The Keto Diet for Diabetes: Does it Work?

The Keto Diet for Diabetes: Does it Work?

Is following a ketogenic diet an effective way to manage diabetes? With keto increasing in popularity, I hear this question in my practice a lot. The theory appears simple: if you significantly decrease overall carbohydrate and sugar intake, you can control high blood sugar, right? Although it may sound straightforward, the human body is very complex. Let’s explain how the ketogenic diet works.

What is the keto diet?

A keto diet follows a very low carbohydrate, high fat eating pattern. General recommendations suggest 70-80% of calories come from fats and 5-10% of calories (or approximately 20-30 grams) come from carbohydrates with moderate protein intake. Originally developed to control seizures in pediatric patients with epilepsy, the diet drives your body to a state of ketosis. Ketosis, which occurs naturally during times of starvation, forces your body to break down fat stores for energy. When following a keto diet, the body uses dietary fat as the main source of fuel.

What is Diabetes?

Diabetes is a medical condition where there is either a lack of availability of insulin or insulin resistance. Insulin is a hormone that allows glucose, the building blocks of carbohydrates, into our cells. Without insulin, our bodies aren’t able to unlock our cells to allow glucose entry, causing glucose to stay in our blood and, therefore, causing blood sugar levels to increase. When diabetes is present, it’s important to watch for signs of low and high blood sugar as both can be very detrimental to health, and in some cases life threatening.

What is the recommended diet to manage diabetes?

According to the 2019 American Diabetes Association's Standards of Care, the best approach to managing diabetes depends on the individual’s personal preferences, needs and goals. This standard of care allows for flexibility in carbohydrate, fat, and protein intake recommendations. Since our bodies utilize carbohydrates as the most readily available source of energy, typical recommendations say you should consume approximately 50-55% of your calories from carbohydrates, which may be 45-60 grams for women and 60-75 grams for men each meal (but this varies per individual). A low-carbohydrate diet may recommend your calories from carbohydrates be 45% or less, but there’s currently no agreed upon definition for low-carbohydrate diets. It’s important to remember that managing blood sugar is not synonymous with low carbohydrate intake. Managing blood sugar simply means ensuring your blood sugar levels are in a healthy range. We do not want them to be too low or too high.

To ensure steady blood sugar control, it’s recommended by the Academy of Nutrition and Dietetics to eat a carbohydrate-controlled, well-balanced, individualized diet with a focus on intake of fruits, vegetables, whole grains, lean proteins and low-fat dairy products.

Precautions to consider if on the keto diet while managing diabetes

Following a ketogenic diet, which is low in carbohydrates, high in fat, and moderate in protein, doesn’t allow the body to readily utilize carbohydrates as a source of energy This eating pattern can also restrict access to vital vitamins and minerals and cause fatigue. A ketogenic diet may be effective in lowering blood sugar but is not necessary for blood sugar control and may be difficult to follow. Choosing the right types of fats while eating keto (high fat) is also critical for those with diabetes; high levels of saturated fat intake can increase heart disease risk in those with Type 2 diabetes, so it’s important to go for healthy, unsaturated fats.

Although there are different beliefs regarding the impact a ketogenic diet has on diabetes, current research is inconclusive on the long-term effects of ketosis on the body and one’s overall health. It’s recommended to follow a well-balanced, carbohydrate-controlled diet to manage diabetes until long-term effects are known. It’s very important to note that you should consult with your physician before changing your eating habits and only enter a state of ketosis while under their guidance and monitoring.

No matter what type of diet you choose to follow, it’s important and helpful to work with a registered dietitian nutritionist who can help you create a plan tailored to your specific needs.

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^{Disclaimer: This information is educational only and not providing healthcare recommendations. Please see a healthcare provider.}