Keto And Hypoglycemia: A Dangerous Combination?

The ketogenic diet is a popular weight-loss strategy that involves eating a very low amount of carbohydrates and a high amount of fat. While the diet has been shown to be effective for weight loss, there have been concerns about its link to hypoglycemia. Hypoglycemia is a condition characterized by abnormally low blood sugar levels, which can cause symptoms such as dizziness, fatigue, and irritability. The ketogenic diet has been associated with an increased frequency of hypoglycemia, especially in children and individuals with diabetes. There are also reports of hypoglycemia in people without diabetes who are following a ketogenic diet. In this article, we will explore the potential risks of hypoglycemia associated with the ketogenic diet and discuss the possible mechanisms underlying this association. We will also provide information on how to manage and prevent hypoglycemia for individuals choosing to follow a ketogenic diet.

Ketogenic diets are associated with an increased frequency of hypoglycemia

The keto diet is a very low-carbohydrate diet that is often used for weight loss. It typically involves getting 65%-75% of calories from fat and only 5%-10% of calories from carbohydrates. By restricting carbohydrate intake, blood glucose and insulin levels drop, and the body starts to use fat as an alternative fuel source, leading to weight loss.

However, this drop in blood glucose levels can also lead to hypoglycemia. This is because the body's natural response to low blood glucose levels is to suppress insulin secretion and prioritize the remaining glucose for the brain. Hormones such as glucagon, cortisol, and adrenaline are released to stimulate the breakdown of glycogen and the production of glucose in the liver, as well as the breakdown of fat tissue. If the body's glucose stores become too depleted, it can lead to dangerously low blood sugar levels, which is known as hypoglycemia.

Several studies have reported cases of hypoglycemia in people following a ketogenic diet. This is particularly concerning for people with type 1 or type 2 diabetes who are already at risk of hypoglycemia. The combination of a keto diet and diabetes may further increase the risk of hypoglycemic episodes.

In addition, the keto diet may also impair the body's ability to regulate blood sugar levels during hypoglycemia. A study in mice found that a ketogenic diet altered the neuroendocrine responses to neuroglucopenia and insulin-induced hypoglycemia. This suggests that the keto diet may increase the risk of iatrogenic hypoglycemia, especially in people with diabetes.

It is important to note that hypoglycemia can be dangerous and may require immediate medical attention. If you are experiencing symptoms of hypoglycemia, it is important to consume a small amount of carbohydrates and monitor your blood sugar levels. If symptoms persist, seek medical attention.

Ketogenic diets can cause hypoglycemia by lowering blood glucose and insulin levels

While ketosis can be beneficial for weight loss, it can also increase the risk of hypoglycemia, especially in people with diabetes or certain metabolic defects. This is because ketogenic diets can interfere with the body's ability to maintain stable blood sugar levels. Normally, when blood sugar levels drop too low, the body signals the liver to release stored glucose. However, if you've been on a ketogenic diet for an extended period, your liver's glucose stores may be depleted, leading to hypoglycemia.

Additionally, ketogenic diets can affect the body's counter-regulatory response to hypoglycemia. In a study on mice, it was found that a ketogenic diet impaired the release of glucagon, a hormone that helps regulate blood sugar levels, during hypoglycemic episodes. This suggests that a ketogenic diet may increase the risk of iatrogenic hypoglycemia, or low blood sugar caused by medical treatment.

Furthermore, ketogenic diets can lead to an overproduction of insulin in response to carbohydrate consumption, known as reactive hypoglycemia. This surge of insulin can cause a rapid drop in blood sugar levels, resulting in symptoms such as dizziness, fatigue, and irritability.

It's important to note that hypoglycemia can be dangerous, and if left untreated, it can lead to more severe symptoms and even coma. Therefore, it's crucial to monitor blood sugar levels closely when following a ketogenic diet and seek medical advice if you have concerns.

Hypoglycemia can be treated with sugar or carbohydrate-rich foods

Hypoglycemia, or low blood sugar, is a condition where your blood sugar levels drop below the normal range, usually considered to be below 3.9 mmol/L or 70 mg/dL. This can occur in people with or without diabetes and can be caused by various factors such as diet, exercise, and medication.

Treating low blood sugar is essential, as it can become dangerous if left untreated. The "15-15 Rule" is often recommended for managing hypoglycemia. This involves consuming 15 grams of carbohydrates and then checking your blood sugar after 15 minutes. If your levels are still below 70 mg/dL, repeat this process until they reach the target range. Some quick sources of sugar and carbohydrates to treat hypoglycemia include:

• 4 ounces (1/2 cup) of juice or regular (non-diet) soda
• 1 tablespoon of sugar, honey, or syrup
• Hard candies, jelly beans, or gumdrops (check the food label for the recommended amount)
• Glucose tablets or gel (follow the instructions)

It is important to note that complex carbohydrates, high-fiber foods, and foods high in fat can slow down the absorption of sugar. Therefore, simple sugars and carbohydrates are typically recommended for treating hypoglycemia. Additionally, young children may need less than 15 grams of carbohydrates, so it is important to consult a doctor for personalized advice.

While the keto diet has been associated with an increased frequency of hypoglycemia, it is important to distinguish between ketosis and hypoglycemia. Ketosis is a state where the body burns fat for fuel instead of glucose, which can be intentional for weight loss or blood sugar control. However, hypoglycemia is a condition where blood sugar levels drop too low, and it requires immediate treatment to prevent potential health risks.

Hypoglycemia can be caused by non-dietary factors like illness or dehydration

Hypoglycemia can be caused by non-dietary factors, such as illness or dehydration, as well as dietary factors, like fasting or low-carbohydrate diets.

Non-dietary factors that can cause hypoglycemia include:

• Illness: Critical illness, such as liver failure, congestive heart failure, sepsis, or renal failure, can lead to hypoglycemia due to impaired gluconeogenesis and depletion of hepatic glycogen stores.
• Dehydration: Dehydration can contribute to the development of hypoglycemia, especially in children.
• Alcohol consumption: Alcohol inhibits gluconeogenesis and blunts the growth hormone response to hypoglycemia, leading to decreased glucose production.
• Medications: Certain medications, such as beta-blockers, anti-infective drugs, and heart arrhythmia medications, can interfere with normal blood sugar regulation and cause hypoglycemia.
• Adrenal insufficiency: Conditions like Addison's disease, which results in primary adrenal insufficiency, can cause hypoglycemia due to a lack of glucocorticoid hormones, which are important for maintaining blood sugar levels.
• Genetic disorders: Rare genetic disorders, such as glycogen storage diseases and hereditary fructose intolerance, can impair the body's ability to regulate blood sugar and lead to hypoglycemia.

Hypoglycemia can be dangerous if blood sugar levels don't rise

Hypoglycemia, or low blood sugar, is when your blood sugar drops below 3.9 mmol/L (70 mg/dL). While it is more common in people with diabetes, it can also occur in people without diabetes. If left untreated, severe low blood sugar can be life-threatening. This is because the brain needs a continuous supply of glucose to function properly.

For people with diabetes, hypoglycemia is usually when blood sugar levels fall below 70 mg/dL. For people without diabetes, it is around 55 mg/dL. However, these numbers might vary depending on the person, so it is important to ask a healthcare provider about the appropriate range to maintain healthy blood sugar levels.

If blood sugar levels drop too low, certain symptoms may occur, such as shakiness, a faster heartbeat, dizziness or lightheadedness, confusion, anxiety, and extreme hunger. If hypoglycemia is not treated promptly, it can lead to severe symptoms, including blurred or double vision, loss of coordination, and loss of consciousness.

In the case of ketotic hypoglycemia, which is common in young children without diabetes, low blood sugar can be extremely dangerous if it is not treated quickly, especially if the child is unable to hold down food or liquid due to vomiting.

Therefore, it is crucial to treat hypoglycemia as soon as possible by consuming carbohydrates or sugar. The "15-15 rule" is recommended by the American Diabetes Association to treat mild to moderate hypoglycemia: consume 15 grams of fast-acting carbs, wait 15 minutes, and check your blood sugar. Repeat this process until your blood sugar reaches at least 70 mg/dL.

If blood sugar levels do not rise after consuming carbohydrates and symptoms persist, seek immediate medical attention.

Frequently asked questions