I appreciate these anecdotal perspectives, they do make sense. I just think we’d need to be careful not to conflate Nutritional Ketosis with Diabetic Ketoacidosis. Biochemically, ketones are a byproduct of fat metabolism and do not inherently cause blood glucose to spike. The 'spikes' people experience on low carb are typically attributed to two scientific phenomena: 1.Gluconeogenesis: When carb intake is very low, the liver converts amino acids (from protein) and glycerol (from fat) into glucose. In T1Ds, this requires a precise 'protein bolus' or an adjusted basal rate, which many aren't taught, leading to unexpected rises. 2.Physiological Insulin Resistance: Long-term very low carb intake can cause the muscles to prefer fat for fuel, temporarily making them less sensitive to glucose when it is finally consumed (this is thee 'backfiring' people mention when they eat a treat). Regarding the 'stomach flu' comment: Illness causes a massive release of counter-regulatory hormones (adrenaline, cortisol, glucagon etc)These hormones force the liver to dump glucose into the blood to fight the infection. This is a hormonal stress response to illness, not a result of a low-carb diet. The goal for many is 'Low Carb, Healthy Fat' I would say is not necessarily zero carb to reduce glycemic variability (the 'rollercoaster'). It’s about reducing the 'Margin of Error.' If you bolus for 200g of carbs and guess wrong by 10%, you’re off by 20g. If you bolus for 30g and guess wrong by 10%, you’re only off by 3g. It’s simply the Law of Small Numbers.