Carole Freeman: Well, hi there. Welcome everyone to the next episode of Keto Chat. This is Carole Freeman. I am the creator of the fast track to keto success program. I am here today, I’m so honored to be interviewing Dr. RD Dikeman. I have an official bio I’m even going to read on him, too. US theoretical physicist, Dr. RD Dikeman, and I’m going to ask you in a minute about what this theoretical physicist is. Why didn’t they give you a real physicist degree? RD Dikeman is producer of Dr. Richard Bernstein’s Diabetes University, a series of free videos on YouTube on how best to manage diabetes. He’s also co-founder of TYPEONEGRIT, an awesome Facebook group for folks aged between one to 81, following Dr. Bernstein’s low carb approach to achieving healthy, normal, non-diabetic blood sugars.
Dr. Dikeman’s son, David, was diagnosed with Type One diabetes in 2013. Like most families, they were sent home with the Type One diagnosis with a diet plan consisting of about 50% of the calories from carbohydrates, the very thing that diabetics can’t metabolize. Watching his son’s blood sugars fluctuate wildly, after a near death experience from ketoacidoses, diabetic ketoacidoses, no joke, was parent torture to the first degree. We’ll talk about this more in a minute, too.
Knowing next to nothing about nutrition or diabetes management, Dr. Dikeman’s family found and immediately implemented Dr. Bernstein’s book, Diabetes Solution, and for three years now, how attained normal blood sugars, A1Cs of 5.0% or less. His son’s growth is on track. Probably he’s taller than average, too. I’ve seen pictures of this kid. He’s pretty amazing. The family has seen a virtual elimination of hypoglycemia, hyperglycemia, so low blood sugars, high blood sugars, diabetic ketoacidosis, for some reason, that’s a mouthful for me this morning, and future diabetic complications. Hope is restored. Dr. Dikeman’s Low Carb, USA Talk on how to avoid Type One diabetes complications is, I’m going to link it below here for everyone.
Well, okay. What should we start with? I’ve got to ask about this theoretical physicist, PhD. What is that about?
RD Dikeman: I studied physics at the University of … Well, I did undergrad at Michigan, but I studied at the University of Minnesota with … They brought some Russians over to start a theoretical physics institute during [inaudible 00:02:53]. When I graduated from Michigan, I went to go study theoretical physics with those guys.
Carole Freeman: What is theoretical physics? How is that different than regular physics.
RD Dikeman: Oh, there’s experimental physics and theoretical physics. I’m an equation writer. I don’t do the experiments to test the equations.
Carole Freeman: Oh, okay, okay. I’ve got it. Growing up in, or living in Minnesota, Michigan, you had to go the polar opposite and move to Hawaii then.
RD Dikeman: Yeah, after about six years in Minnesota, I always tell people, Minnesota made Michigan look like the Bahamas.
Carole Freeman: Okay.
RD Dikeman: I got to travel a lot in graduate school. One of the places that I traveled was Hawaii. Like a lot of people, I kind of fell in love with it. When I graduated, I moved to Hawaii. I got a job. Things worked out.
Carole Freeman: Nice. Well, you probably stand out there a little bit because you’re, what, about 6’5″ or something and pale skinned guy?
RD Dikeman: Yeah, I’m easily recognizable, compared to my Michigan days, no doubt.
Carole Freeman: Yeah, yeah. You’ve been out in Hawaii for how long now then?
RD Dikeman: Well, it’s been about 20 years.
Carole Freeman: Oh, wow. Okay.
RD Dikeman: I’m almost as Hawaiian as I am Michigan.
Carole Freeman: Nice, okay.
RD Dikeman: Yeah.
Carole Freeman: You and your family have always been Hawaii. I’m assuming then, based on how old your kids are, you met your wife in Hawaii, then?
RD Dikeman: Yeah, shortly after I moved here, I met my wife.
Carole Freeman: Okay. Tell us, you have two kids. What are their names? How old are they?
RD Dikeman: Dave is 12 and going to be 13 in a week or two. Hayden is 10. Like you said, Dave was diagnosed when he was nine, so in 2013, with Type One diabetes. That’s kind of the demarkation point in my life where we sort of fell into this low carb world and giving lectures and that sort of thing, working with Dr. Bernstein. Dave was diagnosed, and he was in severe DKA. It’s a pretty common story. He lost a lot of weight. He had flu like symptoms, misdiagnosed by his doctors. They thought he was just sick. Actually, they recommended that he drink a lot of milkshakes. Right, so sad.
Carole Freeman: Yeah.
RD Dikeman: He was in bad shape. Like all diabetic kids, if you don’t catch it, they fall off the cliff, and they lose … Dave must have lost 10, 15 pounds. I don’t think I’ve ever told this story, but when he was sick, we were watching … I said, “Well, just stay home because we’ll watch March Madness.” We were just sitting on the couch, and I was trying to feed him and get him better. He had a lunch. Hey, he’s drinking, and he’s eating, so that’s a good sign. The problem is he wasn’t producing insulin, so he’s literally starving. The glucose can’t get into his … The energy, the nutrients can’t get into his cells.
Anyhow, he vomited on the couch, which is unusual. I picked him up. I said, “I’ll just take you in the shower, Dave, and we’ll get you cleaned up.” I picked him up. He said he couldn’t walk, he was so weak. This is like over a three day period or so, just getting worse and worse and worse. I picked him up, and he was light as a feather. I took him into the bathroom, and I helped him get his shirt off. I looked at his body. It’s the first time in a couple days I had seen his body without any clothes on, and I almost just fell onto the floor because I looked at him, and I said, “You’re dying, not that you’re dying, you’re dead.” I looked at him, and I said, “That’s it,” inside.
I got him cleaned up, and I put him on the couch, and I called Roxanne, my wife, and I said, “Dave’s going to die.” We took him to the doctor, and the doctor said, “Oh, you’ve got to give him milkshakes.” I’m not built to argue with doctors. Okay. The next day we had to take him to the … I called another doctor, and we said, “We’ve got to get to some tests.” We did the tests, and the doctor called us right away, and she said, “Oh, your son’s in DKA. You’ve got to take him to the emergency room right away.”
Here’s the punch line. We take him to the emergency room, and it is packed with a billion people. Oh, my God. What a nightmare, right? Dave’s dying, and we don’t know what to do. The doctor said he’s got diabetes. I don’t even know what diabetes is. I don’t even know what it is. Despite all these people in line, when we sign in, the double doors open, and a team of people come out with a gurney, and they literally have the, what do you call it, the bullhorn, basically. “David Dikeman, where’s David Dikeman?” My wife and I, we were just in … This was like half an hour ago that we were told Dave had diabetes.
We look at each other. It was like oh my God, what is happening? They took him in front of all these people. Anyway, that’s the diagnosis story. You get an infusion of fluids and insulin, and it basically barely saved his life.
Carole Freeman: Wow, in just a matter of days.
RD Dikeman: Hours, yeah.
Carole Freeman: Yeah, so looking back, is there anything, any advice you’d have for other parents that … Are there some signs they could look for, where early on, they could just ask for some other tests? Is there anything you know now that you could have even seen it earlier, knowing what you know now?
RD Dikeman: Yeah, there’s a campaign called Test One Drop because his happens to kids, and they die. Dave was, I think, hours away from being one of those kids. If I showed you a picture, it’s gruesome, what he looks like, gruesome. We missed it, but it happened so fast.
Carole Freeman: Right.
RD Dikeman: Anyway, the Test One Drop is a simple blood sugar test at his pediatrician. If she would have looked at him and looked at his body and said, “This is not right. Let’s test a drop,” you would have seen his blood sugar would have probably been a gazillion, way above. That test costs nothing.
Carole Freeman: Right, yeah.
RD Dikeman: If you see, a symptom is frequent urination because you’re above the renal threshold, and you’re constantly peeing out glucose, and you’re constantly thirsty. That’s a big sign for parents to know.
Carole Freeman: Does that come on like a week or two or months before the place where you’re in the hospital?
RD Dikeman: Yeah, I think what we know is that the autoimmune attack happens over, and it may be a period of a year or more. It [inaudible 00:10:37], so you gradually lose the ability to produce enough insulin to get over the hill and bring down meals down to normal levels, until eventually there’s, like I said earlier, you go off the cliff, and you can’t stop it at all. If you’re lucky, you can catch it early enough, where you don’t have to go through what we went through.
Carole Freeman: What a remarkable story, and I’m so glad that he’s okay now and that you’re the person that you are, that you’re so impassioned about getting the word out about how to prevent other people from getting as close as Dave did to a different terrible story, but also just helping people live with … The quality of life that Dave is going to have because of you, and then all these other people that you’re impacting. It’s such an amazing journey that you’re on. I wonder if we could set the stage first though because I imagine some people watching this are going to have no idea what Type One diabetes is compared to Type Two. Can you just share the basics of what that is?
RD Dikeman: Right, right. Type One and Type Two are both … There’s differences and similarities. Both conditions ultimately result in high blood sugar, which cause the complications of diabetes. The complications are the same. You have these microvascular complications. There’s over a hundred complications from high blood sugars. The origins of the diseases are different. Type One is an autoimmune disease. We don’t know how to provoke the attack in the first place. We don’t know what provokes the attack, and we don’t know how to stop the autoimmune attack.
Type Two is a disease. It’s called a lifestyle disease, but that’s debatable. There’s probably genetic susceptibility. There may be an autoimmune component. It’s very complicated what happens in Type Two diabetes. The goal with both of them, back to the similarities, the goal with both of them is to normalize blood sugars to avoid the complications. The only way to do that with both the diseases is through diet. You have to go for a low carb diet. Otherwise, it’s impossible.
Carole Freeman: Yeah, and the primary difference between the two is that in Type One, the pancreas is making almost nothing or no insulin, which is what the body uses to control blood sugars normally. In a Type Two, typically, they’re overproducing insulin because they’ve been ingesting too many carbohydrates for what their body can tolerate. They both end up resulting in uncontrolled blood sugars, but more so in a Type One. Type Two generally has high blood sugars, predominantly. They don’t run the risk so much of having too low. One of the things that most people have no understanding of is that with Type Ones, following the conventional approach, they’re in real danger, frequently, multiple times a day, of having too low of blood sugars.
I’m curious, then. Can you walk us through in the beginning, the dietary approach that you were given, and what that was like for home life?
RD Dikeman: Right, right. The first part of the story was typical and somewhat gruesome and very sad. The bad news is that once Dave stabilized, there’s another wave of attack that occurs from the medical community. The first wave is typically a misdiagnosis. That’s well known. The second wave, unfortunately, is not so well known, and that is when you recover, you are typically met by a dietician and or endocrinologist who put you on a diet consisting of about 50% roughly carbohydrate. This is very analogous to a situation that could occur with someone with a peanut allergy, who would report to a doctor that they are allergic to peanuts and be put on a peanut of 50% in peanuts.
Carole Freeman: Oh, that’s hilarious. It’s so true.
RD Dikeman: Right. This happened to Dave. Sure enough, we returned home … By the way, I give Dave a lot of credit because when the doctor was explaining to us the basics of insulin and blood sugar management, the statement was, “Here’s your blood sugar. When you eat carbohydrate, it’ll go up, and when you take insulin, it’ll come down. The goal is to keep it between, I don’t know, 200 and 100, or whatever,” was spoken. The doctor was actually very forthright, and I appreciate that. He told Dave, “If you’re too high all the time, everything, amputation, blindness, this is what happens to diabetics, so you have to make sure.” He was very cool and honest, which I appreciated. Then too low, of course, then you’re going to have a hypoglycemic seizure. It’s a balancing act.
Dave was smart enough to say, “Oh, well, I just won’t eat carbohydrate then.” I remember looking at him like, “Dave, let me take care of it. You don’t know what you’re talking about because you’re only a little kid. You need to eat carbohydrate.”
Carole Freeman: A nine year old can figure this out, but most of us …
RD Dikeman: He was right. We return home, and I force fed him oatmeal.
Carole Freeman: Oh, okay because that’s good carbs. Is that why?
RD Dikeman: Hey, you know, I thought … Well, it wasn’t just any oatmeal. It was the steel cut oatmeal.
Carole Freeman: Right.
RD Dikeman: That was on the list of … Oh, bananas were on the list. I totally blew it. I was just following orders. Like everybody else, who knows anything about food. Everyone thinks that carbohydrate is important, blah, blah, blah. We were just falling into the same trap. I ate bowls of cereal and skim milk my whole life to make sure I wasn’t eating too much eggs, and all this nonsense. The bad news is, for Type One diabetics, is they get balled up into this low fat madness that we’ve been put through for three decades, which has resulted in epic levels of obesity and Type Two diabetes and metabolic disorders.
Who goes down the tubes first? The Type One kids, who are lumped into this nonsense. They experience … If we would have kept on that path, then we would have had problems way down the line in our 50s and 60s. The kids get sent down the tubes right away. The complications start happening right away. It’s pointless. There’s no reason for it. Of course, you shouldn’t be put on a diet of carbohydrates. You can see what happens the first time you eat it. The first time Dave at his oatmeal, his blood sugar went up to 350. I said, “Well, I’ll just give him more insulin, and I’ll give it a little earlier.” It doesn’t work like that. You can never control it.
Carole Freeman: Yeah, and I’ve talked to other parents with kids of Type One, and they believe what the doctors told them. The doctor must know what they’re talking about, and they’ll say, “Well, my kid can eat whatever they want as long as we cover it with insulin.” That’s the phrase that they teach you. Right? What’s the fallacy about this just cover it with insulin?
RD Dikeman: You know, the doctors know nothing about nutrition. I tell people asking a doctor, it’s like asking the travel agent to fly the plane. Doctors, clearly … Look, the average A1C for a Type One diabetic kid is about 8%, which is a blood sugar of around 200. Normal kids run in the 70s and low 80s, not diabetic kids. You’re looking at a strategy which results in blood sugars triple normal. It’s a disqualifier for following standard advice. Like I said, the complications come on fast. The strategy that’s being pushed so heavily by the professional diabetes associations and the endocrinologists doesn’t work. We now know that …
I’ll give you an example of what happens. The ADA Journal just published this year a study showing that children following the standard advice in achieving blood sugars which are in the standard guidelines have brain matter differentiation from non-diabetics and IQ drops. You’re getting kids following this advice. Their doctors are bullying them into eating tons of carbohydrate, and for the reason of brain development, and the research shows that he hyperglycemia is causing the brain damage. It’s an unbelievable … It’s a horrible situation what’s being done to these kids. Unbelievable.
Carole Freeman: I’m thinking now likely that this misalignment of advice that’s being given out is based on two false ideas or myths about it. One is that, “Well, we need carbs, and they’re healthy food, so that’s why we need to incorporate them.” Then the other one I think that a lot of parents fall into is that, “Well, I don’t want my kid to feel deprived. I don’t want them to feel like they’re missing out.” What do you think about … We can dismiss the we need carbs and all the healthy foods. Do you have a quick [crosstalk 00:21:18] that myth?
RD Dikeman: If you let your child eat carbohydrate and their blood sugars are around 8%, your kid is guaranteed to get complications. If you study the literature, look at this diet doctor video that you talked about earlier that I go through all the research. The agony and shortened life span is, and like I said, the brain damage, you’re going to have to include those into your strategy. If you think that you’re going to deprive your kid but not face any consequences from diabetes, you’re sadly mistaken. Diabetes is the real deal. You better not lie to yourself because … Look, all I can tell you is it’s not going to happen on my watch. This is not a strategy we’re going to [inaudible 00:22:27].
The good news is that there need be no deprivation when you’re eating a low carbohydrate diet. There’s no recipe that exists that can’t be made arguably better eating a low carbohydrate food. The amount of hassle that’s required to go manage your blood sugar, up and down, all day long, save your kid from dying by giving them a juice box, now it goes rocketing back up to three or four hundred, then he comes rocketing back down versus the small variations you can achieve with healthy food. The deprivation argument is really sort of bogus.
Carole Freeman: Right.
RD Dikeman: Then as far as the complex carbs are “healthy”, all you’re really doing with this diet, the Bernstein diet, is you’re taking the grains and the starches and the sugars and the super sweet fruits, like bananas and apples, and you’re jettisoning them, get rid of them. You’re replacing those foods. You’re replacing them with healthy protein foods and fibrous vegetables. You’re going to get all your phytonutrients. You’re going to get lots of protein for your kid, and you’re going to get normal blood sugars.
On the one hand, here’s your choices. You’ve got normal blood sugars, lots of protein, lots of veggies, and an occasional, delicious, low carb snack so there’s no deprivation. On the other hand, you’re going to eat all the foods that cause Type Two diabetes and obesity in the non-diabetic community. Those are going to be your choices for your diabetic child. We can’t eat those rapid acting carbohydrates with a functioning pancreas. You’re going to give those to a kid with a needle and a syringe and say, “Go ahead and keep your blood sugars normal.” They’re going to eat all this junk. Their blood sugars are going to be wild. There’s no extra nutrition in grains that you … Grains are fortified, they’re so nutritionless, that you can’t get from this.
Those are your choices. God only knows … Well, we do know actually why, but this is the choice. This is the choice is almost universally pushed by the diabetic associations and doctors. If you do this choice, you might end up getting bullied by your doctor to eat more unhealthy food. The world is so bizarre. Every day I see examples of how bizarre this situation is.
Carole Freeman: It is, and even for parents that have kids of normal functioning pancreas, non-diabetic children. The whole argument of well, they’re young. I don’t want them to miss out. I don’t want them to feel like they’re being deprived or anything like that. People need to wake up and realize the poison that they’re giving their children. On the one hand, it’s just nutritionally poor. You’re setting the stage for lifelong disease, chronic disease, diabetes, heart disease, all these things. You’re setting it early. Not to mention the brain chemistry that goes on with these highly refined, sugary things.
No parent out there in their right mind would say, “Well, I want my kid to have a little heroine every day because I don’t want them to feel like their missing out, like all the other kids get to have heroine.” There’s nobody that would say that, but it’s the same brain chemistry of addiction. Yet, parents are lying to themselves by thinking that they’re doing their kids a favor by letting them have these foods.
We need to change the way that parents look at what they feed their kids. I argue that you should care more about what you feed your children. They should get even more healthy foods than you’re worried about feeding yourself because they’re growing. They’re setting the stage for the rest of their life for the way their cells are going to work and the genes and all that. I think it’s even more important that we feed kids nutritious foods than even grandma. That’s my opinion.
RD Dikeman: You’re hitting the nail on the head. We know that child obesity is through the roof. We know that child Type Two diabetes is growing in record proportion. Again, look what’s happening to these kids who have a functioning pancreas. Now, you’re telling the Type One kids to go eat the same thing.
Carole Freeman: Right, right, because they don’t want to miss out either. You don’t want to miss out on all these diabetes and heart disease, do you kids?
RD Dikeman: Well, I tell you what. Most parents have no idea what it feels like to have … and I don’t either, hyperglycemia. These parents should be asking some adult Type Ones instead of talking amongst themselves, their little four and five and six year olds. They have no idea how miserable it feels to go from blood sugars of 50 to 400 and back down again for a crappy piece of grocery store sheet cake on somebody’s birthday.
Carole Freeman: Yeah. I have personal experience. I dated a guy with Type One, and I have a master’s degree in nutrition, and I didn’t know what Type One was like until I got up close and personal with what this guy … I was feeding him low carb meals, but he was still using insulin like he wasn’t having a low carb meal. Fortunately, he adjusted what he thought was appropriate, and it was still too much for the meal that I fed him. He ended up experiencing a low, and I can tell you, I was scared to death that he was going to die right there. Me having a low carb household, I had nothing on hand that could give him to bring his blood sugars up, and he didn’t know as well as what you know now about how to manage that.
Here I am, he’s at 45 blood glucose, laying in my bed like delirious, and I’m driving to Safeway to buy a Coke and a Snickers for him to try to save his life, to literally try to save his life. It’s so scary, and people have no clue. Even most healthcare professionals really have no clue how scary that is. That’s what we’re … the life … not we are, but the healthcare professionals are leading Type Ones to lead, and it’s just not right. It’s not right.
RD Dikeman: There’s two things you hit on there that going back to the Type Two, Type One differences. Type One has a bit of terror to it that the Type Two doesn’t have, a non-insulin using Type Two. Type One, your blood sugar can go to zero if you manage your insulins wrong. That is very scary. If you’re a Type One diabetic, you’re going to experience lows. There’s really no way around it. What you’re going to try to do is minimize how low you go and how fast you go low and how frequent you go low. To do those things, you need to use predictable doses of insulin.
We haven’t started talking about Bernstein yet, but that’s basically his whole mantra is that when you eat low carb, it’s not just the low carb that gets you the normal blood sugars, it’s also the proper use of insulin. The magic is that when you eat low carb, you use small, predictable doses of insulin. What’s going to happen when you use small, predictable doses is you’re going to experience less severe hypoglycemia. It would be very rare if I got a call from my son at school and he said, or the nurse said, “Hey, we found Dave almost passed out.”
What happens when you eat low carb and you take insulins which are longer lasting to cover protein foods is instead of experiencing this high carb, rapid acting insulin roller coaster, you gradually might go up, or you gradually might go down. Because the peaks and valleys are so mild, with disciplined amount of testing blood sugars, you’re able to catch any hypoglycemia. You’re also able to treat any hypoglycemia with a little bit of glucose. Dave will carry a couple of glucose tabs. Let’s see, I should have some around, not on the table. They’re about this big. They’re about the size of a quarter. If he feels himself going low, he’ll check his blood sugar, and he’ll take a glucose tab. He doesn’t get into a situation where he’s trying to save his own life down into the 20s or 30s.
Right there, there’s your number one benefit of low carb is that your kid isn’t going to ber under the threat of death from severe hypogl- or seizure at school from eating a piece of grocery store sheet cake and covering it with 10 units of insulin, not going to do that. You’re not going to undergo these wild excursions They’re scary. Like your example is scary.
Carole Freeman: Yeah, yeah, yeah. Until you’ve been through it, it’s hard to understand what it’s like to see somebody you love and care about laying there.
RD Dikeman: It’s scary, yeah.
Carole Freeman: How did you find Dr. Bernstein’s book?
RD Dikeman: While I was being stupid with the steel cut oatmeal, I’m also the scientist. Right? I was trying to, and I was working with some other scientists who didn’t know what they were talking about either who had some Type One relationships. The goal for me was if I measured out Dave’s oatmeal, or the example I always use is he likes Starbucks chocolate chip cookies, which are about 60 grams of carbs, if I just measured it out, and I measured out the insulin, and I gave him the insulin at the right time, then I figured I could get his blood sugar to be flat because I’m smart. I actually was writing computer modeling programs to do all this stuff and modeling what his glucose would be and measuring …
Carole Freeman: Oh, wow.
RD Dikeman: Yeah. I was doing that for a month, like a fool. Yeah. My wife was kind of watching me do this, and she’s like, well, she knows I’m a smart guy and all that kind of stuff. When I would work, I’d go, “Hey, I got it.” Then we’d try it again, and it wouldn’t work. He’d go low, or the next time, he’d go way up high. She’s like, “This is stupid what you’re doing.” She was googling, and she bought the Bernstein book. When I read that Bernstein book, I was flipping through it, I got it in the mail, and there’s a section on what I was describing earlier, the law of small numbers, which says if you use small doses of insulin, you’re going to get predictable results.
I knew it was right because I had seen it in my models that diabetes on a high carb diet will give a stochastic blood sugar, which is a random blood sugar. I knew it. Then you flip to the table of contents, and I said, “Oh, we got it. This is the right answer.” We started implementing it, and right off the bat, the blood sugars got normal. Then we learned how to manage insulin a little bit better. There’s so much to it. There’s so much architecture to really getting your blood sugars nailed. He will tell you that it’s not just the low carb. Low carb might be …
First of all, you have to do it. There’s no way around it. You still have to learn how to manage the insulin. There’s a lot you’ve got to learn. It’s kind of an art, and you have to study. He’s got the answer to everything. The thing is, if you … I’m of the predisposition that I want to figure something out new. I want to do something new and different. I don’t want to listen to the … There’s got to be something that he missed. I cannot find … Every time I deviate from what he does, life gets a little harder. You may still be able to get the normal blood sugars, but he has really got it down to a science. He is a scientist too.
Carole Freeman: Yeah because I don’t think that any … What we haven’t said is that Dr. Bernstein is 81 years old, living with Type One. What age was he diagnosed?
RD Dikeman: I think at the age of 12.
Carole Freeman: Okay, so he’s had his whole life to figure this out.
RD Dikeman: Yeah, maybe 10 or something like that. I don’t want to get that wrong. Yeah, since he was a little guy he’s had it, and he almost died of kidney disease. Back then, there weren’t much different types of insulin. There was really no strategy, other than to prevent death.
Carole Freeman: Yeah.
RD Dikeman: He got a hold of the first commercial blood sugar meter. It was only available to doctors, but his wife was a doctor. He was in bad shape. He had been on this blood sugar roller coaster for many years, and his kidney disease was end stage. He got a blood sugar meter and just dug out of the dirt a diet and insulin management strategy that gave him normal blood sugars. He stuck to it, and his complications all started healing. He had gastroparesis, which is when your vagus nerve gets paralyzed. He had this kidney disease.
Carole Freeman: He reversed his kidney disease?
RD Dikeman: He did, yeah.
Carole Freeman: That’s exciting.
RD Dikeman: His neuropathy …
Carole Freeman: Oh, yeah. Neuropathies are usually things that take quite a while. They take several years to really heal. For most people, it’s not reversible.
RD Dikeman: Yeah, the toughest is the gastroparesis is a neuropathy, and that takes maybe a decade. I think his took a decade.
Carole Freeman: Oh, okay.
RD Dikeman: You know, to reliable digestion. There’s a lot of things, I think, that he learned from his own experience. He wrote a paper on it. Because he wasn’t a physician, he was just an engineer in his 40s, he couldn’t get it published. He said, “Well, I have to go to medical school then.” I think he was like 42 or 43, so he went to medical school.
Carole Freeman: Wow.
RD Dikeman: Yeah, became a physician, opened his own practice. He worked at a diabetic wound clinic for decades under a very famous German diabetologist. He’s 82 now, and he’s still seeing patients. The mind is like a young physicist’s mind. He’s really an incredible guy.
Carole Freeman: Yeah, that’s great. The gastroparesis, I was experiencing that after the severe inflammation after the car accident that I went through. That’s a pretty miserable thing to experience. It’s just basically you’re really hungry, you’re constantly hungry, but the food won’t digest to move through your digestive track. You’re full and starving at the same time, and you just want to feel satisfied. You want to feel like you’re getting the food to move through. Yeah, that’s a hard one. He had a long journey to heal that. I’m glad that I had a short experience of that. As quick as I got on a ketogenic diet and got my inflammation to drop really quickly, that reversed for me.
RD Dikeman: Great.
Carole Freeman: Who knows how long I could have got stuck with that had I not found this when I did. My next question then is about, you found this book, and you started implementing it. Did you do it family-wide? Did you just say, “We’re all going to do this together”? Did you, at first, make separate stuff?
RD Dikeman: No, we did it family-wide. Yeah, of course, I wanted to experience what … Whatever Dave was going to do, I’m going to do. I’m not going to eat a bowl of Cheerios and say, “Well, you can’t have that, Dave.” We eat the same thing. My wife is eating the same thing, too. You talked about it earlier, that carbohydrate addiction. When I started going cold turkey, I’ll be damned. I always thought, “Oh, there’s no addiction.” I used to walk by the Starbucks pastry cabinet when I was getting my coffee, because I like Starbucks, so I get Americanos, but I would always get those cookies too. Dave and I both liked them.
I’ll be damned. I was like … Not only were my hands kind of shaking a little, I would have this conversation, like a crazy person in my head. “Well, it’s just one cookie. You’ve eaten them before. You just worked out, and you do feel a little like you might need some energy. Actually, it’s probably a good thing that you eat the cookie.” I couldn’t believe it.
Carole Freeman: I’ll just get it and hide it from Dave and go eat it in the bathroom, right, when he’s not watching.
RD Dikeman: Now, that thought kind of would stop me in my tracks.
Carole Freeman: Okay.
RD Dikeman: That would feel wrong. For me, it was easier because that was my stop gap. It wasn’t me arguing with myself. I always felt … Because I was very convinced. I had done enough research at that time to realize that Dave was in for some hell if he didn’t find a way out of this mess. That, to me, that’s a trump card that overcame all that nonsense. I never did cheat. I haven’t cheated for three years, like Dr. B. and I don’t cheat because …
Carole Freeman: High five to no cheating. I’m on that bandwagon.
RD Dikeman: You don’t even have to. We still have a chocolate chip cookie now. It’s made out of almond flour, just not wheat grass. What tastes better?
Carole Freeman: Did you try the keto cookie at the Low Carb, USA, right?
RD Dikeman: Yeah, the keto cookies are great. You don’t need to eat that junk anyway. It is addictive. You’ve got to go cold turkey, and you never want to add back the carbohydrate. I see people struggling with this. I didn’t struggle much once I got over it, but once people start adding it back, it’s just not the way to go. That’s why we don’t cheat in the family. We don’t have, “Oh, Dave. It’s Thanksgiving, so go for it, and we’ll just cover it. It won’t hurt you one time.” We just don’t do it. It’s stupid. Why would we do it?
Carole Freeman: No, and I can imagine he has zero desire, as well, because he knows how that makes him feel.
RD Dikeman: Well, when you get started, it’s natural to kind of test the boundaries. At school, when he got started … He was diagnosed in March. We were low carb by August, something like that, and then he went back to school. In school, they’d have like popcorn. He would try a small eight ounce cup full of popcorn, it was literally like a handful. What would happen? His blood sugar would go so high, and he’s spend the rest of the day working with me on the phone to get it back down. Is it really worth it to have five minutes of popcorn and spend four hours … He’s always been very analytic about what the blood sugars are going to do to him in the long term, so that’s a motivator for him. Anyway, after a few things like that, It was kind of like … He doesn’t cheat either, which I thank my lucky stars because it’s a nightmare.
Carole Freeman: Yeah, yeah. I’m curious, what have you noticed in your own health, in your own body, as you’ve adopted this way of eating in support of your son?
RD Dikeman: Well, I lost a lot of weight. I was like 260 pounds at my max and kind of a disaster.
Carole Freeman: You were working out at that weight.
RD Dikeman: I belong to a gym. I went to the gym. I would do a spin class. I would lift weights. It wasn’t like I was sedentary. I was a big golfer, so I was always outside. You can’t overcome the bad diet. It’s totally true. Then when you get on the good diet, and you really get it nailed, it’s like I was telling someone today, it’s like the weights lift themselves. You have so much energy if you get everything nailed down. I feel better now than I have ever felt in my life, and I’m almost 50 years old. I’m stronger. I have more endurance. That makes a real difference in your attitude towards life.
You feel … I’m so happy. My kid has Type One diabetes, life threatening, 24, 7. I’ve got to get up all night and make sure his blood sugars are good, but I’ve got to tell you. I’ve never been happier because overcoming it and dealing with it and beating it and being on his team and being a part of all that and just feeling better has put a silver lining on this bad situation. I couldn’t have had this situation and continue down that road of being fat and over carbohydrated and not feeling healthy, because you feel terrible all the time too. You feel depressed. I need the energy to deal with this situation, and I need the positive vibration to deal with this situation and to overcome it because it’s a lot of work.
Carole Freeman: Yeah, yeah. Well, good for you. Yeah. I just love hearing stories of people that they’re faced with whatever challenge, health challenge, and then they just look at it like, “I just need to figure this out. I still have the power within me to overcome this. I’m not a victim of my diagnosis. I’m not a victim to my genetics, my environment, I actually can figure this out. I can be really healthy.” Then when you do, you feel better than you ever have.
RD Dikeman: Right, but it’s tough. I think the information is getting out, but it’s tough to come across the information. Social media has been a real blessing. I’ll tell you another part of the story. It wasn’t just Bernstein. It was also that when I was on social media initially, I got on these parent forums, and it was very scary to hear the daily stories of what was happening to these kids. I did stumble across a few success stories. One is a guy named Ryan [Atar 00:46:57], and Ryan was a former Army captain. He was following the Bernstein protocol. He was doing Crossfit. His blood sugars and A1C were good. I thought, “Hey, why don’t we try to find people who are actually Type One diabetics and having success.”
I started to meet all these people across social media, and they were inspiring. Like you’re saying, they’re inspiring. They’re all doing the same thing. They’re all restricting their carbohydrates. They’re all exercising. They all know this Bernstein book. They’re following it pretty close to 100%, some tiny differences around the edges, but everyone is pretty much doing the same thing. That was a really powerful moment, too. I kind of got away from the parent forums and got more interested in networking with the actual adult diabetics who were overcoming the limitations of the disease and learned how to get normal blood sugars.
Man, I learned so fast from these people because, I guess, there’s so many tricks involved. That was an awesome experience, and now I’ve got all these very close friends on a day to day basis that I talk to. Yeah.
Carole Freeman: Nice, nice. I wonder, what are your … One other question I have too is then, compare and contrast Dr. Bernstein’s low carb approach to a ketogenic approach. I know it’s pretty similar, but it’s going to be different. Your goal is not ketosis for what you guys are doing, right?
RD Dikeman: Right. That’s a great question. A few things, okay. First of all, because … You go back to the original Dave story, when Dave was in DKA. The word ketone is going to strike fear into the hearts of both parents and doctors, but there’s a huge difference between ketones and ketoacidosis. The difference is that ketoacidosis requires a zeroing out of insulin onboard and high blood sugars, some [inaudible 00:49:27] high blood sugars. Ketones themselves are not poisonous. They are matabolites of fat. When you’re metabolizing fat in your body for energy, you might see some ketones.
Now, the real thing you have to worry about is the ketoacidosis as a diabetic. By avoiding high blood sugars as your goal, then you’re going to be okay. On a low carb diet, Dave is very rarely above let’s say 130 milligrams per deciliter. If he is, we’re aware of it, and he gets insulin. If you’re on a high carbohydrate diet, your blood sugar is always so high, maybe up in the three or four hundreds at times, that you’re not sure whether you have insulin or not. A typical DKA situation might be like a Type One diabetic eats a piece of cake, and then they might forget to take their insulin or their pump might break, and they go to sleep.
They go to sleep. They’re not getting insulin. Their blood sugar rises. Their body starves from glucose. Then their body starts producing ketones because there’s no energy getting into the cells. Now you have high glucose and high ketones and no insulin. Your body starts reacting to the dual dehydration complex of high blood sugar and high ketones. You get dehydrated, and you enter DKA. The way to avoid that is to keep your blood sugars normal. If you look at the statistics, Type Ones who have very normal blood sugars, A1Cs in the low fives, have much lower incidents of going into DKA than people with high blood sugar. It really is the high carb approach that ends up causing the most DKA.
Now, putting that aside, what about this low carb and ketone thing? There’s Bernstein’s diet, ketogenic or not. Bernstein would say that the goal of his diet isn’t ketones. Okay? The goal of a Type One diabetic, the importance of keeping normal blood sugars is so paramount and of such an overriding difficulty, as far as your hour to hour demands, that seeking out ketones for some other reason is really something that is sort of inconsequential in comparison. His diet, he doesn’t care about ketones. He cares about normal blood sugars.
For kids, the ketogenic diet … Like kids that have epilepsy, it’s generally a high fat diet. The Bernstein approach is to push lots of protein for kids for proper growth. What I track is blood sugar, and I track … Well, he eats enough vegetables, so I don’t worry about that. I do track protein though in grams per day, and I don’t even really measure ketones because if he has ketones, it means that he’s metabolizing some of the dietary fat that he ate. If he eats some eggs or if he has a heavy cream and whey shake, he might make some ketones, which means he’s metabolizing the fat. He’s in no worry of DKA because his blood sugars are normal. That’s kind of the long …
Carole Freeman: Yeah, very cool. Yeah.
RD Dikeman: Is it a ketogenic diet? You might produce ketones from time to time, but certainly it’s not the goal, and it’s not something that has to be measured at all. There’s nothing in the book about you need to measure ketones twice a day. Shoot for ketones of two millimoles or something like that. It’s irrelevant to the approach.
Carole Freeman: I can imagine with the focus on protein, adequate protein, that higher protein, that that helps stimulate appetite, as well, because I know one of the challenges that parents have with a traditional ketogenic diet for kids with epilepsy is that the really high fat diet suppresses appetite a little bit, and so I can imagine. I’ve seen pictures of your son. He’s tall, he’s handsome, he’s healthy. You shared that he’s in normal growth range, so I can only imagine that the way that you’re feeding him, he doesn’t have a problem with not being hungry.
RD Dikeman: No, no. It’s not a problem. No.
Carole Freeman: Yeah, when you offer up a heavy cream shake, I’m sure it’s like, “Yes, please.”
RD Dikeman: Yeah. Well, it is interesting to think about what kind of a meal … What does a day’s worth of meals look like for Dave? Basically, I tell people they’re pretty much the same as a non-diabetic. We just use different ingredients. He has waffles or pancakes for breakfast, but we use almond flour and all these trick recipes that I’m sure you’re totally well aware of that are out there. People are starting to get aware that you don’t have to use wheat to bake things. We had these cheddar biscuits, I think they’re a Maria Emmerich recipe. You cannot believe how good the food can be.
Carole Freeman: Yeah, we live in just a wonderful time. Even five years ago, the creative low carb cooking, it just really wasn’t out there. I’m not quite sure what happened. Maybe it was just the whole focus on foodies and all the cooking shows and people started getting a little more creative with these low carb recipes, but you’re right. There’s a plethora of them. I always tell people that whatever you loved before, your high carb favorites, there is a low carb, keto-friendly version of that. I always jokingly say that the only thing we haven’t mastered yet is craft beer. There’s no low carb version of craft beer yet, but I bet that there’s 10 people right now in their garage working on that. I’m sure not too long, and we’ll have these low carb craft beers, and then we can say truly that there is everything, every version. Before Dave’s 21, there will be that version for him.
RD Dikeman: Yeah, you nailed it on the beer. I don’t drink beer anymore. I drink red wine and coffee. No more pale ales.
Carole Freeman: Yes, that was one of the ones that I gave up as well, but for how good I feel, I’m not missing it at all.
RD Dikeman: [crosstalk 00:56:14].
Carole Freeman: Go ahead. I have one … Well, at least one more question for you. What is your vision? Do you have like a goal or a vision of what you want the approach to Type One … When kids get a diagnosis of that, what do you see as a future? What would you like to be the way that the world works?
RD Dikeman: Well, it’s sort of criminal that the parents … You can’t underestimate the degree at which parents are essentially, I would say nearly, but it actually is, they’re bullied into feeding their kids unhealthy foods that results in diabetic complications. There’s a guideline issue. You have pharma funded professional diabetes associations issuing guidelines that doctors have to follow or feel are correct and are misinformed. There are numerous instances that I know where these guidelines are nearly enforced on these poor kids.
What needs to be done is there needs to be recognition that this whole system is totally wrong and that a low carb approach to managing Type One diabetes and removing the threat of complications and all the insulin management ideas behind doing it. They need to be taught by the doctors. The doctors have no idea how to control diabetes. They need to learn how to control it. They’re spending many years becoming endocrinologists and physicians. It shouldn’t be so hard for them to engage in a little bit of thinking so that they’re not sending these diabetic children down the tubes from the moment that they’re diagnosed.
That’s what I want to change, and I don’t know how to change it. I teach as many people as I can what we’re doing. You can give people the link to the book, and if they’re following the book, then they have success.
Carole Freeman: Yeah, well, and those of you who are watching this now, share this because … What percentage of kids or the population has Type One? What are we talking about?
RD Dikeman: I forget. It’s not a huge number.
Carole Freeman: Yeah, well, so those of you who are watching this, I bet there’s somebody that you know that is affected by Type One, so share this video. We can get the word out. I think, this reminds me of … Do you remember Tony Martinez that talked at Low Carb, USA, one of the last speakers that was there, where he talked about … He’s a lawyer, and he talked about kind of the problem with an approach that’s been the predominant approach bureaucratically, it’s really hard to get them to say, “Oops, sorry. We were telling you the wrong thing.”
It ends up being a groundswell effort that has to be from the patient, the consumer, up. I think the work that we’re doing with sharing stories and success stories and the community that you have on your Facebook group, TYPEONEGRIT, and the video series that you’re doing with Dr. Bernstein, these are all the things that we have to do to empower parents and empower people living with this disease to do something different. You can have that control, and it doesn’t have to be as hard a way of life. You can have an amazing quality of life. Your son, he’s playing basketball and sports, and he’s just a normal kid, right?
RD Dikeman: He’s playing basketball and sports at normal blood sugars.
Carole Freeman: Yeah, yeah.
RD Dikeman: You don’t have to look at your kid like it’s this … I can’t imagine going through my day to day life, looking at my kid like, “Well, you know, I have to reorient my thinking about his future. He’s caught a bad break.” There’s actually something that you can do about that. Why wouldn’t you do something about it? I say to the parents, “Why wouldn’t you do something about it?” They say, “Oh, you are a bully to your son. You’ve got to control everything that goes into his mouth.” If you have a 13 year old, I tell this, there’s no way that I can control what goes on. I say goodbye to Dave at 6:00 a.m., and I pick him up at 6:00 p.m. That’s 12 hours that he’s away that he can do whatever he wants. I tell him, “I cannot control you, but I can control myself, and I will never eat the foods like grains and starch and sugars and fruits that will hurt you.” I think that makes a big difference, to set the example, especially, I blew it on the oatmeal, so I have to make up for that.
Carole Freeman: Yeah, yeah. Well …
RD Dikeman: He sees the difference that it makes with me. So far, so good.
Carole Freeman: I applaud you. You are a model father and family leader.
RD Dikeman: Thanks.
Carole Freeman: I shared with you after you spoke at Low Carb, USA just how touching the work you were. Of all the speakers that were there, you made me tear up with what you’re doing because it’s just … It’s kids. It’s adults too, but it’s kids. This is important stuff. Adults can make their own decisions about what they put in their body, but kids don’t know any better. They don’t know any better. Well, so just in closing, is there anything else that you were hoping that I’d ask or that you wanted to talk about?
RD Dikeman: Well, that’s a tough one. We covered so much ground. I would just … There’s a couple good resources, Diabetes University on YouTube. There’s the book Diabetes Solution, and that book is like a reference guide. It has everything in it that you could possibly need to know about Type One. Some of the videos are really geared towards initial contact with Type One diabetes, and I think they’re really helpful. When we made the videos, I said to myself, there’s a couple of videos where I interviewed Bernstein, I said, “What would I want to know, if I could redo this from the get go and that if only someone would have told me?” That’s what I tried to achieve with some of those interviews with him is to help the newly diagnosed parents before they get into this rut of riding this roller coaster all day long in the name of eating steel cut oatmeals and juices and all that nonsense.
Carole Freeman: Yeah, and not missing out on the Starbucks cookies, right?
RD Dikeman: Yeah, right. There’s all the mythology that you have to fight just to … These parents are being told by their doctors to go down this … Of course, everybody trusts the doctor, and they think that they know what their talking about. In this case, they don’t.
Carole Freeman: Right, right. Yeah, so we’ll put links to all those below here, as well. My closing question, I think I stole this from a podcast, it might have been Dave Asprey or something like that that I stole, but what … I’m going to ask a double. I usually ask if you knew today was your last day on Earth, what would be your final meal, but I’ll ask, too, if you know what Dave’s would be, as well. I’d be curious.
RD Dikeman: Oh, okay. What would Dave’s meal be? You know, I don’t know. That’s a good one. Dave’s a big steak guy. He likes the most expensive steak. He likes the filet mignons, right? I get a lot of those. I know that would be on the menu. What does he like for dessert? Okay, I get the dessert. Here’s the low carb dessert recipe to check out. Carolyn Ketchum’s site, All Day I Dream About Food, she has a Boston Cream Poke Cake.
Carole Freeman: Oh, I saw that show. I think you posted … You made a banana cream pie out of that. Yeah, okay, I saw that.
RD Dikeman: That is the … Roxanne made one of those Sunday, and three quarters of it is gone. I ate very little of it. That is a good one. That would probably be it, steak and poke cake.
Carole Freeman: Okay, okay. How about, you too, or what would you have?
RD Dikeman: I’d be happy eating that, too, but I would tell you that even on my last day, I am still not eating carbohydrate. If Dave was eating it, and the nuclear bombs were going off in the background, I’d still look at him and go, “Dude. I beat you, man.” We would not go for it. I don’t think he would go for it. He’s stubborn.
Carole Freeman: That’s one of the things I love about this question is that it shows people that even … This isn’t a torturous diet. People aren’t doing this, feeling deprived, and they can’t wait until the day that they can have whatever crap again. It’s like, they just enjoy the food so much that even on their last day, they’re still going to have that same food. I love that.
RD Dikeman: Yeah, yeah. No, oatmeal, not on the menu anymore.
Carole Freeman: Yeah, yeah. I hear my son is here, so I’m going to invite him so you can say to my son.
RD Dikeman: Okay, cool. That’s great.
Carole Freeman: Kendall.
Carole Freeman: Come here. I’m talking to Dr. Dikeman in Hawaii right now.
Carole Freeman: Yeah, come say hi.
Kendall: How’s it going?
Carole Freeman: This is my little child.
RD Dikeman: Hey, how old are you?
RD Dikeman: Oh, alright, not so little one.
Carole Freeman: He’s just over a year keto, and he’s had some really amazing health benefits.
RD Dikeman: Oh, good for you.
Carole Freeman: Clear skin, relief of anxiety, depression …
Carole Freeman: Tons of energy. He’s getting straight As in college now. It’s good.
Kendall: It’s a miracle drug.
RD Dikeman: It is. I agree with you, Kendall.
Carole Freeman: He just got back from picking up heavy cream from the store after a day at college.
RD Dikeman: That’s funny. See this list right here? Heavy cream is on the list.
Carole Freeman: Butter, too. Nice, nice.
RD Dikeman: Butter, bacon bits …
Carole Freeman: Alright. Well, I’m going to let you go. I know you’ve probably got some work to do out there, like go play golf or something in Hawaii.
RD Dikeman: Yeah, yeah. No, I’ve got to shop. I’ve got to get food for the [crosstalk 01:07:30].
Carole Freeman: Okay.
RD Dikeman: I’m trying to avoid Costco tomorrow.
Carole Freeman: Oh, yeah, yeah. Okay. That’s probably a good idea.
RD Dikeman: It was fun talking to you.
Carole Freeman: Yeah, thank you so much. This has been such a joy and pleasure. For those of you watching, if you like this video, give us a thumbs up. Subscribe if you want to see more. Please share it. We want to spread the word that there’s really an awesome way for all these people to live.