Iron Man Triathlete Only Feels “Slightly Uneasy” at 2.2mmol/L (37mg/dL)

Last post, I shared how my wife, Nicole, can now function fine with a blood sugar of 2.1mmol/L (37mg/dL). This uncanny ability is thanks to a low-carb, high-fat diet and Buteyko Breathing exercises. But what about a more active person with type-1 diabetes?

Let me introduce you to Egemen Erden. He competes in iron man triathlons in his home country of Turkey. Each day he performs as much as three hours of intense exercise – running, swimming, weight-lifting, rowing. He probably carries a few refrigerators up and down stairs just for fun.

Recently he transitioned into a low-carb, high fat diet.  At the same time, I’ve been helping him apply the Buteyko Breathing Method to his intense workouts. Last week he wrote to let me know an unexpected side effect of his high-fat, high-oxygen experiment:

When I woke up this morning with a BG of 41mg/dL [2.2mmol/L], I noticed that I only felt slightly uneasy. This is the feeling I get when around 75mg/dl [4.1mmol/L]. At 41mg/dl, I should be already pretty agitated, sweating and shaking with a loss of focus and concentration. I got up, and waited a bit to make sure I felt low, then measured and slowly corrected with the help of a banana. No panic, no agitation, no shaking, shivering. This lead me to suspect that my system has started to adopt to low BG already.

I think the reasons for this are many:

  • When you become used to a normal blood sugar level of around 4.7mmol/L (83mg/dL) then dropping down to 2mmol/L isn’t such a far fall. While if you are used to 8mmol/L it’s too far of a leap.
  • The more your body becomes used to relying on fat and oxygen for fuel, the less it minds an absence of sugar in the bloodstream. But if glucose is your main source of fuel, then all the biological alarm bells start to sound when glucose is in short supply.
  • The less the muscles rely on sugar, then what little is left in the bloodstream can be preserved for the brain. But if you’re muscles are dependent on sugar, then there won’t be much left for the grey matter.

Without adequate glucose the brain has trouble with concepts like: “Hey, that’s a red light at a busy intersection I’m about to drive into. Maybe I should hit the break.” Indeed, bio-hacking one’s body to depend on fat and oxygen, not glucose and fermentation, could literally save the life of someone with type-1 diabetes. And, as Egemen has demonstrated, doesn’t get in the way of athletics.

Thinking outside the type-1 matrix,

–John C. A. Manley

P.S. Next post, I’ll share some details about how Egemen is applying the Buteyko Breathing method to raise his oxygen levels and lower his insulin needs. For more on proper breathing during exercise check out: Does Exercise Really Help People with Type-1 Diabetes?

P.P.S. Egemen’s been following a low-carb, high-fat diet as outlined in The Ketogenic Diet: A Complete Guide for the Dieter & the Practitioner by Lyle McDonald. It’s available at, and

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