the ride, and after lunch when the liver rebuilds its stores.

Exercise may be beneficial, but it seems pointless that it requires high sugars for 8 hours of the day. So I'm reducing both the distance and intensity. 

I currently inject 12 units of Levemir and about 15 of Novorapid per day. I keep a detailed log and tweak insulin dosages. They seem to be trending up.

My diet is similar to yours, very much starch focused. I do eat more grains, oats, rye and barley. I really love the starch diet and am thriving on it. Is there a reason why you don't seem to eat much grains?

Every day I get a little better at following your method. My biggest issue is learning to catch the lows in time, and when I do have one (usually mid afternoon), to be calm about it and not eat the fridge empty.

Thanks again for your information and enthusiasm. You inspire me.

Rien.

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 7
Sean Carney Accepted Answer Pending Moderation
0
Votes
Undo

Rien,

I hope it is OK for me to interject a comment from another discussion that Dr. Carney posted a couple days ago regarding Omega-3's:

I actually recommend that people consume the majority of their omega-3 fatty acid precursors from leafy greens at 2 different meals per day, rather than from walnuts, flax seeds, and chia seeds.  Most people will get all the omega-3s that they need from leafy greens twice per day, even if they never ate flax, chia, or walnuts (each of which is much higher in fat than leafy greens).

This came from a discussion located at https://www.drcarney.com/talk/1418-how-about-hemp-seeds

Thank you for your responses to Ken. I believe that many others will be benfited as well from your interactions.

Sean

 

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 8
Ken Thomas Accepted Answer Pending Moderation
0
Votes
Undo

Hi Rien,

Thanks for the update! It's great to hear your experiences!

How do you take care of your omega-3 needs? I take flaxseed meal and chia seeds.

I don't worry about omega-3's or any of the fatty acids. Years ago, I was completely ignorant about them. Then, by the time I learned about them, I found that I was already getting plenty from the greens I eat. I never eat any seeds, nuts, etc. because the high fat concentration increases insulin resistance - which in turn increases insulin response delay - which in turn increases blood-sugar spikes and reduces energy.

I've modified my exercise routine in order to achieve a better A1c. I still walk 6km (one hour) before breakfast every morning. It is lovely to watch the new day break over the Coral Sea. I used to eat some bread before the walk, but that spikes much more than a banana. A banana is a mere pimple on my Freestyle Libre graph. 

The post breakfast bike ride I've had to halve. I used to ride about 2 hours at high intensity. Now I do just over half the distance at a more leisurely pace. Now that I inject rapid insulin to take care of the breakfast spike, I will go much too low mid-ride. In addition, after injecingt rapid to take care of the lunch spike, I get the mother of all hypos mid afternoon. This is well after the rapid action should be finished. I figure it is the so-called post exercise late onset hypoglycaemia phenomenon, where the liver scavenges all available glucose to replenish the stores that I so inconsiderately depleted during the ride.

Before starting the 'both ends' method I was injecting 6 units of slow acting Levemir once a day, no rapid at all. The bike ride would take care of the 500gm of carbs I eat every day, and give me an A1c of 5.8%. But, that requires high blood sugars after breakfast before the ride, and after lunch when the liver rebuilds its stores.

I have confidence that once you get the "both-ends" mastered, you won't have to limit or modify your exercise. You should be able to exert any level or duration without any blood-sugar high's or low's. I too experience mid-exercise lows, but I have learned to anticipate and take a snack during the exercise. I can pop one or more medjool dates, during the exercise, before the expected low, and more again if another low is expected in the duration of the exercise. If I go on any really long energy intensive endeavor requiring more snacks than will fit in my pocket, I take them in a back-pack; my "fuel tank". Keeping fueled during exercise seems to help prevent "post exercise late onset hypoglycemia phenomenon", because it keeps me fueled, thus not depleting the liver/muscle glycogen stores. The dates short duration works pretty well because after the exercise, I don't want blood-sugar to rise before the liver figures out that the exercise is over. If I happen to miss calculate and catch myself low, I fix it with a 6-8 oz. shot of apple juice. That fixes an in-progress low within 5 minutes. Anything eaten is too slow, prompting "panic eating".

Exercise may be beneficial, but it seems pointless that it requires high sugars for 8 hours of the day. So I'm reducing both the distance and intensity. 

I currently inject 12 units of Levemir and about 15 of Novorapid per day. I keep a detailed log and tweak insulin dosages. They seem to be trending up.

I have also found that as insulin sensitivity increases, insulin response and duration increases. My Humalog duration goes well beyond the published curves.

My diet is similar to yours, very much starch focused. I do eat more grains, oats, rye and barley. I really love the starch diet and am thriving on it. Is there a reason why you don't seem to eat much grains?

I do eat grains! Just happened to not be much during the particular week of my posted diet list. I do, however, not eat any wheat, barley or rye, because I am also celiac. While not banned, I do limit oat's because they are over my 10% fat limit. Every day, lunch is always 2-1/2 cups of brown and wild rice mix.

Every day I get a little better at following your method. My biggest issue is learning to catch the lows in time, and when I do have one (usually mid afternoon), to be calm about it and not eat the fridge empty.

My goal is; "Let there be no spike." Likewise, "Let there be no dip." This is accomplished by insulin sensitivity and snacks as opposed to limitations of carbohydrates or activity. And since insulin sensitivity is so diminished by fats, that is why I so adamantly avoid them. In that effort, however, I have found that I can't eliminate fats to a detrimental level, because they are in everything. That's a good thing since they are essential, but the good thing is that I don't have to worry about getting enough of any particular type no matter how fanatically I avoid them. Fats are so concentrated that I don't have to seek a prominent source. Just eating a whole food plant based diet with plenty of variety (and greens) has me covered.

Ken

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 9
Norma Jean Gaston Accepted Answer Pending Moderation
0
Votes
Undo

Hi Ken, I was wondering if you eat pasta, and what whole grain cereals do you like? In addition what kind of BBQ sauce do you use?

  1232 Brookside Dr, Hurst, TX 76053, USA
Visit 
Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 10
Ken Thomas Accepted Answer Pending Moderation
0
Votes
Undo

Hi Ken, I was wondering if you eat pasta, and what whole grain cereals do you like? In addition what kind of BBQ sauce do you use?



Hi Norma,


I do occasionally eat brown rice or quinoa pasta. I don't eat any wheat, barley or rye because I am celiac.I don't eat cereals very often, but I eat boiled brown rice every day. I eat steel cut oats very rarely (about 3 times per year) because its fat content is too high (~20%).The BBQ sauce most often used is Walden Farms Honey BBQ Sauce.

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 11
Norma Jean Gaston Accepted Answer Pending Moderation
0
Votes
Undo

Sounds good, I just discovered Teff, which is an ancient whole grain and of Ethiopia. It cooks up like creamy hot cereal, is gluten free, and is 8.33% fat calories. It has 6 grams of protein and 5 grams of fiber. I mixed it with frozen mixed berries and it was quite tasty and filling! BTW, I, too am celiac. Thanks so much for the info!

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 12
Ken Thomas Accepted Answer Pending Moderation
0
Votes
Undo

Sounds good, I just discovered Teff, which is an ancient whole grain and of Ethiopia. It cooks up like creamy hot cereal, is gluten free, and is 8.33% fat calories. It has 6 grams of protein and 5 grams of fiber. I mixed it with frozen mixed berries and it was quite tasty and filling! BTW, I, too am celiac. Thanks so much for the info!



Hey Norma,


Thanks for the great tip! I'll have to check out some Tiff!

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 13
Ken Thomas Accepted Answer Pending Moderation
0
Votes
Undo

Hi All,


Regarding my Type-1 diabetes "both-ends" control method (controlling both highs and lows), some have expressed that they could not use this method because they cannot feel when they go low. I have also recently read a science study where a method (product) is being developed to help Type-1's with that issue.


This information prompts me to clarify that my method does not rely on anyone "feeling" when they are low - not even me. It is also important to note that I never wait until I'm low before correcting. That would be like pressing the brake petal on your car after the impact.


Instead of "feeling", I use instrumentation to know what my rise or fall rate is, making it easy to know when I will go low and then to have a snack at the right time to stop the fall before it reaches 70 mg/dl.


I don't use any fancy continuous monitoring gadgets; I only have a cheap glucose monitor, but it does just fine letting me know where I'm going and how fast I'm headed there. I "double-test" to determine the rate. "Double-testing" is where I test twice, fifteen minutes apart. The difference lets me know how far out the low is and how soon I need the snack. After years of experience doing this, however, I can generally predict it even if I happen to miss a double-test opportunity - but I never rely on feeling.


Happy Tuesday!


Ken

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 14
Sean Carney Accepted Answer Pending Moderation
0
Votes
Undo

Thanks Ken for clarifying that. It is an important point you are making. 


Sean

Comment
There are no comments made yet.
  1. more than a month ago
  2. Support Questions
  3. # 15
  • Page :
  • 1


There are no replies made for this post yet.
However, you are not allowed to reply to this post.