Keto And Hypoglycemia: A Balancing Act For Blood Sugar Control

Hypoglycemia, or low blood sugar, is a condition where blood sugar levels drop below 3.9 mmol/L (70 mg/dL). While it is more common in people with diabetes, it can also occur in those without the condition. Certain factors, such as dietary choices, can increase the risk of hypoglycemia. One such diet that has gained popularity in recent years is the ketogenic diet, which involves a significant reduction in carbohydrate intake. The ketogenic diet has been associated with both benefits and risks when it comes to blood sugar management. This article will explore the relationship between the keto diet and hypoglycemia, discussing how the keto diet may affect blood sugar levels and whether it can be a viable approach for managing hypoglycemia.

Ketogenic diets can cause hypoglycaemia in non-diabetic adults

The ketogenic diet is a high-fat, low-carbohydrate diet that has been shown to improve glucose regulation and reduce the risk of hypoglycaemia. However, there have been a few case reports of hypoglycaemia occurring in non-diabetic adults following a ketogenic diet. This may be due to the diet's effect on counterregulatory responses to hypoglycaemia, which could increase the risk of hypoglycaemia.

Ketogenic Diet and Hypoglycaemia

The ketogenic diet restricts carbohydrate intake, which lowers insulin levels and causes the body to break down fats for energy, resulting in a state called ketosis. This diet has been shown to improve glucose regulation and reduce the risk of hypoglycaemia, especially in people with diabetes.

Case Reports of Hypoglycaemia in Non-Diabetic Adults

Despite the benefits of the ketogenic diet in regulating blood sugar, there have been a few case reports of hypoglycaemia occurring in non-diabetic adults following this diet. In one case, a 69-year-old woman who followed the ketogenic diet for a year developed hypoglycaemia after consuming alcohol. Another case report described hypoglycaemia occurring in eight children following a low-calorie ketogenic diet, which was thought to be due to a failure to adapt to "fat burning".

Effect on Counterregulatory Responses

The ketogenic diet may increase the risk of hypoglycaemia by altering the body's counterregulatory responses to hypoglycaemia. A study in mice found that a ketogenic diet blunted glucagon release in response to hypoglycaemia, which is a critical hormone for preventing life-threatening hypoglycaemia. However, the ketogenic diet has also been found to protect against hypoglycaemia-induced neuronal damage, possibly due to the induction of molecular adaptive mechanisms.

While the ketogenic diet is generally considered safe and effective for improving glucose regulation, there have been a few cases of hypoglycaemia occurring in non-diabetic adults following this diet. More long-term studies are needed to fully understand the effects of the ketogenic diet on blood sugar regulation and counterregulatory responses to hypoglycaemia.

Ketogenic diets can cause hypoglycaemia in children

Ketogenic Diets Can Cause Hypoglycemia in Children

Ketogenic diets are low-carbohydrate, high-fat diets that have been used to treat epilepsy since the early 1900s. They are also popular for weight loss, and more recently, they have been used to manage diabetes. However, despite their benefits, ketogenic diets are not without risks. One of these risks is hypoglycemia, which is more commonly seen in children following this dietary pattern.

Ketotic hypoglycemia is a common type of low blood sugar that occurs mostly in young children without diabetes. It is characterised by blood sugar levels dropping below 70 mg/dL, along with the presence of ketones in the urine or blood. This condition is typically triggered by prolonged periods of not eating, such as during fasting or illness, and can be exacerbated by dehydration. The main symptoms include sluggishness, dizziness, irritability, and unexplained tantrums or crying.

The ketogenic diet severely restricts carbohydrate intake, which leads to a drop in blood glucose and insulin levels. As a result, the body starts breaking down fat for energy, producing ketones. While ketones can be used as an alternative fuel source, an excess can lead to ketonemia and, in some cases, ketoacidosis. Prolonged adherence to a ketogenic diet can disrupt normal glucose homeostasis, increasing the risk of hypoglycemia. This risk is particularly prominent in children, with younger age being a risk factor.

The treatment for ketotic hypoglycemia is simple: giving the child any form of sugar will help raise their blood sugar levels. Juice or other sugary foods and drinks are effective options. If the child is unable to eat or drink due to vomiting or severe lethargy, they may require emergency medical attention and intravenous fluids containing glucose.

Ketotic hypoglycemia usually resolves on its own as children get older, typically by the age of 5 to 6 years. However, to reduce the risk of hypoglycemic episodes, it is recommended to limit fasting periods and ensure regular intake of sugary beverages, especially during illnesses. Checking blood glucose levels during illnesses can also help prevent hypoglycemia.

Hypoglycaemia can be treated with sugar

Hypoglycaemia, or low blood sugar, can be a challenging condition to manage. It is characterised by abnormally low blood sugar levels, which can cause a range of symptoms, such as dizziness, fatigue, irritability, and mental fogginess. For people with diabetes, hypoglycaemia can be particularly dangerous, and even life-threatening. The standard treatment for hypoglycaemia is to consume carbohydrates, especially sugar, to quickly raise blood sugar levels back into a safe range.

When blood sugar levels drop too low, it is important to act quickly to raise them back up. Pure glucose, in the form of tablets, gels, or liquids, is the preferred treatment for hypoglycaemia as it is already in a form that the body can use for fuel. This means it can raise blood sugar levels immediately. Other fast-acting sources of sugar include hard candy, jelly beans, fruit juice, and regular soda. These sources of sugar are easily accessible and can help to quickly relieve the symptoms of hypoglycaemia.

It is recommended to follow the "15-15 rule" when treating hypoglycaemia. This involves consuming 15 grams of carbohydrates, such as glucose tablets, and then waiting 15 minutes to check blood sugar levels. If blood sugar levels are still low, another 15 grams of carbohydrates can be consumed, and blood sugar levels should be checked again after another 15 minutes. This process can be repeated until blood sugar levels are in a safe range, which is typically above 70 mg/dL (3.9 mmol/L).

While treating hypoglycaemia with sugar is effective, it is important to note that the ketogenic diet has also been shown to help stabilise blood sugar levels and reduce the risk of hypoglycaemia. The ketogenic diet is a high-fat, moderate-protein, low-carbohydrate diet that can improve glucose regulation. By restricting carbohydrate intake, the ketogenic diet helps to reduce insulin spikes after meals, which can lead to rapid drops in blood sugar levels. Additionally, the ketogenic diet has been found to improve insulin sensitivity, addressing underlying issues related to insulin resistance and hypoglycaemia.

In summary, hypoglycaemia can be effectively treated by consuming sugar and other fast-acting carbohydrates to quickly raise blood sugar levels. At the same time, the ketogenic diet can also be a useful long-term strategy for managing hypoglycaemia by improving glucose regulation and insulin sensitivity.

Hypoglycaemia can be caused by low-carb diets

Hypoglycaemia, or low blood sugar, can be caused by a low-carb diet. When you eat carbohydrates, your body converts them into glucose, which your cells use for energy. On a low-carb diet, your body needs to get its fuel from another source. For the first few days, your body will use stored glucose. But when that runs out, you start to burn fat for energy.

Burning fat causes your body to create ketones, which become a central energy source on very low-carb diets. The ketogenic (or keto) diet, for example, aims to keep the body in a state of ketosis, where it uses only fat for fuel. However, ketosis should not be confused with diabetic ketoacidosis (DKA), a rare but life-threatening condition associated with extremely high blood sugar in people with type 1 diabetes.

Low-carb diets can be beneficial for people with diabetes, helping them to avoid high blood sugar and improve their overall health. However, they can also be hard to follow, and people with diabetes need to be cautious when starting a low-carb diet. If the body isn't getting many carbs, certain diabetes medications could lower blood sugar levels too far, causing hypoglycaemia. It is important for people with diabetes to consult their healthcare team and monitor their blood sugar levels closely when starting a low-carb diet. They may need to adjust their medication dose.

Low-carb diets can also cause what is known as keto flu, with symptoms such as constipation, diarrhoea, headaches, and changes in mood or cognitive function. These symptoms are usually temporary and go away in the first few days of starting the diet. They are caused by low sodium and potassium levels, as lowering your carb intake reduces your insulin levels, which can lead to excess urination that flushes out these vital nutrients.

Additionally, if you have hypoglycaemia, cutting out all carbs can be dangerous. Your body can transform fat and protein into glycogen, but if you have hypoglycaemia, your body may not be able to release glycogen fast enough to maintain healthy blood sugar levels. Turning fat and protein into glycogen is inefficient and slow, so eating foods without carbohydrates won't quickly alleviate hypoglycaemic symptoms. Instead, it is important to keep some carbohydrates in your diet, choosing whole grains, vegetables, fruits, and legumes, which are high in fibre and help to slow digestion, keeping blood sugar levels consistent.

While low-carb diets can cause hypoglycaemia, they can also be used as a treatment for hypoglycaemia. The keto diet, for example, can help to stabilise blood sugar levels and reduce the demand for insulin. This can be particularly beneficial for people with reactive hypoglycaemia, as it minimises post-meal insulin spikes that can lead to rapid drops in blood sugar. The keto diet has also been shown to improve insulin sensitivity, addressing underlying issues related to insulin resistance and hypoglycaemia.

Hypoglycaemia can be caused by intense exercise

Hypoglycaemia, or low blood sugar, can be caused by intense exercise. During exercise, the body's demand for glucose increases, as active muscles require more fuel. This can lead to a drop in blood sugar levels, especially if the body does not have sufficient energy stores. In addition, exercise can increase insulin sensitivity, meaning that insulin works more effectively to lower blood glucose levels. This can be beneficial for individuals with diabetes, as it helps regulate blood sugar. However, for those with hypoglycaemia, it can further increase the risk of low blood sugar.

Several factors can contribute to exercise-induced hypoglycaemia:

• Engaging in intense workouts that demand more energy
• Already having low blood glucose levels due to factors such as hunger or diabetes medication
• Insulin sensitivity or insulin intake
• Not consuming enough carbohydrates
• Exercising immediately after a meal
• Alcohol consumption without food, as alcohol can lower blood sugar levels

It is important to note that exercise-induced hypoglycaemia can affect individuals with or without diabetes. For those with diabetes, it is crucial to monitor blood glucose levels before, during, and after exercise, and to consult with a healthcare professional to adjust medication and carbohydrate intake accordingly. For individuals without diabetes, preventing exercise-induced hypoglycaemia can often be achieved by ensuring proper nutrition before workouts and gradually increasing the intensity of exercises.

Symptoms of exercise-induced hypoglycaemia include weakness, shakiness, fatigue, an unusually fast heart rate, dizziness, and confusion. If left untreated, severe or prolonged hypoglycaemia can lead to more serious complications, such as loss of consciousness. Therefore, it is essential to treat hypoglycaemia promptly by consuming fast-acting carbohydrates, such as juice or glucose tablets, and resting to allow blood sugar levels to rise.

Frequently asked questions