• Ariel Warren, RDN, CDCES

Keto or Plant Based for Type 1 Diabetes

Keto has been all the rage lately in the diabetes world lately. As a Registered Dietitian and a Diabetic Educator, I would say that about 60% of my patients are asking about going Keto.

Keto for Type 1 Diabetes

Keto can be a great way to manage blood sugar. It is an extremely low carb diet, high fat, and moderate protein diet. By keeping the carbs low, it greatly decrease meal time insulin. Keeping insulin lower, can help a diabetic stay in better control.

Standard Ketogenic Diet Macros

These macros can change depending on the individual's level of activity, age, gender, etc.

What does Keto look like? Here's a 1 Day Meal Plan to give you an idea.

1 Day Keto Meal Plan

Breakfast: Egg Muffins

Lunch: Keto Cobb Salad

Dinner: Pizza Cups

Night Time Snack: Chocolate Fat Bombs

If you want to do Keto, here is 1 Day Meal Plan.

Plant Based for Type 1 Diabetes

Plant Based. The typical plant based diet is diet higher in carbs, lower in fat (especially saturated fat), and moderate in protein.

When diabetics hear "high carb diet", it usually makes their skin crawl and they immediately think, "Yeah right!! That would make my diabetes go bonkers!"

I know, because that was my thought when I first considered to going Vegan.

Well my friend, as a Dietitian and a Diabetes Educator, I have some great news.

First. By doing a Plant Based, WHOLE FOODS approach, you can greatly decrease your insulin resistance.

Let me emphasize WHOLE FOODS. You can be Junk Food Vegan by eating a diet of Twizzlers, skittles, Doritos, Fritos, Nutter Butter cookies, you get the idea. Very refined and processed foods.

Being a Junk Food Vegan is NOT going to help your diabetes.

While eating Plant Based, Whole Foods, you need to eat a diet of plants [fruits, veggies, whole grains, nuts, seeds, etc]. Eating plant based, whole foods means to eat plants and to limit refined foods such as white flour and sugar.

Chickpea Salad (recipe post below)

Since this experience, I have been eating Plant Based. As I have been eating plant based, I have had . . .

1. Decrease my basal (background insulin)

From about 14.5u = 11.75u

2. High blood sugar when corrected comes down about 1/5X faster.

3. Increased my carb:insulin average ratio (get ready for this...)

My Old Carb Ratio 1:15

Plant Based Carb Ratio 1:21

4. However, no noticeable change with my correction factor, just the time to get a high down.

DISCLAIMER: I am 18 weeks pregnant since I first wrote this post, so my carb ratio and basal has increased, but is still much higher and lower since going plant based, especially compared to my last pregnancy by 18 weeks. HUGE difference in resistance.

To be honest, I'm still in disbelief about my carb-ratio difference. Every diabetic is different, but there has been an amazing difference in insulin sensitivity thus far eating plant based, and it is exciting.


Whole grains is another topic that Diabetic usually glaze over and think, "yeah, maybe if I had a working pancreas I could eat grains, why too carb heavy."

Turns out. As long as I use my carb ratio, I am able to incorporate whole grains in my diet.

Benefits of Whole Grains:

  • Consuming whole grains as part of a healthy diet may reduce the risk of heart disease.

  • Consuming foods containing fiber, such as whole grains, as part of a healthy diet, may reduce constipation.

  • Eating whole grains may help with weight management.

  • Eating grain products fortified with folate before and during pregnancy helps prevent neural tube defects during fetal development.

Choose My Plate

A Day in the Life of Plant Based.

The other day, it was a very high carb, but completely plant based day.

Breakfast: 3 giant buckwheat pancakes + 3 tbsp of honey + 1 cup of blueberries

Lunch: 1 leftover buckwheat pancake + 1 tbsp honey

Afternoon Snack: 1 giant apple + 1/4 cup dry-roasted peanuts

Dinner: Thai Food with the husband: 1 1/2 cups of sweet coconut curry and tofu + 3/4 cup white rice (they didn't have brown) + 1 oz of naan bread.

Late Night Snack: 2 giant apples + chocolate dusted almonds

Here is my Dexcom G6 graph for the day. I keep my range between 70 - 130 mg/dL.

The last hour of the graph, I took a mini walk, but it stabilized at 88 mg/dL and stayed there.


As a Dietitian and a Diabetes Educator, I believe that every diabetic is different, therefore can benefit from a customized approach.

Keto may be the perfect way of life for you, BUT if you love fruit, lots of veggies (starchy and non starchy), love grains, and seem to be more resistant when you eat meat/dairy, plant based may be a more beneficial approach for your diabetes management.

No matter what, a diet that limits highly processed foods, refined flours and sugar is beneficial for more stable blood sugar control. A whole foods diet approach that is full of dietary fiber, protein and healthy fats will benefit any diet (pancreas or no pancreas).

Plant Based Fudge Bean Brownies (see recipe below)

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As always, if you are having trouble with your diabetes and/or weight loss, email me or visit my website so we can figure out a customized game plan based entirely on you. I'm 100% here for you and understand all your frustrations because I am a T1D and a Registered Dietitian.

When we talk, I will look in detail at what, when, and the amount you are eating, along with what you are doing for exercise (or not doing, we'll be honest with each other). Together we will analyze your blood sugar (use your Dexcom Clarity reports if you have a Dexcom) and together we will decipher why you are getting your frustrating highs and lows. After a single session, you will have answers and a much better clarity of why your blood sugars react they way they do to your food, exercise, and lifestyle.

After talking, we will stay in touch, and you will have direct access to me for any questions. I deeply care about each and everyone of my clients.

If you just have a general question, send me an email and I will get back to you ASAP.


Your friend & Dietitian,

Ariel Warren, RD, CD, T1D

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