Keto And Diabetes: A Risky Combination?

The ketogenic diet, or keto, is a high-fat, low-carb diet that has been linked to weight loss and improved blood sugar control, making it a seemingly attractive option for people with type 2 diabetes. However, the keto diet is highly restrictive and difficult to maintain, and there is conflicting evidence about its long-term effectiveness and safety for people with diabetes. While some people with type 2 diabetes have found success in managing their blood sugar and reducing their medication needs with keto, it is not a one-size-fits-all solution, and individual needs and preferences must be considered.

Keto can help manage blood sugar levels

The ketogenic (keto) diet is a high-fat, low-carb diet that can help manage blood sugar levels for people with type 2 diabetes. The keto diet changes the way the body stores and uses energy, which can ease diabetes symptoms. By reducing carbohydrate intake, the body converts fat, instead of sugar, into energy, which can lower blood sugar levels.

The keto diet was created in the 1920s as a treatment for epilepsy, but it has also been studied for its potential benefits for people with type 2 diabetes. On the keto diet, the body enters a state of "ketosis", where it burns fat instead of carbohydrates for energy. This can lead to rapid weight loss when followed properly.

Research on the Keto Diet and Blood Sugar

Scientific research has confirmed that the keto diet can effectively manage type 2 diabetes by lowering blood sugar and promoting weight loss. A 2008 study found that participants who followed the keto diet saw greater improvements in blood sugar control and medication reduction compared to those on a low-glycemic diet. Additionally, a 2013 review reported that the keto diet led to more significant improvements in blood sugar control, weight loss, and insulin requirements than other diets.

Considerations and Potential Risks

While the keto diet can be beneficial for some people with type 2 diabetes, it may not be suitable for everyone. Managing diabetes with diet requires an individualized approach, and it is important to consult with a doctor or dietitian before starting any restrictive diet. The keto diet can be challenging to stick to in the long term, and there may be a risk of nutrient deficiencies, constipation, and low blood sugar (hypoglycemia).

Food Choices on the Keto Diet

When following the keto diet, it is important to focus on heart-healthy fats, such as olives, olive oil, nuts, and nut butters, rather than saturated fats. Additionally, it is crucial to monitor blood sugar and ketone levels regularly to ensure they remain within a safe range.

Comparison with Other Diets

The keto diet has been compared to other low-carb diets, such as the Mediterranean diet, which emphasizes whole grains, fruits, vegetables, legumes, and healthy fats. While both diets can be effective in controlling blood glucose levels and aiding weight loss, the keto diet may be more restrictive and challenging to follow in the long term.

In conclusion, the keto diet can be a valuable tool for managing blood sugar levels in people with type 2 diabetes. However, it should be approached with caution and under medical supervision to ensure safety and effectiveness.

It may not be suitable for everyone

While the keto diet may be beneficial for some people with type 2 diabetes, it is not a one-size-fits-all solution. Here are some reasons why keto may not be suitable for everyone:

Individual Needs and Goals

Managing diabetes through diet requires an individualized approach, taking into account a person's health needs and goals. Some people may find that keto helps them manage their diabetes, while others may not experience the same benefits. It's important to work with a healthcare professional to determine the best diet plan for your specific needs.

Restrictive Nature and Sustainability

The keto diet is highly restrictive, drastically reducing carbohydrate intake and prohibiting legumes, fruits, and whole grains. This level of restriction can be challenging to adhere to in the long term. The Mediterranean diet, for example, which is less restrictive and includes heart-healthy carbohydrates, may be a more sustainable option for managing diabetes.

Potential Health Risks

The keto diet can lead to a variety of potential health risks, including an increased risk of nutrient deficiencies, constipation, and dyslipidemia. There is also conflicting evidence regarding the risk of cardiovascular disease in people with type 2 diabetes following a keto diet. Additionally, there is a risk of developing ketoacidosis, a potentially life-threatening condition where the blood becomes too acidic due to high levels of ketones. This risk is higher for people with type 1 diabetes but can also occur in those with type 2 diabetes.

Pregnancy and Lactation

The keto diet is not recommended for women who are pregnant or lactating. It is important for women in these life stages to prioritize a nutritious and well-rounded diet to support the health of both mother and child.

History of Eating Disorders

The keto diet is not advised for individuals with a history of or current diagnosis of an eating disorder. This is because the restrictive nature of the diet may trigger unhealthy behaviours or thoughts associated with disordered eating.

Certain Medications and Health Conditions

Individuals taking certain medications, such as SGLT-2 inhibitors, or those with disorders of fat metabolism, are advised against following the keto diet. This is due to potential interactions or complications that may arise from the high-fat content of the diet.

Social and Lifestyle Factors

The keto diet may also not be suitable for individuals who frequently attend social gatherings or have a busy lifestyle. Finding keto-friendly options in social settings can be challenging, and preparing keto meals may require more time and planning than some individuals are able to commit to.

It can be hard to stick to

Sticking to the Keto Diet

The keto diet is notoriously difficult to stick to. It is highly restrictive, and people will typically find it more beneficial to follow a moderate diet that is sustainable in the long term.

Social Gatherings

Finding keto-friendly foods can be difficult at social gatherings, and it can be depressing to obsess over what you can and can't eat. It is helpful to look at the menu in advance and see if there is something you can eat. Salads with ranch or another low-carb dressing and a non-marinated protein are generally safe.

Whole Foods

It is best to stick with a 'whole foods' concept on keto. It can be tempting to reach for a protein bar or processed food, but it is better to try keto with more whole foods so you can get a better grip on the diet.

Meal Prep

If you have the time, meal prepping can really help. Knowing what you are going to eat that day or week will make it easier for you to stick to keto and your goals.

It Takes Time

At first, you will lose a significant amount of water weight, which can be exciting. But after a while, you'll notice that it tapers off, and you may get demotivated. Don't worry about it—just keep doing what you're doing.

Binge Eating

It is important to re-evaluate your relationship with food and learn to control any binge eating habits. Bad food choices can lead to something bigger.

Cheating

You may gain some weight back due to letting yourself have cheats here and there, especially during the holidays and when with friends and family.

Motivation

Success doesn't happen overnight. Finding motivation can help you stay on track. For example, you may want to get healthier for your child so that you can be sure you're always there for them.

It may not be safe long-term

While the keto diet may be a viable option for some people with type 2 diabetes, it may not be safe long-term. The keto diet is a high-fat, low-carb diet that can help manage blood sugar and reduce the need for insulin. However, there are several risks and drawbacks associated with this diet that should be carefully considered.

First and foremost, the keto diet is highly restrictive and can be challenging to stick to in the long term. It requires a significant shift in eating habits, and people may find it difficult to maintain over time. The restrictive nature of the diet can lead to ""yo-yo dieting," which is dangerous for diabetes management. It is important for individuals with diabetes to develop sustainable, long-term healthy habits rather than relying on restrictive diets that may not be maintained.

Additionally, the keto diet can lead to a higher risk of cardiovascular disease (CVD) due to the increased consumption of fat. People with diabetes already have an elevated risk of CVD, and the additional fat intake associated with the keto diet may further increase this risk. However, the scientific evidence on this topic is conflicting, and more research is needed to fully understand the long-term effects of the keto diet on CVD risk.

Furthermore, the keto diet can also result in nutrient deficiencies due to the restriction or exclusion of certain food groups. This can lead to health complications and may require supplementation to ensure adequate nutrient intake. The diet may also cause constipation, as it tends to be low in fiber.

Another concern with the keto diet is the risk of developing diabetic ketoacidosis (DKA), a potentially life-threatening condition. DKA occurs when there is a buildup of ketones in the blood, making the blood more acidic. While DKA is more common in type 1 diabetes, it can also occur in type 2 diabetes if ketone levels become too high. Illness, especially while on a low-carb diet, can increase the risk of DKA.

Lastly, the keto diet may not be suitable for everyone with type 2 diabetes, as it needs to be tailored to individual needs and goals. Carbohydrate intake, for example, should be determined on an individual basis with the help of a doctor. The keto diet may also interact with certain medications, such as those that increase insulin levels, and can lead to a higher risk of hypoglycemia (low blood sugar). Therefore, it is crucial to consult with a healthcare professional before starting the keto diet to ensure it is safe and appropriate for your specific situation.

It may not be recommended for those with high cholesterol

The ketogenic diet is a high-fat, low-carbohydrate diet that can be beneficial for people with type 2 diabetes. While the keto diet may be effective for some people living with type 2 diabetes, it is not recommended for those with high cholesterol. This is because the keto diet can lead to a significant increase in low-density lipoprotein (LDL), or "bad" cholesterol, which is linked to atherosclerosis and an increased risk of heart disease and stroke.

Several studies have shown that the keto diet can lead to a dramatic elevation in LDL cholesterol levels, particularly in individuals with a genetic predisposition to cholesterol metabolism dysregulation. This increase in LDL cholesterol may be due to the high consumption of red meat and saturated fats associated with the keto diet. While the diet may produce modest reductions in triglycerides and minimal changes in LDL for some people, the impact on those with high cholesterol could be detrimental.

People with diabetes are already at risk for high cholesterol and heart disease. Therefore, it is crucial for individuals with high cholesterol to consult a doctor or dietitian before starting the keto diet, as it may not be the best option for them. Other diets, such as the Mediterranean diet, may be more suitable and safer for those with high cholesterol.

It is important to note that the keto diet should be approached with caution, even for those without high cholesterol. The diet can be restrictive and challenging to stick to in the long term. Additionally, it may not be suitable for everyone with diabetes, as it can lead to low blood sugar, or hypoglycemia, which can be dangerous. As such, it is always recommended to consult a healthcare professional before starting any new diet, especially for those with existing health conditions.

Frequently asked questions