Dr. Keith Runyan is a retired physician who practiced Emergency Medicine, Internal Medicine, Nephrology, and Obesity Medicine during his 28 year career. In 1998, he developed type 1 diabetes at the age of 38 and struggled to manage his blood glucose due to hypoglycemic episodes. When he started regular exercise in 2007, his sports nutrition (sugar) exacerbated his glycemic control further. While preparing for an ironman distance triathlon, he discovered the ketogenic low carbohydrate diet that had been used for all persons with diabetes prior to the discovery of insulin in 1921. It was resurrected by Dr. Richard K. Bernstein and Dr. Runyan adopted his method of diabetes management. To Dr. Runyan’s surprise, his hypoglycemic episodes dramatically improved as did his glycemic control. He remains active with swimming, cycling, scuba diving, and more recently olympic weightlifting. He writes about his experiences to help educate others with diabetes in his blog, Ketogenic Diabetic Athlete.
The next piece to this puzzle is to know that nutrition is barely discussed in most (not all) medical schools. At Emory, in 1982, we had about 2 weeks of education in “nutrition.” But what was covered was how the body metabolizes protein, carbohydrate, and fat, nutritional deficiency diseases, and the nutritional requirements to prevent those diseases.
I am a retired physician living with Type 1 diabetes since 1998. I started to exercise regularly in 2007 to help ward off complications, particularly cardiovascular disease. I was unaware at the time that aerobic exercise alone would have little impact on the development of cardiovascular disease. It wasn’t until 2011 when I contemplated doing an ironman distance triathlon, that I discovered diet is the most important determinate in the development of most chronic diseases, including cardiovascular disease.
