Do a diabetes and ketogenic diet make a perfect match ? 

Some experts and diabetics think so ! When you follow a ketogenic diet, your body converts fat, rather than sugar, into energy which may improve blood sugar levels while also reducing the need for insulin.

In many ways, a keto diet seems like it’s made for people trying to avoid or manage diabetes because it takes away 2 of the most concerning aspects of most diets — sugars and carbohydrates.  

While following this new way of eating, Individuals with diabetes  have seen drastic reductions or even elimination of their medications (more on those studies to come).

And don’t worry — this diet doesn’t make you feel deprived. If anything, it has a reputation for making people feel very satisfied and energetic once they reach a state of ketosis. Let’s take a look at whether or not the ketogenic diet may be a healthy choice for you and your diabetes management ! 

Diabetes and Ketogenic diet. 

For people with prediabetes, type 2 diabetes and type 1 diabetes, minimizing sugar as well as carbohydrate intake is typically suggested to maintain healthy blood sugar levels. The keto diet is a very low-carb and high fat diet that changes the body’s “fuel source”  from burning glucose (or sugar) to burning dietary fat instead. 

Making this major switch in dietary habits promotes a state of “ketosis” which means your body is now a fat burner rather than a sugar burner.  

Research as well as firsthand accounts show that this ketogenic way of eating may help some diabetics to decrease and better control their blood glucose levels. 

Ketogenic diet for prediabetes

Over weight or Obesity is one of the principle risk factors for diabetes and following a keto diet has been shown to help with weight loss. 

According to scientific article published in 2014, “A period of low carb ketodiet may help to control hunger and may improve fat oxidative metabolism and therefore reduce body weight.”

Many prediabetics struggle with being overweight so a ketogenic diet can help promote weight loss, which can help to decrease the chances of developing full blown diabetes. 

In addition, as the Harvard School of Public Health points out, “Carbohydrate metabolism plays a huge role in the development of type 2 diabetes, which occurs when the body can’t make enough insulin or can not properly use the insulin it makes.”  

When a carbs containing food is eaten, the digestive system has to process these carbohydrates and turns them into sugar which then goes into the bloodstream. 

The keto diet majorly minimizes carbs intake so prediabetics, as well as type 1 and type 2 diabetics, aren’t challenging their bodies with carbohydrate breakdown that can raise blood sugar levels and create problematic insulin demands for the body. 

Type 2 diabetes & Keto diet .

Is a ketogenic diet good for type 2 diabetes ? 

The ketogenic diet can be very helpful for type 2 diabetes since the body is now using fat rather than carbs as its main source of fuel. This way of eating decreases the body’s demand for insulin and helps to keep blood glucose levels at a low yet healthy level. 

If you’re a type 2 diabetic who takes insulin, then you may likely need less insulin as a result of following the ketogenic diet.

A ketogenic diet & diabetes study published in 2012 in the journal, Nutrition, compares low-carbohydrate keto diet (LCKD) with a low-calorie diet (LCD) in improving glycemia (the presence of glucose or sugar in the blood). 

Overall, the study finds a low-carb ketogenic diet to be more beneficial than a low-calorie diet for obese type 2 diabetics. 

The study concludes, “The keto diet appears to improve glycemic control. Therefore, diabetic patients on a keto diet should be under strict medical supervision because the Low carb keto diet (LCKD) can significantly lower blood glucose levels.” 

Previous studies and research has also shown that for patients with type 2 diabetes, long-term administration of the keto diet lowered body weight, improved blood sugar levels and can result in a smaller needed dose of antidiabetic medication. 

Another earlier study published in the journal, Nutrition and Metabolism, finds that both a low-glycemic index, reduced-calorie diet and a low-carb, keto diet can improve glycemic control, encourage weight loss, and reduce or eliminate the need for diabetic medication over a Twenty four week period with the lower carb ketogenic diet being “most effective for improving glycemic control.”

Researchers note that subjects taking between Fourty to Ninty  units of insulin before the study were able to completely eliminate their insulin use while also improving blood sugar control ! They also point out that this effect happens “immediately upon implementing the dietary changes” so people with type 2 diabetes need to monitor their blood sugar closely and likely adjust their medication dosages/needs with the help of their doctors. 

Type 1 diabetes & Ketogenic diet.

An article published in the New York Times in 2018 explores the use of a ketogenic diet and diabetes type 1. The article points out how many diabetes experts will not recommend low-carbohydrate diets for type 1 diabetics, especially if they are children, due to concerns over hypoglycemia as a result of carbohydrate restriction and the possibility of this having a negative effect on a child’s growth. 

The New York Times pieces also points out that studies are disproving this concern and making a case for both children and adults with type 1 diabetes to consider a keto diet. Specifically, a 2018 study published in the journal, Pediatrics, which took a look at glycemic control among children and adults with type 1 diabetes who followed a very low-carb, high-protein diet. 

The researchers found that both the children and adults who consumed this diet along with smaller doses of insulin than typically required exhibited “exceptional” blood sugar control without high rates of complications. 

In addition, the study data did not show an adverse effect of a very low-carb diet on children’s growth, although more research may still be a good idea, according to researchers.

Keto Diet Meal Plan for Diabetics

If you have diabetes, talk to your physician before starting a keto diet meal plan. Once you get approval from your physician or doctor, here are some of the key building blocks of the keto diet to get you started:

• Healthy fats : This includes saturated fats, monounsaturated fats & some PUFAs (polyunsaturated fats) , especially omega-3 fatty acids. It’s best to include all of these varieties on a daily basis, with an emphasis on saturated fats, especially compared to PUFAs (Polyunsaturated fats).
• Protein: A typical suggested keto protein intake is between 1 & 1.5 gms / Kg of your ideal body weight. To convert pounds to kilograms, divide your ideal weight by 2.2. It’s important to note that Kidney Disease : Improving Global Outcomes (KDIGO) suggested that adults with diabetes limit their protein intake to less than 1 gm / Kg of body weight each day and that adults with chronic kidney disease avoid protein intake greater than 1.3 gms / Kg / day.

• Carbohydrates: Historically, a targeted ketogenic diet consists of limiting carbs intake to just 20–30 net gms / day . “Net carbs” is the amount of carbohydrate remaining once dietary fiber is taken into account. Because fiber is indigestible once eaten, most people don’t count gms. of fiber toward their daily carbohydrate allotment. In other words, total carbs – grams of fiber = net carbs. That’s the carbohydrate counts that matter most.
• Water: Drinking enough water can help you to avoid fatigue and is important for good digestion. Water is also needed for detoxification of the body . Aim to drink 10–12 eight-ounce glasses a day.

There no “cheat days” or “cheat meals” on the ketogenic diet. The main reason is that if you eat a meal too rich in carbs , it will take you out of ketosis and then will be like you are starting all over. Plus, if you do have a cheat meal, you may experience a return of keto flu symptoms that you already made a thing of the past. 

Ready to dive in to your new ketogenic diet plan ?

Here are some examples of foods that are top choices for a keto diet and for keeping blood sugar levels down. You will certainly  want to add many of the following to your next grocery list: 

Healthy Fats :  

Medium chain triglycerides (MCT oil ) , palm fruit , cold-pressed coconut, olive oil, flaxseed, macadamia and avocado oil — ZERO net carbs per tablespoon.
Ghee & Butter — ZERO net carbs per tablespoon.
Lard, chicken fat or duck fat — ZERO net carbs per tablespoon.

Protein : 

Grass-fed, fatty meat is preferable because it’s higher in quality omega-3 fats — Zero grams net carbs/ 5 Oz.
Poultry, including turkey, chicken, quail, pheasant, hen, goose, duck — Zero grams net carbs / 5 Oz.
Cage-free eggs and egg yolks — One gram net carb each
Fish, including trout, tuna,anchovies, bass, flounder, mackerel, salmon, sardines, etc. — Zero grams net carbs / 5 Oz.

Vegetables (Non Starchy) : 

All leafy greens, including dandelion or beet greens, mustard , collards, chicory , turnip, arugula, endive, fennel, radicchio, romaine, escarole, sorrel, spinach, kale, chard, etc. — range from 0.5–5 net carbs per One cup.
Cruciferous veggies like cabbage, broccoli, Brussels sprouts and cauliflower — 3 to grams net carbs per One  cup.
Certain fermented foods like Kimchi , sauerkraut, dairy or coconut kefir (also beneficial for gut health) — 1to 2 gms.  net carbs per 1/2 cup.
Cucumber,Celery, zucchini, chives and leeks — 2 to 4 gms. net carbs per One cup.
Fresh herbs — close to 0 grams net carbs per 1–2 tablespoons.

Fat-Based Fruit : 

Avocado — 3.7 gms. net carbs per half.

Snacks : 

Bone broth (homemade or protein powder) — Zero  grams net carbs / serving.
Minced meat wrapped in lettuce — 0–1 grams net carbs.
Hard-boiled eggs — 1 g. net carb.
1/2 avocado with sliced lox (salmon) — 3 to 4 gms. net carbs.
Condiments.
Herbs & Spices  — Zero grams net carbs.
Hot sauce (no sweetener) — Zero grams net carbs.
Unsweetened mustards — 0 to 1 grams net carbs.
Apple cider vinegar — 0 to 1 grams net carbs.
Poppy seeds — Zero grams net carbs.

Beverages : 

Unsweetened black coffee and tea ; drink in moderation since high amounts can impact blood sugar— Zero  grams net carbs.
Water — Zero grams net carbs.
Bone broth — Zero grams net carbs.

Looking for ketogenic diet recipes for diabetics ? You’ll find many delicious options here : 44 Keto Recipes — High in Healthy Fats + Low in Carbs

Ketogenic Diet and Diabetes Precautions

Does keto raise blood sugar ? Most individuals see improvements in their blood sugar levels when following a ketogenic diet, but some individuals may notice a rise in fasting blood glucose after being on a very low-carb diet. 

Let your healthcare professional (doctor) know if this occurs.

Is a low-carbohydrate diet safe for diabetics ? A low-carbohydrate diet like the ketogenic diet can be safe for some diabetics if followed appropriately while being monitored by their healthcare professional (doctor) . 

It’s also essential that diabetics continue to follow their doctor’s instructions, including appropriate insulin use, while following any diet.

Can keto trigger diabetes ? The early findings of one research study published in 2018 finds that short term feeding of a ketogenic diet appears to trigger insulin resistance in rodent subjects. 

Sometimes ketosis is confused with ketoacidosis. Ketosis is the result of following the standard keto diet. Ketosis takes place when glucose from carbohydrate foods is drastically reduced, which forces the body to find an alternative fuel source : fat. 

In the end result is staying fueled off of circulating high ketones.

Ketoacidosis is what happens when “ketosis goes too far.” 

People with diabetes can experience diabetic ketoacidosis (DKA), when they don’t take sufficient amounts of insulin or when they are sick, dehydrated, or they experience physical or emotional trauma.

As per American Diabetes Association, “Diabetic ketoacidosis (DKA) is a serious condition that can lead to diabetic coma (passing out for a long time) or even death.” 

This is why following a keto diet meal plan when you have diabetes has to be done very cautiously & carefully and under the supervision of a doctor. 

People with type 1 diabetes are more likely to develop ketoacidosis. If you experience symptoms of ketoacidosis, your blood sugar level is consistently above 300 mg per deciliter (mg/dL), or 16.7 millimoles per liter (mmol/L), or you have ketones in your urine and can’t reach your doctor, seek emergency medical care.

If you are a diabetic following a keto diet, it’s vital that you follow this new way of eating under your doctor’s supervision, check your blood sugar regularly and take insulin as recommended. Insulin dosages often need to be adjusted after changing to a keto diet.  It’s also important to monitor the renal function of diabetics while they are following a keto diet.

Final Thoughts 

• A keto diet is a very low-carbohydrate way of eating that changes the body’s “fuel source”  from burning glucose (or sugar) to burning dietary fat instead.
• Some studies show that this can help people with prediabetes, type 2 diabetes, and type 1 diabetes to lower their blood sugar levels and decrease or eliminate the need for insulin.
• The ketogenic diet has been shown to reduce obesity, which is a major risk factor the development of diabetes.
• When following a keto diet meal plan for diabetes, make sure you check with your healthcare professional (doctor) about your planned intake of nutrients, especially appropriate daily amounts of protein since diabetics with kidney issues need to be mindful of their intake.
• While consuming a low-carbohydrate diet, it’s essential that people with type 1 and type 2 diabetes to monitor their blood sugar levels closely and to adjust their medication dosages as needed with their doctor’s help.
• Never put a child on a keto diet without the guidelines & approval of a doctor.
• Untreated diabetic ketoacidosis can be fatal so seek urgent medical care if you experience symptoms of ketoacidosis.