Por Andrew Koutnik
I was 16 when I ended up in a hospital bed and heard three words that changed my life: type 1 diabetes. What I didn’t know then – and what very few doctors recognize today – is that dietary changes are often the best way to combat the disease.
For decades, doctors have treated type 1 diabetes as if insulin alone could handle it. But despite billions invested in medications and devices, most people with type 1 diabetes still do not achieve recommended blood sugar control. I know this firsthand, as a scientist and as a person living with type 1 diabetes.
When I was first diagnosed, I did what everyone told me to do: count carbs, take insulin, and wait for the numbers to balance out. I lived with constant ups and downs in blood sugar that left me exhausted and discouraged.
I tried different strategies, but nothing got me off the roller coaster. My health only began to improve when I tried a diet that would put me into therapeutic ketosis. Because carbohydrates raise blood glucose higher and faster than insulin can lower it, eliminating them almost completely from my diet made my blood sugar levels much more predictable. Almost immediately, my blood glucose levels normalized and I needed less insulin. My mental health improved.
Science backs this up.
Multiple studies have shown that people with type 1 diabetes who follow low-carbohydrate diets can reduce their blood sugar to a normal range, significantly decreasing the risk of long-term complications such as brain, vision, and nerve damage.
I have even included my own case in the scientific literature so that researchers can benefit from the findings. For more than 10 years on a ketogenic diet, I have kept my HbA1c around 5.5% – the healthy goal for someone without diabetes – while reducing my insulin use by 43%.
Insulin remains essential. Every person with type 1 diabetes needs it to survive. But eating in a way that minimizes blood sugar ups and downs allows me to use insulin the way it was intended: to normalize glucose levels.
This is not “marginal.” Ketogenic diets have been the standard of care in diabetes treatment since 1797. Despite centuries of evidence, nutrition remains an afterthought in diabetes care. More than two-thirds of health professionals are not educated about these strategies.
Insurance coverage for nutrition and monitoring remains spotty at best. Access to continuous glucose monitors has improved in recent years, but patients still face barriers with high costs and insurance denials. And ketone monitoring – a critical safeguard for those of us on low-carb diets – is inconsistently covered.
If my health results had come from a new medication, they would be considered a breakthrough. Because the intervention is food, our system dismisses it. That must change.
After 17 years with type 1 diabetes, my life is not dictated by blood sugar chaos. Insulin saves lives – but combining it with low-carb diets transforms them. It’s time for our healthcare system to upgrade.
Dr. Andrew Koutnik, Ph.D., is a research scientist specializing in nutrition, exercise, and stress in metabolic health and a member of the Metabolic Health Coalition advisory committee.
Related
Keep reading