Several scientific studies show the effectiveness of a low-carbohydrate, high-fat ketogenic diet for the treatment of diabetes. In this article we will tell you everything you need to know about the ketogenic diet for diabetes.
A keto diet offers many nutritional benefits. For example, the keto diet is an effective way to control your blood sugar levels and help you lose weight. Both of which are crucial for the treatment and prevention of type 2 diabetes.
Diabetes is one of the most common metabolic diseases worldwide. There are currently more than 465 million people with diabetes worldwide.
More than 90 percent of those affected suffer from type 2 diabetes.
Most physicians agree that type 2 diabetes can be prevented with special diets and lifestyle changes. But not everyone agrees on the right diet to do the job.
Fortunately, there are now many studies and research suggesting that a low-carbohydrate, high-fat ketogenic diet can help regulate blood sugar levels and get your diabetes symptoms back on track.
Some experts claim that the keto diet can completely reverse type 2 diabetes.
So, let’s take a look, shall we? Could the keto diet be diabetic friendly?
What Is the Keto Diet?
The keto (short for ketogenic) diet is a very low-carbohydrate, high-fat diet, which leads the body from burning carbohydrates (glucose) for energy, to using fat as a source of energy instead. This state is called ketosis.
The ketogenic diet was originally developed for therapeutic purposes. It was conceived in 1924 as a nutritional therapy for treating epilepsy in children. Today researchers are focusing on the positive effects of ketogenic nutrition in diabetes.
A very low-carbohydrate diet for diabetes makes perfect sense. The keto diet is known to lower blood sugar and make your cells more sensitive to insulin, so you will not experience blood sugar fluctuations associated with carbohydrate consumption.
The ketogenic diet is also known for numerous health benefits like:
- Rapid fat loss
- More energy
- Better body composition
- Better brain function
- Reduced inflammation
But what if the keto diet could do more than fast weight loss and clear thinking?
What if ketosis could help people with diabetes become less insulin-resistant and get their blood sugar back on track?
In this article you will learn more about diabetes and how most people can actually reverse this common disease with a ketogenic diet.
What Is Diabetes?
Before looking at the role of ketogenic nutrition in diabetes, it is important to understand how diabetes works and know some basic medical terms.
Diabetes is a disease that can occur when you have high blood sugar levels over a long period, also known as chronic high blood sugar.
Blood sugar (or blood glucose) occurs when your body breaks down the food you eat (usually carbohydrates) into glucose. Your blood then transports glucose through your bloodstream to all the cells in your body, where it is used as an energy source.
Glucose is the most important source of energy for most people – unless you are in ketosis. But we’ll get to that in a moment.
Insulin is a hormone produced by your pancreas to help transport glucose into your cells for energy.
The whole process looks like this:
- When you eat food, your body breaks down the carbohydrates it contains into glucose
- Glucose gets into your bloodstream
- Your body senses an increase in blood sugar and your pancreas receives the command to produce insulin
- Insulin helps to transport glucose into your cells for energy production
If your body does not produce enough insulin or does not use it properly, sugar (glucose) will remain in your bloodstream instead of being released to your cells to produce energy.
Over time, excess levels of circulating glucose in the blood lead to a number of metabolic and inflammatory problems, also known as diabetes.
The Two Types of Diabetes
Type 1 Diabetes
Type 1 diabetes is an organ-specific autoimmune disease that causes your immune system to destroy the cells in your pancreas that are responsible for insulin production.
This happens through a combination of genetic and environmental factors. As a result, people with type 1 diabetes cannot produce natural insulin and must take insulin daily.
Although this form of diabetes is sometimes called juvenile diabetes, you can develop type 1 diabetes at any age.
It is estimated that 1.25 million Americans have type 1 diabetes and more than 200,000 of which are people under the age of 20 years old.
Type 2 Diabetes
Type 2 diabetes is the most common form of diabetes.
In type 2 diabetes, you either become insulin-resistant – this means that your pancreas produces insulin, but your cells reject it. Or your pancreas stops producing enough insulin to cope with chronic high blood sugar.
Either way, type 2 diabetes is usually the result of chronically high blood sugar caused by poor diet and lifestyle choices.
You can get type 2 diabetes at any age, but it is most common in middle-aged and older adults.
The Keto Diet and Type 2 Diabetes
The ketogenic diet lowers blood sugar levels, which can help if you have type 2 diabetes.
The use of ketogenic nutrition for other types of diabetes – such as type 1 or gestational diabetes – is somewhat more complicated. More on this below.
In type 2 diabetes, your body does not respond properly to insulin – also known as insulin resistance. If you are insulin-resistant, your cells cannot use your blood sugar for energy. Instead, the sugar builds up in your bloodstream, also known as chronic high blood sugar.
Because a keto diet changes your system from using glucose to making and using ketones from fat as fuel, your blood sugar naturally begins to drop when you get into ketosis.
Therefore, people who follow a strict ketogenic diet begin to notice positive changes in blood sugar and insulin levels.
Some people even claim that the keto diet can reverse or prevent type 2 diabetes altogether.
To reach the state of ketosis, a strict macro nutrient ratio is required, which you may not be used to. The most important part of keto is that you must remove most starchy carbohydrates from your diet.
Our dietary guidelines state the Acceptable Macronutrient Distribution Ranges (ADMR) for adults are 10-35% protein, 45-65% carbs, and 20-35% fat. Whereas, in contrast, most people on a keto diet limit carbohydrates to 30 grams or fewer per day, which results in about only 5% of your daily intake.
With such a low carbohydrate intake, your body naturally has a lower blood sugar level and needs less insulin to transport this sugar into your cells.
In addition, a keto diet can help you lose weight quickly, which is crucial for preventing and controlling diabetes.
To summarize it again briefly, the ketogenic diet offers the following main advantages:
- Improvement of insulin sensitivity
- Lowers your blood sugar level
- Helps you lose unwanted fat
- Gives you more energy
- Reduces inflammation
All of these benefits help enormously in the control and prevention of diabetes.
Can Keto Diet Cause Diabetes?
There is some confusion about whether the ketogenic diet causes diabetes.
This is because people confuse the terms ketosis and ketoacidosis. These are two completely different biological states, one of which has many health benefits, while the other can be fatal.
When you switch your main energy source from glucose to fat, you increase your blood ketone levels. More ketones in your blood is good news because your body and brain use ketones for fast, clean energy.
If your blood ketone level is around 0.1 mmol/liter to 1.5 mmol/liter, you are in nutritional ketosis.
Ketoacidosis, on the other hand, refers to diabetic ketoacidosis, usually a complication of type 1 diabetes. This occurs when there is a dangerously high number of ketones in the blood – usually above 3.0 mmol/liter.
(You want to start a ketogenic diet? HERE is a Keto Diet food list to help get you started!)
If you suffer from type 1 diabetes or suspect that your ketone levels are too high, you can measure your ketone levels, read more in this article: How To Measure Ketosis
The American Diabetes Association (ADA) recommends testing for ketone levels when blood glucose is higher than 240 mg/dL.
Monitoring Diabetes in a Keto Diet
If you currently have diabetes and would like to try a ketogenic diet, you should consult your doctor.
Monitoring your blood glucose and ketone levels is crucial, especially if you develop ketosis.
Some experts even recommend formal medical care in the beginning. However, please talk to your doctor before you change your diet and almost completely give up carbohydrates.
Once your body gets used to using ketones as an energy source, you should still make it a priority to see your doctor regularly to make sure your ketogenic diet is working properly for your body.
And because your diabetic symptoms are likely to improve, you may need to change your medication. Again, keep up to date with your blood glucose and ketone monitoring and stay in close communication with your doctor.
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How the Keto Diet Affects Blood Sugar Levels
Dietary ketosis has a positive effect on so many diabetics because it naturally lowers blood sugar and increases insulin sensitivity.
A compelling 2016 study found that a low-carb diet improves blood glucose levels and helps weight loss in adults with type 2 diabetes.
At the end of the 10-week low-carb study, nearly 60% of 262 type 2 diabetics reduced or stopped taking their diabetes medication.
Each person was required to consume no more than 30 grams of carbohydrates per day, while increasing fats and proteins.
In other words, they followed a ketogenic diet (it was just not called that). Several smaller studies show similar positive results.
Why Fat Helps Prevent Diabetes
It has been shown that a ketogenic diet offers both long and short-term benefits for people with diabetes.
The Diabetes Prevention Program conducted a study that followed 1,079 people with pre-diabetes. The results showed that 58% of people were able to prevent the progression of diabetes simply by losing weight and changing their diet.
And while the ketogenic diet is not a standard diet for diabetics, studies show that this high-fat diet can help enormously with weight loss.
Increasing fat intake helps to regulate hormones – including the hunger hormone ghrelin – which results in the reduction of all major cravings.
By not craving too much carbohydrate or sugar, you are better able to stick to a low-carbohydrate diet and keep blood sugar levels low.
Another study conducted by researchers at Duke University Medical Center examined 28 overweight people with type 2 diabetes. During the four-month study, they consumed a low-carbohydrate, high-fat ketogenic diet while reducing their diabetes medication.
The researchers concluded that there was a 16% decrease in hemoglobin A1c (HbA1c), a blood marker that measures your blood sugar over 2-3 months.
The participants also lost an average of 8.6 kg, their triglyceride levels fell by 41%, their blood pressure improved, and their blood sugar levels dropped by 16%.
Eating more fat does not necessarily make you fat! The fact is, if you eat a ketogenic diet and avoid carbohydrates as much as possible, it can even have the opposite effect and help you lose weight and regulate your hormone balance.
Are Saturated Fats Healthy?
Many people are reluctant to follow a ketogenic diet because of its relatively high saturated fat content – and we all know how much saturated fat has been demonised in recent decades.
Because of these guidelines, most doctors tell diabetics to limit their intake of saturated fat to about 10% of their total calories.
Fortunately, there is research that suggests that eating more saturated fat as part of a low-carbohydrate diet is beneficial to overall health, especially if you have risk factors for diabetes and want to lose weight. The next section will discuss this research more.
Low-Carb-High-Fat Diets for Your Health
A study examined 83 adults with a BMI of 33 (technically obese) and a high risk of type 2 diabetes.
They divided them into three different diet groups with the same calorie intake:
- One diet was a very low-fat diet consisting of 20% protein, 70% carbohydrates and 10% fat.
- The second diet was a high-fat diet consisting of 50% carbohydrates, 30% fat and 20% protein.
- The third diet was a very low carbohydrate diet with 20% protein, 61% fat and only 4% carbohydrates.
For each diet, 20% of the total fats were saturated and the subjects were put on an exercise program.
At the end of the three-month study there was an almost identical body fat reduction between the three diets.
But the big surprise was that the very low carbohydrate diet group had improved markers for HDL or “good” cholesterol compared to the other groups.
Even in the very low carbohydrate group, insulin levels decreased by 34%, in the highly unsaturated fat group by 18% and in the very low fat group even by 15%. This shows that low-carbohydrate, high-fat ketogenic diets have identical weight-loss characteristics while lowering total insulin levels compared to other diets.
Saturated fats should not be important if you have diabetes or are pre-diabetic, as long as you consume them as part of a balanced ketogenic diet.
Is the Ketogenic Diet Useful for Other Types of Diabetes?
With the overwhelming evidence supporting ketogenic nutrition as a means of preventing diabetes, there are some precautions to consider.
For example, if you have kidney disease, you need to adjust the amount of protein you eat. Too much or too little can lead to complications.
The keto diet is traditionally a low protein diet with moderate protein intake, but some experts claim that you do not need to limit your protein intake to stay in ketosis.
Be sure to talk to your doctor about your optimal protein intake if you have kidney disease.
What about other forms of diabetes? Is ketosis still safe? Or even beneficial?
Keto With Gestational Diabetes
Gestational diabetes, or pregnancy diabetes, gestational diabetes mellitus (GDM), or type 4 diabetes, manifests itself in pregnant women in the 24th to 28th week of pregnancy.
It causes high blood sugar levels and insulin resistance, which is dangerous for mother and child.
The development of GD does not mean that you had diabetes before you became pregnant, or that you will have it afterwards. But it generally increases your risk of developing type 2 diabetes.
There is some discussion about the best diet for women with gestational diabetes.
The general “safe” consensus among mainstream health professionals is that you should not follow a ketogenic diet during pregnancy.
But the truth is that ketosis is a natural part of being human (it always has been), and while there are not many studies on gestational diabetes and ketogenic diets, if you do more research you will find several positive anecdotal reports about it.
But the answer is not so simple.
The introduction of a ketogenic diet may help to relieve the symptoms of gestational diabetes, but it should be done with extreme caution and medical supervision.
Eating a low-carbohydrate diet may be a better approach to prevent and control gestational diabetes.
Make sure you consult with your gynecologist before changing your diet so that he can guide you through the process.
Check out this post for more information about doing a keto diet while pregnant.
Is the Keto Diet Safe for Type 1 Diabetes?
The short answer is maybe. The long answer is a little more complicated.
Type 1 diabetes is not only an autoimmune disease, it also prevents your pancreas from producing insulin at all.
This is different from type 2, which causes a reduction in insulin production or insulin resistance.
For example, ketosis might not work with type 1 diabetes for a variety of reasons:
- No matter how low your blood sugar is, your pancreas will never produce insulin if you have type 1 diabetes.
- You are more prone to low blood sugar when you have type 1 diabetes.
- You are more susceptible to diabetic ketoacidosis if you have type 1 diabetes – a dangerous condition that increases blood pH and could kill you.
However, some doctors, like Dr. Richard Bernstein, who controls his own type 1 diabetes with very low carbohydrate levels, believe that ketogenic diets can help protect blood glucose levels from increasing. Check out his book on Amazon.
Another advocate of the keto diet is, actress Halle Berry, who uses the keto diet to control her type 1 diabetes and maintain a healthy weight.
Be sure to talk to your doctor before you change your diabetes treatment plan.
How Can the Keto Diet Help With Diabetes?
To conclude, let’s talk about how the keto diet helps with diabetes.
Ketogenic nutrition can be a beneficial diet for the prevention and treatment of diabetes. In particular, a ketogenic diet can help people at risk for type 2 diabetes by:
- Promoting healthy weight loss
- Improvement of insulin sensitivity
- Regulation of your hunger hormones to reduce the desire for food
- Increasing levels of good cholesterol
- Improvement of the HbA1c markers – your average blood sugar over 2-3 months
But it is important to remember that no diet works the same for every person.
The ketogenic diet may be useful for people with type 2 diabetes, but be careful if you have type 1 or gestational diabetes and follow a strict ketogenic diet only after consulting your doctor.
Always consult your doctor before you make any drastic restriction in your life or start a new diet, especially if you are currently taking medication.
If you want to give keto diet a chance in the treatment of diabetes, monitor your blood sugar and ketone levels closely and make sure that a low-carbohydrate, high-fat diet is appropriate for your body.
Thanks for reading!