Keto Diet For Diabetics: Does It Work?

The ketogenic diet, or keto, is a low-carb, high-fat dietary regimen that has been linked to improvements in insulin sensitivity and higher rates of weight loss — both positive factors in managing type 2 diabetes. Lowering carb intake induces a metabolic state known as ketosis, through which the body produces ketones that burn fat for energy instead of carbohydrates. While the keto diet can be beneficial for some people with type 2 diabetes, it also has potential risks and side effects, and it's not recommended by the American Diabetes Association (ADA). Here's what you need to know about the keto diet and type 2 diabetes.

Potential benefits of a keto diet for diabetics

A keto diet may benefit people with type 2 diabetes, but it is important to consult a doctor before making any drastic dietary changes. Here are some potential advantages of a keto diet for diabetics:

Improved Blood Glucose Control and Reduced Medication Dependence

The keto diet can lead to better blood glucose control in people with type 2 diabetes. By reducing carbohydrate intake, the diet lowers glucose levels, which can help achieve the recommended A1C goal of 7% or less. Improved glycemic control may also reduce the need for insulin and other diabetes medications over time.

Weight Loss and Obesity Remission

Weight loss is often a goal for people with type 2 diabetes, as obesity is a major risk factor for insulin resistance. The keto diet has been shown to aid weight loss, and losing above 10% of body weight or 15kg can put type 2 diabetes into remission.

Improved Insulin Sensitivity

The keto diet's high-fat content and reduced carbohydrate intake can improve insulin sensitivity, meaning the body's ability to respond to insulin may get better. This can lead to a reduced dependency on anti-diabetic medication.

Lower Hemoglobin A1C Levels

The keto diet has been associated with lower hemoglobin A1C levels, an important clinical measure of blood sugar control for people with type 2 diabetes.

Reduced Triglyceride Levels

Studies have shown that a long-term keto diet reduces triglyceride levels in people with obesity. High triglyceride levels are an independent risk factor for diabetes.

While a keto diet may offer these potential benefits for people with type 2 diabetes, it is important to note that it also has certain drawbacks and risks. It is always advisable to consult a healthcare professional before making any significant dietary changes, especially if you have a medical condition such as diabetes.

Risks and side effects of a keto diet for diabetics

The keto diet is a low-carb, high-fat diet that causes the body to burn fat instead of carbohydrates, leading to weight loss. While it has been shown to be effective for some people with type 2 diabetes, there are several risks and side effects associated with it.

Short-term side effects

Following a keto diet may result in short-term side effects such as:

• Keto-flu, which is a group of symptoms that resemble the flu
• Changes in bowel habits, such as constipation or diarrhea
• Uncomfortable leg cramps
• Loss of energy

Long-term side effects

Long-term effects of a keto diet may include:

• Development of kidney stones
• Increased risk of nutrient deficiencies due to the restriction of certain food groups
• Risk of dyslipidemia, an imbalance of lipids in the body
• Elevated risk of fatty liver disease
• More frequent hypoglycemic episodes
• Higher risk of cardiovascular disease due to a buildup of fats in the arteries

Other considerations

The keto diet can be difficult to stick to in the long term due to its restrictive nature. It may also lead to yo-yo dieting, which can be dangerous for diabetics. Additionally, those following the keto diet alongside an insulin regimen may have a higher risk of developing low blood sugar, or hypoglycemia.

It is important to consult with a healthcare professional before starting a keto diet, especially for those with diabetes, as it may require adjustments to diabetes medication.

How to follow a keto diet

The keto diet is a low-carb, high-fat dietary regimen that has been linked to improvements in insulin sensitivity and higher rates of weight loss. Lowering carb intake induces a metabolic state known as ketosis, through which the body produces ketones that burn fat for energy instead of carbohydrates.

If you want to try the keto diet, it is important to consult your doctor and dietician, who will need to supervise you closely. Here are some general guidelines on how to follow a keto diet:

• Carbohydrates: 5%-10%. In a 2,000-calorie daily diet, this equates to around 20-50g of carbohydrates.
• Fats: 70%. Focus on unsaturated fatty acids and healthy fats such as avocados, olive oil, nuts, and seeds.
• Protein: 20%-30%. Include lean meats, fish, poultry, eggs, and dairy.

Foods to eat on a keto diet:

• Low-carb vegetables: Leafy greens, broccoli, eggplants, bell peppers, celery, and asparagus.
• Healthy fats: Avocado oil, flaxseeds, pumpkin seeds, nuts, coconuts, high-fat dairy, high-fat salad dressing, and avocados.
• Protein sources: Chicken, turkey, beef, salmon, tuna, shrimp, pork, cheese, and eggs.

Foods to avoid on a keto diet:

• Grains: Rice, corn, cereal, pasta, and other wheat-based foods.
• Sugar: Honey, syrups, agave, juice, candy, and anything else high in sugar.
• Legumes: Peas, lentils, chickpeas, and beans.
• Tubers and root vegetables: Potatoes, yams, carrots, beets, radishes, and turnips.
• Saturated fats: Mayonnaise, processed vegetable oils, sausages, hard cheeses, and butter.
• Fruits: All fruits except limes, lemons, tomatoes, and berries.

It is important to remember that the keto diet can be restrictive and may be challenging to follow in the long term. It is not recommended to follow this diet for longer than 12 months. Additionally, it is crucial to monitor your symptoms closely and be aware of potential side effects, such as "keto flu," which may include unpleasant symptoms such as headaches, vomiting, constipation, mood swings, and more.

Other diets for people with type 2 diabetes

While there is no one-size-fits-all diet for managing type 2 diabetes, certain dietary patterns can help keep blood sugar levels in check. Here are some alternative diets for people with type 2 diabetes:

Mediterranean Diet

This diet focuses on whole foods like fruits and vegetables, whole grains, olive oil, legumes, nuts, and poultry and fish, while limiting red meat. It has been researched extensively and is known to reduce the risk of heart disease, which is important for people with diabetes as they are at a higher risk of cardiovascular issues.

DASH Diet

The DASH diet is similar to the Mediterranean diet, emphasising fruits and vegetables, whole grains, fish and poultry, beans, nuts, and fat-free or low-fat dairy. It also involves limiting sodium intake to 2,300 mg per day (1,500 mg if advised by a doctor). This diet is beneficial for reducing blood pressure, a key risk factor for heart disease and kidney disease, which are common complications of diabetes.

Vegetarian or Vegan Diet

Plant-based diets are associated with positive health outcomes for people with type 2 diabetes. A meta-analysis found that a vegetarian diet led to weight loss and improved glycemic control, as well as a reduced risk of cardiovascular issues.

Low-Carb Diet

This dietary approach restricts carbohydrate intake, which can help regulate blood sugar levels in people with type 2 diabetes. While it may be challenging to maintain long-term due to its restrictive nature, there is evidence that it can lead to weight loss and improved blood glucose control.

Low-Fat Diet

While low-fat diets are not as popular nowadays, fat restriction is still synonymous with weight loss. The American Diabetes Association (ADA) notes that lowering fat intake can improve blood sugar levels, especially when it results in weight loss. Structured very-low-fat diets, like the Ornish diet, may be particularly beneficial.

Intermittent Fasting

Intermittent fasting involves restricting your eating window to a certain number of hours per day or significantly reducing your calorie intake on certain days. While it may have benefits for blood glucose control and weight loss, skipping meals can also negatively affect blood sugar levels, especially for those on insulin or certain medications.

Paleo Diet

The paleo diet involves eating like our hunter-gatherer ancestors, focusing on fruits, vegetables, nuts, lean meats, and certain fats while eliminating grains, legumes, and most dairy. A review found that this diet improved glucose metabolism and reduced insulin resistance, but it did not outperform other diabetes diets.

It is important to consult with a healthcare professional before making any significant dietary changes, especially if you have type 2 diabetes. They can help you determine the best diet choice for managing your condition and make any necessary adjustments to your medication.

Long-term effects of a keto diet on type 2 diabetes

The keto diet may be beneficial for people with type 2 diabetes, but it is important to note that there is a lack of long-term data and research on its effectiveness and safety for this specific group. The keto diet is a low-carb, high-fat dietary regimen that has been linked to improvements in insulin sensitivity and higher rates of weight loss, which are positive factors in managing type 2 diabetes.

Potential Benefits

The potential benefits of a keto diet for people with type 2 diabetes include:

• Improved insulin sensitivity
• Weight loss
• Better glycemic control
• Lower hemoglobin A1C levels
• Reduced triglyceride levels
• Reduced need for diabetes medication

Potential Drawbacks and Risks

However, there are also some potential drawbacks and risks associated with the keto diet for people with type 2 diabetes, including:

• Difficulty adhering to the restrictive nature of the diet long-term
• Risk of nutrient deficiencies, especially fiber, thiamin, and vitamins B6, C, D, and E
• Possible spikes in cholesterol, especially LDL cholesterol
• Risk of hypoglycemic episodes, especially for those taking insulin
• Potential development of ketoacidosis, a dangerous condition
• Increased risk of cardiovascular disease

Recommendations from Health Authorities

Health authorities in the United States do not recommend the keto diet to manage type 2 diabetes. Instead, they suggest:

• Following a balanced diet rich in fresh fruits and vegetables
• Spreading out carbohydrate intake evenly throughout the day
• Eating smaller meals more frequently rather than a large meal once a day
• Working with a healthcare professional to choose the best plan for an individual's lifestyle

Individual Experiences

Some individuals with type 2 diabetes have reported success with the keto diet, experiencing improved blood sugar control and a reduced need for insulin. However, others have found it challenging to maintain long-term due to its restrictive nature.

In conclusion, while the keto diet may offer some potential benefits for people with type 2 diabetes, more long-term research is needed to fully understand its effectiveness and safety. It is important for individuals to consult with their healthcare team before starting the keto diet, especially if they are taking insulin, to ensure close monitoring and appropriate adjustments to their medication.

Frequently asked questions