Paleolithic Ketogenic Diet for T1 Diabetes

Lately, I’ve been hearing about some of the amazing results that people have had following what is known as the Paleolithic Ketogenic Diet, which is a specific protocol made by the research group Paleomedicina. They have evidence showing that this approach, which is essentially a strict high-fat carnivorous WOE, has helped reverse a plethora of autoimmune disorders in their patients; such as cancer, Crohn’s, and even type 1 diabetes. And, by reverse, I mean actually getting type 1 diabetics off insulin entirely. Really!


How Does it Work?

The idea is that all autoimmune disorders are caused by intestinal permeability. Essentially, a leaky gut. Many of the foods we eat (including some of our favorite keto goodies) can disrupt the lining of our gut, poking holes in it and allowing foreign materials (such as the dairy proteins in the Rebel Ice Cream you gorged on last night) into the blood stream, causing an autoimmune response. The immune cells target whatever gets through the gut, but unfortunately these foreigners sometimes look similar to our own cells. Thus, our over-zealous immune system ends up inadvertently attacking our own body, such as the beta cells in our pancreas. To stop the autoimmune attack, you must stop eating the foods causing intestinal permeability. Once you do, you can heal. And what’s left to eat is, essentially, meat.

They do make it clear that only those with some remaining beta cell function have a chance of getting off insulin. Recently diagnosed diabetics or those with LADA might be able to, but once that window closes, it’s closed for good. So as a guy who has had no beta cell function for 14 years, I knew my chances were zero. Regardless, I find this approach very interesting. After listening to podcasts about this diet, and hearing from diabetic friends who swear by how well it works (even for those that still need insulin) I decided to give it a try.


What I Ate

For the past two weeks, I have partaken in what I dub my PKD Experiment. I strictly ate what I understood as the Paleolithic Ketogenic Diet. This meant eating nothing but meat, fat, organs, and salt. No eggs, dairy, spices, or supplements allowed! And by fat, I mean a lot. The recommendation is 35g of fat for every 100g of meat. I chose to eat exactly that, twice a day, using 100g of rare steak and 35g of fat trimmings. I also ate some organ meats (tripe, heart, and liver). I drank nothing but water and did my best to follow this approach to a T. I even substituted glucose tabs for raw honey, as the latter doesn’t seem to impact intestinal permeability.


100g of steak, 35g of crispy fat, and some tripe!

I’ll be real here.. it was a struggle. Even though I’ve been doing a relaxed carnivore approach for over half a year, this was on a whole other level. No eggs, and no spices? No coffee? No BUTTER?? But I stuck with it, for two long weeks! In doing so, I can now share my experience with you, the pros and the cons, to help you determine if this is the right approach for you.


Pro – Basal Needs Dropped WAY down!

Before starting this experiment, my daily basal dose was 11 units of Tresiba. When I started I assumed it may go down a little bit because I was eating less protein, and I assumed right. In a couple days I was already down to 9. But, to my surprise, it just kept going. I changed it down to 8, then 7, then 6.. and after just a week my basal needs we’re all the way down to just 4 units a day. FOUR! That’s only 1/6th of a unit per hour, less than half of what I needed before. And I was already eating almost entirely zero-carb. I have never had my basal this low in my life, so I was very surprised by this.


Con – I kept going low!

That first week was a tough transition. My ever-decreasing basal needs forced me to gorge on honey like a bear in spring. Even today, running on 4 units of basal, my blood sugar still trends very slightly downward during the day. I’ve had maybe just two days without any honey needed. And not only did my blood sugar drop, but at first my energy levels dropped too. Likely this is due more to caffeine withdrawal, but it was still a burden nonetheless. My energy levels have somewhat returned to normal, but I still miss my delicious caffeine.


It just tastes so good man


Pro – Amazing Blood Sugar Control

Despite dealing with lows, my blood sugar trends have been amazingly flat for the most part. Testing above 120 was even more rare than previously, despite less basal and less bolus insulin. To my surprise, the honey never spiked me too high either. These two weeks for me are boasting an average blood sugar of 88mg/dl, and my A1C at-home test today came in at ___! This all may be due to the decreased protein and increased fat, allowing a slower and smaller rise from protein which was easier to manage. Or, it could be the remedied intestinal permeability. Either way, it worked very well!


One of my better days on the PKD.


Con – It’s Pretty Inconvenient

Not only is this approach incredibly strict, but it also requires eating lots of extra fat per meal and incorporating organ meats every week. Finding non-dairy fat sources and offal can be difficult here in the states. I was able to find what I needed through international (and Mexican) grocery stores and my local butcher, but it was certainly less convenient then just getting some steak and butter. The extra fat/organs can, at times, be literally hard to swallow too. They aren’t always the most palatable. And, if you go out, you would have to bring that fat with you. Even if you can get a plain, unseasoned steak, they aren’t going to provide extra fat trimmings or bone marrow. Plus, I had numerous false readings due to sticky, honey-coated fingers.


Is it Worth it?

I had amazing blood sugars on this experiment, and it was nice to use much less insulin, but the rest of my routine remained largely the same. My bolus needs went down, but I still had to split it. I still had to inject Tresiba every night. And my blood sugar was already very well-controlled before this experiment, so for me the marginal improvement isn’t worth cutting out so much of my favorite foods. If you’re like me and you are already doing an amazing job taming type 1, you don’t have any other autoimmune issues to address, and its too late for you to get beta cell function back, I’d say this is a tough sell. I, personally, am not continuing this experiment.


But it Could be Worth it for You

Given my drastic decrease in basal needs, I’m convinced that many people who try this early on after diagnosis really could get off insulin, or at least their basal (such as my good friend Vlad has). The prospect of not needing insulin, and not needing all of the micromanagement that comes with manual injections, is a BIG deal. I believe that getting off insulin would far outweigh the inconveniences of this WOE. This approach is also worth considering if you have other autoimmune issues that the PKD could help with, or if your current approach is not working as well as you’d like. So if you’re recently diagnosed, LADA, have other disorders, or simply want better control, I’d encourage you to consider this approach.

In the end, it’s all a matter of preference, priorities, and weighing the pros/cons for yourself. Hopefully, my PKD experiment can help with your decision.

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