Blood Sugar And Keto: Should You Be Worried?

The ketogenic diet is a popular eating pattern that has been around for years. It is a high-fat, low-carb diet that can change the way the body stores and uses energy. While the keto diet can be beneficial for people with diabetes, there are some risks associated with it. It is important to monitor blood sugar levels and ketone levels to ensure that the diet is not causing any negative effects. The keto diet may not be suitable for everyone, and it is essential to speak with a doctor before making any drastic dietary changes.

The keto diet can help manage blood sugar levels

The keto diet is a low-carb, high-fat diet that can be an effective tool for managing blood sugar levels. Here are some key points to understand the relationship between the keto diet and blood sugar control:

Impact on Blood Glucose

The keto diet has a direct impact on blood glucose levels due to its low carbohydrate content. Carbohydrates break down into simple sugars in the body, leading to an increase in blood glucose. By restricting carbohydrate intake, the keto diet helps minimise blood sugar spikes. This is particularly beneficial for individuals with diabetes or insulin resistance, as it can improve blood glucose control and reduce the need for insulin.

Ketosis and Blood Sugar

When following the keto diet, the body enters a state called ketosis, where it burns fat instead of carbohydrates for energy. This shift in energy source from glucose to fat can lead to more stable blood sugar levels. However, it's important to monitor both blood glucose and ketone levels to ensure a healthy balance.

Individual Variation

It's important to personalise carbohydrate intake within the keto diet. The optimal level of carbohydrate restriction may vary from person to person, and it's best to work with a healthcare professional to determine a safe and effective long-term plan. Additionally, not everyone may find the keto diet sustainable due to its restrictive nature.

Blood Sugar Monitoring

Measuring blood sugar levels is crucial when following the keto diet. This allows individuals to understand how their body responds to specific foods and make necessary adjustments. However, it's important to interpret blood glucose readings correctly, as factors such as stress, sleep, and technical variability can influence the results.

Other Benefits

In addition to blood sugar management, the keto diet offers several potential benefits. It can aid in weight loss, improve insulin sensitivity, reduce the risk of heart disease, and even help prevent neurological diseases. However, it's always recommended to consult with a doctor before making significant dietary changes to ensure a safe and effective approach.

Carbohydrates have a direct impact on blood sugar

The type and amount of carbohydrates you consume can make a difference to your blood glucose levels. Carbohydrates can be grouped into those that contain mostly starch (such as bread, rice, pasta, and potatoes) and those that contain mostly sugars, such as fruits, some dairy foods, sweets, chocolate, sugary drinks, and desserts.

When blood sugar levels rise, the pancreas produces insulin, a hormone that prompts cells to absorb blood sugar for energy or storage. As blood sugar levels continue to rise, the pancreas starts making glucagon, a hormone that signals the liver to start releasing stored sugar. This interplay of insulin and glucagon ensures that cells throughout the body, especially in the brain, have a steady supply of blood sugar.

The glycemic index ranks carbohydrates on a scale from 0 to 100 based on how quickly and how much they raise blood sugar levels after eating. Foods with a high glycemic index, like white bread, are rapidly digested and cause substantial fluctuations in blood sugar. On the other hand, foods with a low glycemic index, like whole oats, are digested more slowly, prompting a more gradual rise in blood sugar.

Eating many high-glycemic-index foods can lead to an increased risk of type 2 diabetes, heart disease, and weight gain. In contrast, low-glycemic foods have been shown to help control type 2 diabetes and improve weight loss. Therefore, it is important to choose nutrient-dense carbohydrates that are rich in fiber, vitamins, and minerals, and low in added sugars, sodium, and unhealthy fats.

Additionally, the quality of carbohydrates is more important for general health than the quantity consumed. Lower glycemic index foods are useful for managing blood glucose levels, and choosing high-fibre and whole-grain foods instead of refined carbs is better for heart health and reducing the risk of certain types of cancers.

In summary, carbohydrates have a direct and significant impact on blood sugar levels. The type, amount, and quality of carbohydrates consumed can influence blood glucose levels and overall health. Therefore, it is essential to make conscious choices about the carbohydrates we include in our diet.

Insulin resistance and diabetes

Insulin resistance is a complex condition where the body does not respond normally to insulin, a hormone produced by the pancreas that regulates blood sugar levels. Insulin resistance occurs when cells in the muscles, fat, and liver do not respond adequately to insulin, leading to elevated blood glucose levels. This condition can be temporary or chronic and is often associated with type 2 diabetes.

When functioning correctly, insulin acts as a key, allowing blood sugar to enter body cells and be used as energy. Any excess blood sugar is stored in the liver for later use. However, when the body is exposed to high levels of blood sugar over an extended period, it can develop insulin resistance. The pancreas releases higher levels of insulin to compensate, but over time, the cells become resistant to its effects. As a result, blood sugar levels remain high, and the pancreas struggles to keep up, leading to a further increase in blood sugar.

High blood sugar levels are damaging to the body and are linked to an increased risk of diabetes and heart disease. Insulin resistance is a precursor to prediabetes and type 2 diabetes. It is also associated with other conditions, including cardiovascular disease, non-alcoholic fatty liver disease, and polycystic ovary syndrome (PCOS).

The development of insulin resistance is primarily caused by excess body fat, especially around the belly, and physical inactivity. A diet high in processed, high-carbohydrate foods and saturated fats can also contribute to insulin resistance. Certain medications, such as steroids and specific blood pressure and psychiatric medications, can also cause insulin resistance.

To manage insulin resistance, lifestyle modifications are crucial. This includes eating a healthy diet with fewer carbohydrates and unhealthy fats, increasing physical activity, and losing excess weight. These changes can increase insulin sensitivity, lower blood glucose levels, and reduce the risk of developing type 2 diabetes.

The pros and cons of the Atkins diet

The Atkins diet is a very low-carb diet that has been around since the 1970s. It has evolved over the years and now includes three phases of carb intake, starting with a ketogenic-style diet. Here are some of the pros and cons of the Atkins diet:

Pros:

• Weight management: The Atkins diet can help with weight loss, especially in the initial stages when the body sheds excess water weight. Studies have confirmed that a very low-carb diet does promote weight loss.
• No calorie counting: The Atkins diet does not require calorie counting, which can be restrictive and triggering for some people. Instead, you only need to pay attention to carb intake, specifically net carbs (total carbs minus fiber and sugar alcohols).
• Hearty eating plan: The Atkins diet includes protein, dietary fats, and high-fiber vegetables, which can be filling and satisfying. This can lead to a lower overall calorie intake.
• Clearly-defined guidelines: The diet provides simple instructions and food lists for each phase, making it easy to follow.
• Focuses on fiber-rich carbs: The diet encourages the consumption of complex carbs such as whole grains, legumes, fruits, and vegetables, which offer more nutritious benefits.
• Offers multiple resources: The Atkins website provides various resources, including sample meal plans, recipes, shopping lists, and a discussion board for support. Atkins also offers snack bars and meal replacements.

Cons:

• Requires reduced fruit and grain intake: The classic phase of the Atkins diet prohibits fruits and grains, which can be difficult to adhere to. These foods provide important amounts of fiber, vitamins, and nutrients. Reduced fiber intake can also lead to constipation.
• Produces side effects: The Atkins diet can cause side effects such as fatigue, nausea, headaches, brain fog, bad breath, constipation, and hunger. Some people have also reported hair loss or thinning due to vitamin and mineral deficiencies.
• Becomes hard to maintain: The Atkins diet can be restrictive and may be difficult to maintain in the long term, especially when eating out or socializing. Studies have found that adherence to the diet is low.
• Requires counting net carbs: Learning to count net carbs can be challenging and tedious, especially when dining out or at social gatherings. The definition of "net carb" is also not clearly defined by the Food and Drug Administration, which can make it difficult to know the exact carb content of foods.

Blood Sugar and the Keto Diet:

Now, onto your blood sugar concerns. When following a keto diet, your blood sugar levels will generally remain more steady due to the low carbohydrate intake. However, it is still important to monitor your blood glucose levels, especially if you are diabetic or prediabetic. Here are some key points to consider:

• Blood glucose levels: These levels will rise and fall when you eat food, and the amount they spike depends on the type of food you eat. A high-carb meal will spike your blood glucose more than a low-carb, high-fat meal.
• Risk factors: Higher than normal blood glucose levels can increase your risk of diabetes and heart disease. Doctors use a blood glucose test to diagnose type 2 diabetes.
• Ketosis and blood glucose: Blood glucose levels do not indicate whether you are in ketosis, but they are correlated with ketone levels in your body. Monitoring your blood glucose can give you insights into your body's response to specific foods.
• Optimal blood sugar levels: According to the Mayo Clinic, a fasting blood sugar level under 100 milligrams per deciliter is healthy. Your blood sugar should not exceed 125 milligrams per deciliter after eating, as this is a sign of prediabetes.
• Managing blood sugar: To keep your blood sugar levels healthy, it is important to exercise, sleep well, and avoid carb binging. The keto or intermittent fasting diets can also help enhance insulin function and improve your blood sugar response.

How to monitor blood sugar and ketone levels

Blood Sugar Monitoring

Blood glucose, or blood sugar, is the amount of sugar circulating in your blood. It is necessary for survival, with red blood cells and the brain being heavy users of glucose.

Blood sugar levels rise and fall when you eat food, and how high your blood sugar spikes depends on the food you eat. A high-carb meal will cause a bigger spike than a low-carb, high-fat meal.

You can measure your blood sugar levels with a blood glucose monitor. These are relatively affordable and easy to find. To test your blood sugar, you simply prick your finger, insert the test strip, and record the result.

The best time to test your blood sugar is at the same time each day, guaranteeing that your body is always in a similarly fasted state.

Ketone Monitoring

Ketones are produced by the body as an alternative energy source to sugar. The body produces ketones by breaking down fats, a process known as ketosis. Ketosis occurs in the liver, which releases ketones into the bloodstream, where they travel throughout the body, providing energy.

You can test your ketone levels with a blood ketone meter, which is the most accurate way of testing for ketones. You can also test your urine for ketones, but this is less accurate as it will only reflect the ketone levels from a few hours previously.

If you are testing your blood ketone levels, the process is similar to a blood glucose test. You put a blood ketone strip into the meter, prick your finger, allow blood to go onto the strip, and then safely discard the strip and lancet.

If you are testing your urine ketone levels, you remove a strip from the tub, being careful not to touch the spongy end, and pass urine over the test area of the strip, or collect urine in a container and then dip the strip into it. You then compare the colour of the test area to a colour chart on the side of the tub of strips.

The Relationship Between Glucose and Ketones

Glucose and ketones are inversely related. As glucose rises, ketones fall, and vice versa. Therefore, it is important to monitor both when on a ketogenic diet.

Optimal Levels

According to the Mayo Clinic, a fasting blood sugar level under 100 milligrams per decilitre is healthy. After eating, your blood sugar should not exceed 125 milligrams per decilitre, as this is a sign of prediabetes.

For blood ketone levels, a normal value is considered to be under 0.6 mmol/L. A level of 0.6 to 1.5 mmol/L indicates that more ketones are being produced than normal, and a level of 1.6 to 3.0 mmol/L is high and could be risky. A level of above 3.0 mmol/L is dangerous and requires immediate medical care.

Frequently asked questions