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The Empowering Neurologist – David Perlmutter, MD and Dr. Keith Runyan

I think it is very clear that, when discussing diabetes, I am almost always talking about type 2. Mostly, this is because type 2 diabetes is so much more common and, to a significant degree, avoidable.

Type 1 diabetes, on the other hand, is less related to lifestyle choices as it is an autoimmune condition.

By and large, dietary recommendations for type 1 diabetic patients center on trying to supply carbohydrates to balance the dosage of insulin that is being used. Our guest today, Dr. Keith Runyan, himself a type 1 diabetic and the author of a groundbreaking book on the subject, challenges this long-held approach. Dr. Runyan believes that by allowing the body to adapt to using fat as its primary energy source, a healthier relationship exists in terms of keeping blood sugar in balance, as well as in overall health. Again, this idea is not generally accepted amongst mainstream healthcare providers, But for those of you who have been following the ketogenic diet story, what Dr. Runyan has discovered does indeed have significant scientific underpinning.

Dr. Runyan has practiced clinical medicine in the areas of emergency medicine, internal medicine, nephrology, and obesity medicine for 28 years. As mentioned, he was diagnosed with type 1 diabetes in 1998 and with conventional advice achieved the “recommended” HbA1c of 6.5-7% over the next 14 years. However, he was disturbed by frequent unpleasant and embarrassing hypoglycemic episodes. After starting regular exercise to train for triathlons in 2007, his glycemic control actually worsened while taking sports gels to prevent hypoglycemia. When he contemplated doing an Ironman distance triathlon, he sought a better method to control his diabetes.

He came across the ketogenic diet in 2012 and experienced not only an improvement in glycemic control, but also a reduction in hypoglycemia and its symptoms. He completed an Ironman distance triathlon in 2012, without hypoglycemia or the need for sugar or food due to the fat adaptation afforded by the ketogenic diet. He is now an advocate for the use of the ketogenic diet for the management of diabetes and has co-authored the book, The Ketogenic Diet for Type 1 Diabetes, which explains its use and benefits for type 1 diabetes. He documents his glycemic results on his blog.

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  • Mike Keyes

    The cells don’t become insulin resistant. I can’t believe these . People have not worked it out .

    The cell membrane don’t shout down . And there ant too much sugar in the cells .

    As long as he thinks like this their get no where .

    • Mary Nelson

      Mike, Interesting speculation. Autoimmunity is so widespread today. We may find out that could be correct.

      • Mike Keyes

        The insulin gets modified. Nothing todo with cells .

    • Lisa R

      Please check out “The stydy on cell shut down”
      University of Liverpool
      April12, 20!2

      • Mike Keyes


  • Neil Gamble

    Dr Perlmutter – thank you for all that you do. Amazing. My question is about seeds. I have been enjoying breakfasts made up of raw seeds – a mix of pumpkin, sunflower, sesame seeds and with some almond nut shavings….add some blue berries and a touch of coconut milk. How do seeds fit into this Ketogenic way? We know seed oils are a no-no. What about a) raw seeds and b) toasted seeds? Thank you.

    • David Perlmutter

      I do think raw seeds are a nice option, especially on a salad.

  • Scott Robertson

    the hybrid wheat from the 40’s to 60’s might have something to do with all the wheat allergies , we do not have the intelligent capabilities to manipulate food yet !!

    • Yvonne Forsman

      Farmers spray wheat with the toxic herbicide Glyphosate, using it as a ripening agent. Glyphosate destroys our body on the cellular level, through our mitochondria, causing a long list of diseases! 1 in 2 Americans gets a cancer diagnosis during their life time! Statistics predict that by the year 2025 every other child will have autism. Say hello to Glyphosate!

      • Scott Robertson

        Yes so true, but Man has done all this in the name of science ? greed ? Humanity ? I’m so glad we are in a new para-dime and the old lies are going to be blow up and a new world be born

  • Rochelle

    Great interview. It was valuable that you’ve mentioned the protein intake, some people who restrict carbs end up eating too much protein which is also harmful. Thank you.

    • David Perlmutter

      Important to spread that message.

  • Gela K

    Another great interview. There is another doctor who follows a low carbohydrate diet, Dr. Richard Bernstein. He is 83 years and was diagnosed Type 1 diabetic as a child. At 83 years old he has NO diabetic complications. He has fascinating story. He actually started out as an engineer. He was able to purchase a glucose monitor using his wife’s medical license. Through trial and error he figured out how to consistently have a glucose of 83. He tried to tell the ADA about his discovery only to be turned away because he did not have the credentials. So in his mid 40’s he decided to become a doctor and still sees patients. He wrote the Diabetes Solution (on it’s 4th Edition). He has a monthly YouTube Q&A. For those with Type 1 and Type 2 diabetes he is another excellent resource.

    • David Perlmutter

      Thanks for watching Gela, and for sharing that resource.

  • rm

    keto is great – keeping me alive. My blood sugar is stable all day long now. Lost over 100#. Agree with this program. Need to cleanse the liver (greens) with the saturated fat. Coconut oil every day. Brain is sharp all day. Avocado 1/2 for breakfast and dinner. High in calories but nutrient dense. I don’t get hungry anymore. hate the taste of processed foods and sugar. Heal the gut. Eat eggs for breakfast. green bananas in low quantities. Have to watch the amount of protein for two reasons – kidneys and excess turns to fat.

  • ML H

    Thank your for this interview, Dr. Perlmutter. I too, was diagnosed with type 1 at the late age of 55. I am now 60 and still trying to get the hang of it. I have a question… During the interview, you started to ask Dr. Runyan if had been in the hospital or had any surgeries prior to being diagnosed. His answer was no. I had surgery just prior to being diagnosed with hyperthyroidism (now under control through diet) and then type 1. Could this surgery have triggered the diabetes and an autoimmune tendencies? My doctors tell me to not bother asking the question and to just take my insulin…

    • David Perlmutter

      Thanks for watching ML! I’m glad to know you enjoyed this interview.

  • sd

    Does he use a insulin pump or a combo of long acting and pre-prandial injections?

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