Welcome to Type1Keto
Rethinking Type 1 Diabetes
Insulin — as much as needed, as little as possible.
This work began long before the book, Shifting Gears.
It began with a quiet realisation: despite doing everything “right”, something wasn’t working.
For years, the established approach was followed. Carbohydrates were counted, insulin adjusted, HbA1c targeted. The model was trusted.
But type 1 diabetes is not lived in guidelines. It is lived in real time, in real physiology, with real consequences.
And the reality is this:
For most people, the system is harder than it needs to be.
Only a small minority consistently achieve the balance between insulin and carbohydrate that the current model assumes is possible. The majority are left managing variability, hypoglycaemia, rising HbA1c, and the constant background effort of trying to stay in control.
The three principles
Everything at Type1Keto is built around three connected ideas:
1. Insulin — as much as needed, as little as possible
Insulin is essential. Without it, survival is not possible.
But it is also a powerful hormone. The more that is required, the harder the system becomes to manage.
Larger doses create larger margins for error.
Larger errors lead to greater glucose swings.
The aim is not to avoid insulin, but to use the minimum effective amount.
2. Metabolic flexibility
The body is not designed to run on glucose alone.
It can use multiple fuels, including fatty acids and ketones. Some tissues, particularly the brain and muscle under certain conditions, function effectively on these alternative fuels.
When carbohydrate intake is reduced, the body shifts towards using fat and ketones more efficiently. This is not “starvation mode”. It is normal physiology.
This creates metabolic flexibility – the ability to switch between fuels depending on demand.
3. Optimised insulin
These ideas come together in one practical goal:
Optimised insulin across all areas of life.
This extends beyond matching insulin to food, and includes understanding how insulin requirement is shaped by:
- nutrition
- movement
- sleep and circadian rhythm
- stress and mindset
- environment
When these are aligned, insulin requirements fall, and control becomes easier.
What this is really about
Type 1 diabetes is often described as a problem of blood glucose.
But at its core, it is a condition of insulin deficiency. Raised glucose is a symptom of type1 diabetes; very low glucose is a symptom of overcorrection with insulin.
Insulin must be replaced externally, effectively making type 1 diabetes a form of hormone replacement therapy. This places responsibility for managing one of the most influential hormones in human physiology into daily life.
Insulin does far more than control glucose. It determines how energy is stored and used, influences fat metabolism, hunger, inflammation, and fuel selection.
Yet most approaches still focus on reacting to glucose raising potential of the diet rather than understanding insulin itself.
That is the shift.
Where carbohydrate fits
Most starchy carbohydrates — bread, pasta, rice, potatoes — are broken down into glucose and raise blood sugar directly.
So the relationship is straightforward:
More carbohydrate → more insulin required
Less carbohydrate → less insulin required
This is not about restriction for its own sake. It is about understanding the mechanics of the system.
Smaller inputs lead to smaller corrections.
Smaller corrections lead to fewer errors.
A different option
A very low-carbohydrate approach offers something simple but powerful:
A way to reduce insulin demand at source.
When that happens, the effects are consistent:
- more stable glucose levels
- fewer hypoglycaemic episodes
- lower total insulin requirements
- reduced need for constant correction
- a greater sense of control
For many people, this represents the difference between managing diabetes and constantly reacting to it.
Beyond food: the foundations
Insulin requirement is not determined by food alone.
It is shaped by multiple interacting factors:
- movement and physical activity
- sleep and circadian rhythm
- stress and mindset
- environment and light exposure
- illness and recovery
These form the foundations, or roots, of health.
Insulin sits at the centre of them all.
Change the foundations, and insulin need changes.
Change insulin need, and glucose control follows.
Why this matters
Across the UK, outcomes remain largely unchanged.
Most people are not reaching target HbA1c.
Most are living with ongoing variability.
And there is a real cost.
For every year spent above target HbA1c, there is a measurable and significant reduction in life expectancy.
Continuing with the same approach is not a neutral choice.
What this offers
Type1Keto is not about replacing one rigid model with another.
It is about informed choice.
It offers:
- a framework centred on insulin rather than glucose alone
- a practical understanding of how diet influences insulin need
- a broader view of lifestyle factors that shape control
People living with type 1 diabetes should be able to decide what works best for them, based on physiology rather than assumption.
The bigger shift
Glucose is what is measured.
Insulin is what drives the system.
A glucose-focused approach is reactive.
An insulin-focused approach allows the system to be shaped upstream.
A starting point
For those living with type 1 diabetes, caring for someone who is, or part of a family navigating it together, this might be worth exploring:
Not to abandon what is known, but to look again.
To ask whether the difficulty of managing type 1 is inevitable, or whether it is partly created by the model itself.
To consider whether reducing insulin demand might simplify the system.
And to explore a different way of thinking, grounded in physiology and lived experience.
Type1Keto
Insulin — as much as needed, as little as possible.