What do Diabetes and Epilepsy have in common?
This morning I watched a youtube presentation from the latest low-carb summit (Low Carb Breck 2018) by Dr. Eric Kossoff, specialist in epileptic children and ketogenic diets. It brought back a memory. Two years ago I wandered the aisles in the health food store in Hot Springs looking for a low carb protein powder I could use to make faux pizza crust. As a diabetic I don’t “do” grain but occasionally would like to create a substitute. The sales clerk was very interested in my mission because her daughter is epileptic and treated with a ketogenic diet. Apparently this diet had almost completely eliminated her daughter’s seizures. So the question is, what do diabetes and epilepsy have in common?
Cool stuff! Seems some version of a ketogenic diet will help control blood sugar for diabetics, be very effective for losing excess weight, managing epileptic seizures, and preventing/treating other brain conditions like dementia and Parkinson’s. What these conditions have in common is not immediately evident. So what the heck does a ketogenic diet have to do with it?
A definition would be a good start. A ketogenic diet (there are many versions) has very low carbohydrates and a much higher percentage of fat in the diet. Why is that combination important?
The answer is insulin resistance.
In the simplest terms the body has two sources of energy, glucose (sugar) and fat. Glucose is either provided by carbohydrate containing foods or manufactured by the liver. In a pinch the liver can use almost anything including protein to manufacture glucose. A small backup supply of glucose is always required. The liver manufactures the glucose and stores it away, anticipating ongoing short term need for quick energy.
Fat is either delivered from fat containing foods (like meat or, to a smaller degree, vegetables and some fruit) or manufactured by the liver. The liver manufactures fat from excess glucose and stores it away in our body fat stores. While glucose has no purpose in the body other than energy production and blood sugar maintenance, a large percentage of the body construction is actually fat.
When the energy needed is greater than that available from dietary glucose or the limited storage of glucose in the liver/muscles, the body removes fat from fat cells and converts that fat into ketones. The ketones then are available to do all the energy production work that glucose does – just in a different way.
So if the body perceives that a person actually is or appears to be in energy deficit (starving) the body automatically goes to plan B, converting body fat into ketones and using those ketones for energy.
The appropriate presence or absence of the hormone insulin is required for all the glucose stuff to happen. In the case of glucose, insulin is required to deliver the glucose into all the body cells (including brain cells). What happens in all of the conditions listed above is that insulin resistance builds up; creating a flood of glucose that is blocked from reaching its destination.
Ketones, on the other hand, can be delivered and used for energy without the presence of insulin. Are you getting the picture?
Chronic Insulin resistance develops when insulin levels remain high on an ongoing basis. This is typically true of a long term usually high processed starch diet but can also occur with ongoing illnesses, medications, or chronic stress. Occasional insulin resistance is perfectly normal and required. Ongoing is not.
So insulin resistance is the common thread.
- Glucose energy and insulin are in abundance, insulin resistance develops. Blood sugar levels rise and remain high. This is called diabetes.
- We have all this stray sugar hanging around in the blood. The liver ramps up conversion of excess glucose into fat. This is called overweight or obesity.
- The glucose streams into the brain but the brain has insulin resistance and is starving for energy. This is called a lot of things, Parkinson’s and dementia are just two. Dementia is now often called type 3 diabetes.
One of insulin’s jobs is to keep fat in the fat cells. And when things get really bad, insulin fails in that job too, allowing fat to flood the blood stream when blood sugar is high. Double load of energy with nowhere to go.
If you ask the right questions on Google, you can find multiples of studies associating insulin resistance with all sorts of conditions, including things that go wrong in the brain.
When it comes to epilepsy, after 100 years researchers are still trying to “prove” exactly what energy dysfunctions cause epilepsy. Epilepsy is a complex condition. The one thing they know for sure is this. In a large percentage of cases, significant reductions in the presence of glucose and the substitution of ketones for energy can make an amazing difference in seizure levels. Back before scientific research was so big, fasting (as in not eating) was the epileptic treatment of choice. In fasting, glucose levels are low and ketone levels are high although they didn’t know it at the time.
For those with a particular interest in epilepsy, here is the you-tube presentation by Dr. Kossoff for your review.
If you want to go really deep into epilepsy, this article will also be helpful.
For those who want to deal with diabete, overweight, or potential dementia/other neurologic disorders, your issue is likely excess insulin rolling around, creating insulin resistance. Start by eliminating processed foods from your diet and give ketones a chance. If you don’t know what that means for you personally, I recommend my book, it’s All about the Food.
Pat Smith is the author of “It’s All about the Food,” a book that guides nutritious food choices as the way to avoid illness and maintain a healthy weight. Pat is a resident of Montgomery County, AR, president of Ouachita Village, Inc. board of directors (Montgomery County Food Pantry); chairman of the Tasty Acre project; and member of the Mount Ida Area Chamber of Commerce board of directors. Her website is http://allaboutthefood.org/