Keto Diet For Type 2 Diabetes: Pros Cons And Official Recommendations
If you have type 2 diabetes, you need to be careful about what you eat. When trying a new diet, you need to know how it affects your condition.
Keto diet is a low-carb and high-fat eating plan which people adopt for many purposes, including weight loss. Research¹ suggests that it may also improve insulin sensitivity in some people with diabetes. This means your body’s ability to respond to insulin may get better.
Let’s take a closer look at the effects of the keto diet on type 2 diabetes.
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Type 2 Diabetes Is A Condition That Impacts Blood Sugar Control
The Ketogenic Diet is trendy to lose weight fast.
The best for a Diabetic is losing weight, but is it a safe, effective method to help Diabetes patients?
The American Diabetes Association does not recommend the Keto Diet.
A Keto Diet is a low-carb, high-fat eating plan. About 20%-30% of the diet is a protein like chicken breast or fatty like bacon.
Foods contain carbohydrates, the primary fuel for our body. The body needs insulin to bring glucose from the blood into the cells for energy.
Usually, your body fuels itself from glucose that it gets from carbs. After a few days of the Keto Diet, your body operates out of glucose, so it starts burning body fat instead. This process called nutritional ketosis.
For a Diabetic Patient, insulin is either missing or insufficient, so the Keto Diet is not so safe.
Eat a high-carb food, can lead a Diabetic to a spike in blood glucose.
Heart Diseases for eating a lot of fat.
Lack of nutrients.
Talk to your doctor before you sign up in a trending diet. You need to eat healthily, but with an excellent guide, you can reach your goals!
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The Ketogenic Diet And Type 2 Diabetes
Type 2 diabetes is a condition where your body does not properly regulate and use glucose for energy. The pancreas may not produce enough insulin to regulate sugar consumption and your cells tend to respond poorly to insulin. Over time, this leads to an accumulation of sugar in the bloodstream, which increases your risk for complications of the circulatory, nervous, and immune system. Eating foods that are high in sugar causes an increase in blood glucose. For people living with diabetes, this increases the speed of sugar saturation throughout your circulatory system. There are a number of ways in which a ketogenic diet can impact type 2 diabetes management, but everyone is different. Always talk to your doctor prior to trying a keto diet, especially if youre living with diabetes.
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Is The Ketogenic Diet Safe For People With Diabetes
The keto diet can be done safely and effectively for some people living with diabetes. Matteo says determining whether its right for you is a question of weighing the pros and cons, and talking with your doctor.
Diabetes is a lifelong condition, so managing your diabetes needs to work within your lifestyle, Matteo notes. Restrictive meal plans like keto can be effective, but its not always the right choice when it comes to sustainability.
Very Low Calorie Diets
Very low calorie diets can also lead to rapid weight loss and diabetes reversalâµ. However, these diets can only be followed for a few months, after which weight maintenance and continued diabetes control are difficultâ¶. Very low calorie diets are usually medically supervised and require an intake of less than 800 calories per day.
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Impact Of Keto On Medication
Since the keto diet helps to lower blood sugar, some people with type 2 diabetes may find that they dont need to take insulin as often. As mentioned, you still need to monitor your levels throughout the day as the diet may lead to hypoglycemia or low blood sugar. If this occurs, consuming more carbohydrates is necessary to avoid dangerous situations such as diabetic ketoacidosis.
The Keto Diets Effects On Blood Glucose
For people with diabetes, there is real cause for concern if their blood sugar drops too low, she says. Low blood sugar is especially a risk if youre also on certain diabetes medications or taking insulin. Monitor your blood sugar levels regularly and speak with your doctor to see if medication adjustments are necessary.
A blood glucose level thats lower than the normal range of about 70 milligrams per deciliter is called hypoglycemia. Its a potentially dangerous condition that can occur, particularly for those living with diabetes, when your food intake and medication levels are out of balance.
Symptoms of hypoglycemia can include:
- Weakness or shaking.
- Nightmares, bad dreams or restless sleep.
- Blurred vision.
- Headaches and seizures.
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How The Ketogenic Diet Works For Type 2 Diabetes
The ketogenic diet, commonly referred to as the keto diet, is a way of eating that focuses on consuming low-carb, high-fat foods. The goal of the keto diet is to change the way that your body stores and uses fat. Normally, your body will use glucose from carbs as energy. In the keto diet, your body is depleted of glucose and therefore is forced to extract energy from body fat or fat thats consumed. In this state of nutritional ketosis, your body relies on fatty acid substances called ketones for energy extraction. Here, well discuss how the ketogenic diet works for type 2 diabetes.
Clarifications On Fat Intake In The Keto Diet
While the keto diet focuses on consuming higher amounts of fats instead of carbohydrates, its important to differentiate between different types of fat. The key is incorporating high amounts of heart-healthy fats, not saturated or trans fats. This means eating more eggs, fatty fish, avocados, olives or olive oil, nuts, nut butter, seeds, and cottage cheese. Avoid or limit processed foods alongside trans-fat, saturated fat, and fats from deli meats. Similarly, fried food is high in unhealthy fat and can lead to other problems like heart disease and health conditions.
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Warnings For Diabetics Going Keto
According to Anis Rehman, MD, assistant professor and associate program director of Endocrine, Diabetes and Metabolism Fellowship at Southern Illinois University School of Medicine, keto may pose several risks to diabetes patients.
Diabetes type 1 patients can result in diabetic ketoacidosis, a medical emergency that can be fatal. Diabetes type 2 patients who are ketosis-prone may also suffer from , which requires hospitalization.
Heres what you should know about DKA: When you change from carbs to fats as an energy source, you increase ketones in the blood .
If you have too many ketones in your blood, you could suffer from diabetic ketoacidosis. This is a dangerous, potentially fatal condition that comes from high blood sugar and increased acid. As Dr. Rehman says, people with type 1 diabetes are greatly affected by it, although people with type 2 diabetes are also at risk, especially if you are not taking insulin or have uncontrolled blood sugar.
If you are sick while eating a very low carb diet, this could increase your risk of DKA as well. Signs of DKA include breath that smells like fruit or acetone , mental slowness, impaired thinking, heavy breathing, and acting drunk while sober. You might also experience serious thirst, urination, and appetite.
Check your blood sugar levels throughout the day while on the keto diet. You can also ask your doctor to check your ketone levels, especially if your blood sugar is higher than 240 mg/dL.
Benefits Of Keto For Diabetes
Quick weight loss
May reduce need for insulin
Increases heart-healthy HDL cholesterol levels
Improves cognitive function
Dr. Marinov says the keto diet as well as very low-carb diets do show consistent benefits for people with diabetes and prediabetes by vastly improving blood sugar levels and reducing the need for insulin. They also help the weight come off faster than other diets.
A person who is diabetic likely will also experience weight loss on the keto diet, too which is an added bonus, since weight loss can improve insulin resistance.
The ketogenic diet helps with insulin resistance in multiple ways: by reducing carbohydrate intake, presence of ketones, and potential weight loss, says Kristin Gillespie MS, RD, LD, CNSC, and a registered dietitian and certified nutrition support clinician.
In fact, The British Journal of Nutrition found that people using a keto diet dropped and kept off more weight than people on other diets, especially low-fat diets.
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Animal Studies Have Mixed Results
A few animal studies have examined the effect of a ketogenic diet in type 1 diabetes, but their significance in humans is unclear. Poplawski et al examined the effects of an 8-week ketogenic diet vs a high carbohydrate diet in rat models of type 1 diabetes with nephropathy. The ketogenic diet group had a drastically improved albumin-creatinine ratio, indicating reversal of diabetic nephropathy.
Al-Khalifa et al placed 42 rats on either a normal diet, low carbohydrate diet, or high carbohydrate diet, all ad libitum, for 8 weeks. Half of each group was injected with streptozotocin to induce diabetes. Blood glucose levels and food and water intake increased with the normal and high-carbohydrate diets but not in the low-carbohydrate group . Weight gain was also significantly lower in the low-carbohydrate group . In the low-carbohydrate group, the number of beta cells did not differ between the control group and the group with the streptozotocin injection, while the other diet groups had a significant decrease in beta-cell mass in the streptozotocin groups vs controls. These results suggest that a low-carbohydrate diet may attenuate or prevent the development of diabetes.
Blood Pressure Evidence Scant
Data regarding the impact of a ketogenic diet on blood pressure have been inconsistent, and little exists specifically in the setting of type 1 diabetes. Several studies demonstrated no significant reduction in blood pressure with a ketogenic diet, while others suggested a mild benefit., A long-term study on the cardiovascular impact of a ketogenic diet on 10 children with glut-1 deficiency over the course of 10 years found no change in systolic or diastolic blood pressures compared with healthy controls .
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How A Ketogenic Diet Works
On a ketogenic diet, blood glucose levels are kept at a low but healthy level which encourages the body to break down fat into a fuel source known as ketones
The process of breaking down or burning body fat is known as ketosis
People on insulin will typically require smaller doses of insulin which leads to less risk of large dosing errors.
The diet helps burn body fat and therefore has particular advantages for those looking to lose weight, including people with prediabetes or those otherwise at risk of type 2 diabetes.
Effects On Lipids Kidney And Liver Function
The effects of KD on lipid profile are heterogenous, with improvement of LDL-cholesterol and triglycerides reported by some authors, while others reported no significant change in LDL-cholesterol and triglycerides , or even an increase in triglycerides .
No significant changes in renal parameters were reported after 4 months or 12 months of KD . A study noticed an improvement of the glomerular function in the initial 70 days of follow-up .
Liver function tests, specifically alanine aminotransferase and aspartate aminotransferase , did not differ after 4 months of follow-up . Significant reduction of AST and ALT was reported after 8 weeks and 70 days .
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Variations Of The Keto Diet
Aside from the standard keto diet described above, there are a few other variations of the keto diet, including:
The cyclical ketogenic diet, which allows for eating 100-150 grams of clean carbs one to two days per week.
The targeted ketogenic diet, which follows the same rules but asks you to time when you eat carbs, such as before or after a workout.
The very low carb diet approach, which allows people to eat high fat, moderate protein, and very low carbs. Compared to the standard keto diet, this is more generous. It allows for 100-150 grams of carbs daily, versus the standard ketos 50 grams daily or the cyclical ketos approach and may not get you into ketosis.
Preparing For Side Effects
When your body enters ketosis , you can start experiencing unpleasant side effects, including headaches, muscle spasms, excessive thirst, fatigue, and insomnia. For many people, these side effects go away after a few weeks.
If ketosis hinders your quality of life significantly, speak to your doctor about an alternative eating plan.
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Effects On Lipids Mixed
Concerns have been raised regarding the ketogenic diet and adverse lipid profile changes, but the literature is inconsistent, and few publications have assessed the issue specifically in type 1 diabetes. Effects of ketogenic diets such as decreased total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels and increased high-density lipoprotein cholesterol levels have been reported.
Yancy et al, compared a low-carbohydrate diet to a low-fat diet in a randomized control trial of 120 overweight patients with hyperlipidemia. The low-carbohydrate diet led to greater decreases in serum triglyceride levels compared with patients on a low-fat diet and greater increases in high-density lipoprotein levels , but no significant differences were seen in low-density lipoprotein levels .
Using an online survey of a social media group for children and adults with type 1 diabetes who were following a very low carbohydrate diet, Lennerz et al found that 51 of 316 respondents reported having a diagnosis of dyslipidemia .
In a retrospective chart review of 30 patients with either type 1 or type 2 diabetes on a low-carbohydrate diet , ONeill reported that low-density lipoprotein levels decreased by 17%, from 155 to 130 mg/dL , and triglyceride levels decreased by 31%, from 107 to 74 mg/dL .
Keto And Mediterranean Diets Both Help Manage Diabetes But One Is Easier To Maintain
In a trial of the two low-carb diets, both were similarly effective in controlling blood glucose. Ketos more severe carb restrictions did not provide additional overall health benefits.
Stanford researchers found that the Mediterranean diet, rich in whole grains, fish and vegetables, was as effective as the carbohydrate-restrictive ketogenic diet in controlling blood glucose in a study of people who tried both. Participants also found the Mediterranean diet easier to follow.
A low-carbohydrate diet is generally recommended for people who have Type 2 diabetes or who are at risk of developing the disease. But there isnt wide agreement on how low to go in carbohydrate consumption or which carbohydrate foods to include, and little research is available to help people make informed decisions.
A new trial by investigators at Stanford Medicine has compared two popular low-carb diets ketogenic and Mediterranean in their effect on blood glucose, cardiometabolic risk factors, weight loss and nutrition, as well as how easily people can adhere to them.
The ketogenic diet is an ultra-low-carb, very high-fat diet that involves a drastic reduction in carbohydrate intake. The Mediterranean diet is a low-carb, moderately high-fat diet that emphasizes vegetables, legumes, fruits, whole grains, olive oil and fish.
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Is A Keto Diet Safe For People With Diabetes
While there hasnt been a lot of research done on the long-term effect of following a keto diet, its generally considered safe for most people with diabetes.
The main risks when following a keto diet are related to mental health. ANY restrictive diet can potentially lead to an unhealthy relationship with food, and, in some cases, eating disorders.
If you find yourself constantly thinking about food, avoiding social situations where food is involved, or struggling with a negative body image, please seek professional help.
NOTE: Its important to stress that this risk isnt related specifically to a keto diet but dieting in general!
Keto Diet Vs Conventional Diets
Maintaining a healthy weight and watching what you eat are the main recommendations for type 2 diabetes. That’s why many patients adopt low-calorie diets. Could the ketogenic diet offer better results than conventional low-calorie diets? Some studies say that they can. It is important to emphasize that the keto diet is a low-calorie diet most of the time. Like any other hypercaloric diet, a high-calorie keto diet can lead to weight gain and other negative outcomes.
A study³ with 28 overweight participants with type 2 diabetes demonstrated that the keto diet could improve glycemic control to a point where diabetes drugs were discontinued or reduced.
Another study with 83 people showed that the keto diet might be useful for the short-term management of insulin resistance.
A study with 132 obese adults with diabetes revealed that a low-carb diet was more favorable than a conventional diet. Although both groups had similar weight loss results, the effects on glycemic control were better for those on the low-carb diet.
Another 2012 study observed 163 overweight and obese adults. They had an opportunity to choose a low-calorie diet or a keto diet.
After 24 weeks, researchers found that both diets had a beneficial effect on the subjects. However, the benefits were more noticeable in the keto group. The diet appeared to improve glycemic control.
Overall, this study concluded that a low-carb diet could improve blood glucose levels better than a low-fat diet.
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