THE KETOGENIC DIET & DIABETES

Reports that adopting a keto lifestyle can make a positive difference to diabetes symptoms has been a game-changer for diabetics all over the world. Not only are more and more people sharing their success in managing diabetes using a ketogenic diet, but many doctors are in agreement as the scientific evidence mounts up. (1)    

Diabetes is a condition that can be mild, or it can be life-threatening - with some people suffering kidney failure, heart attacks, strokes, blindness, and lower limb amputation. And with over 500 million sufferers worldwide, the demand for ways to control and treat diabetes has never been higher. (2) The spotlight is now increasingly on keto diets as a way to manage diabetes symptoms, but just remember to check with your doctor before making any major changes to diet and lifestyle – especially if you have a pre-existing condition.

To help you get started, we’ve complied answers to the most commonly asked questions about managing diabetes on a keto diet….

 

How can a keto diet make a difference to diabetes?

Insulin is the hormone in charge of controlling blood glucose levels. Diabetes happens when this process doesn’t run smoothly, and blood sugar levels hit unhealthy peaks and troughs – these fluctuations can wreak havoc with other bodily processes and internal organs.

When someone reduces their carbohydrate intake on a keto diet, blood glucose levels naturally fall, and the body enters ‘ketosis’ – meaning fat is used for energy. Overall, this has two benefits – a reduced reliance on insulin and improved functioning of the insulin circulating the body.

Scientific studies into ketogenic diets have found that they lower blood glucose levels, body fat storage and insulin levels. (3) And as many as 95% of participants in one study were able to stop or lessen their diabetic medication during a 24-week study into blood sugar levels on a keto diet. (4)

 

Will I notice any other benefits on a keto diet?

As a bonus, once your body is regularly in ketosis, you’ll probably feel some extra health benefits too. People often report that on a keto diet they have a reduced appetite, lose weight, have less inflammation, increased heart health, sharper mental focus, increased energy, lower blood pressure and healthier cholesterol levels. (5)  

 

What is type 1 diabetes?

In type 1 diabetes, a person’s immune system destroys the insulin-producing cells in the pancreas. With less insulin being released, the body’s blood sugar levels creep higher, until symptoms become obvious.

It’s important to know that insulin also controls ketone levels – and if ketone levels get out of control, then a person can develop ketoacidosis, a serious and sometimes fatal condition. (6) The upshot of this is that people with type 1 diabetes starting a keto diet can be at risk if they don’t stick to their insulin medication programme or make severe changes too quickly. Type 1 diabetes is a hereditary condition and can be tested for.

Keto diets have been shown to help with type 1 diabetes, but your doctor should be aware of major changes in your diet and lifestyle.

 

What is type 2 diabetes?

Over 90 to 95 % of people with diabetes have type 2 diabetes. Although some people may be more likely to develop it than others, type 2 diabetes is often caused by metabolic imbalances, diet, obesity, a sedentary lifestyle, and aging. (7)

Type 2 diabetes is a lifestyle disease and can be reversed or managed with changes in diet and lifestyle.

Over time the body produces less insulin, or the body's cells do not respond to insulin in the way they should causing blood glucose levels to rise. To lower or reverse the impact of type 2 diabetes, it’s essential to get your blood sugar levels under control and improve insulin efficiency. This is exactly what a keto diet is designed to do.

Getting the body into a state of ketosis can also target the root causes that lead to diabetes - excess weight and insulin resistance - before it even starts.

 

What is prediabetes?

If blood glucose levels are higher than they should be, but not high enough to be classed as diabetes, then ‘prediabetes’ is diagnosed.

If one of these categories applies to you, then testing for prediabetes might be a good idea….

  • are overweight or obese
  • have a weight circumference higher than 35 inches (women), 40 inches (men). 
  • have a high fasting blood glucose level - above 5.5 mmol 
  • have high blood pressure - above 130/85
  • have low HDL (‘good’ cholesterol) or high triglycerides
  • have a close relative who currently has or has had diabetes
  • are over the age of 40
  • have given birth to a baby who weighed over 9 pounds

Prediabetes is a metabolic condition that can progress into type 2 diabetes if left untreated. (8)  The good news is that sticking with a keto diet can reverse prediabetes and prevent diabetes type 2 from developing.

 

What makes a ketogenic diet unique?

A ketogenic diet recommends 20 - 50g carbohydrates per day, 40 - 60g of protein and no limits on fat. This can be easier to visualise in percentages and would work out as 70 – 75% fat, 20% protein, and 5 - 10% carbs. 

Compare this to an average diet of 10 – 30% daily calories from protein, 45 – 65% from carbohydrates and 25 - 35% from fat, and you can see how carbs are vastly reduced on a keto diet. This ratio helps the body go into ketosis and utilise fat for energy rather than glucose. 

The important thing to remember is that you need to get more of your calories from fats and less from carbs. Up to 75% of calories from fats can sound like a lot to people unfamiliar with keto diets, but it’s important to give your body fuel that doesn’t easily turn to sugar and spike insulin levels. And there are tonnes of healthy, satisfying fats out there like eggs, meat, avocado, dairy, olive oil, coconut oil and oily fish.

Even with such low amounts of carbs, veggies are still allowed – just stick to non-starchy varieties such as courgettes, green peppers, celery, leafy greens, broccoli and cauliflower.

 

Is a keto diet difficult to follow?

For some, starting a keto lifestyle can be a big change, but these days, there’s no need to give up comfort foods and sweet treats. There’s a booming number of keto recipes and food stores online as well as keto-friendly products available on the high street. We’re pretty proud to say our own keto snack bars only have 2 - 4g net carbs per bar and only contain natural ingredients - guilt free snacking that goes perfectly with a cuppa!

As our bodies are amazing ‘adapters’, if your carb intake varies, so will your body’s response vary.  Our advice? Start gradually and find foods you enjoy. This will make it easier to maintain the consistency needed to give your insulin response the best chance of recovery.

 

Should I be worried about any risks or side effects?

Making significant changes to your diet and lifestyle can bring risks with it – especially if you go too fast too soon or don’t speak to your doctor first. When first starting a keto diet, some people get ‘keto-flu’ and generally feel under the weather, but this is a normal sign that your body is adapting and should pass in about 2-6 weeks. You can lower your chances of ‘keto-flu’ by taking your time as you change your diet and transition to a lower carbohydrate intake.  You can find out more about the keto flu here

People who are taking insulin medication need to be particularly careful when starting a keto diet. Firstly, if your medication isn’t properly managed and you plunge into a very low carb diet overnight, there can be risk of hypoglycaemia (dangerously low blood sugar).

And secondly, there is the possibility of ketoacidosis happening when someone misses their insulin dose or severely reduces their food intake very quicky. This can result in the body producing too many ketones which can be a life-threatening issue for those with diabetes. (9) Mostly this is a concern for people with type 1 diabetes, but it can occasionally affect type 2 diabetes sufferers too.

The benefits of a keto diet can far outweigh the risks – but it is crucial to keep your medications well managed and in regular communication with your doctor.

 

Is a keto diet right for everyone?

If you fall into one of these groups, it’s usually recommended that a keto lifestyle isn’t for you…

  • Pregnant or breastfeeding women
  • People on hypo-causing medication or taking SGLT2 inhibitors
  • People who are underweight or have an eating disorder
  • People with gallstone problems or who have had their gallstones removed
  • Children or adolescents under 18 years old - unless supervised by a medical professional.
  • Anyone undergoing or recovering from a medical procedure

 

Diabetes and the keto diet: key points

Diabetes happens when blood glucose levels aren’t fully controlled, and the body doesn’t produce enough insulin. However, insulin function can be improved by following a keto diet where carbohydrate intake is reduced until the body uses fat for its fuel. This changed state can steady blood sugar and help many people manage, or even reverse their diabetes symptoms. We recommend starting gradually and, of course, always check-in with your doctor first, but starting a keto diet could be the step that helps free you from the symptoms of diabetes or prevent it developing in the first place.

 

References

  1. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus - PMC (nih.gov)
  2. Facts & figures (idf.org)
  3. Insulin Resistance - StatPearls - NCBI Bookshelf (nih.gov)
  4. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus - PMC (nih.gov)
  5. Losing Weight | Healthy Weight, Nutrition, and Physical Activity | CDC
  6. Diabetic Ketoacidosis | Diabetes | CDC
  7. Is Type 2 Diabetes Genetic? Environmental Factors and More (healthline.com)
  8. Prediabetes - Your Chance to Prevent Type 2 Diabetes | CDC
  9. Diabetic Ketoacidosis | Diabetes | CDC