Did The Ketogenic Diet Cause Type 2 Diabetes Not So Fast One Dietitian Says
Grandl and his colleagues compared a high-fat diet with a ketogenic diet in mice, feeding the animals specific foods and then conducting tests to understand how their bodies reacted to the diets. The study showed that compared with the mice on the high-fat diet, those on the low-carb, high-fat keto diet appeared healthier while on the keto diet but also began to quickly develop insulin resistance meaning that their livers were less able to respond to insulin and regulate sugar levels in the blood.
When we measured fasting plasma levels, we found low insulin and low glucose, which is good not suggestive of diabetes, he says. However, when we challenged the animals with glucose giving them a relatively large amount of glucose, as they would get by ingesting a meal we found that their plasma glucose levels went higher than mice on normal chow and stayed high longer.
This suggests the animals were less able to quickly clear glucose from their blood, he says. And this is a hallmark of insulin resistance.
Mice were the focus of this study, which means the effects in humans must still be investigated. But mice are typically considered accurate models of potential biological processes in humans.
The study was also short and does not mean the ketogenic diet causes diabetes, says , a spokesperson for the Academy of Nutrition and Dietetics who was not involved in the research.
Pro: Less Hunger & Controlled Appetite
Besides body fat stores breaking down, weight loss on a ketogenic diet occurs for a couple of different reasons:
- Participants in several research studies reported feeling less hungry and eating less food overall, likely because fat and protein fill you up more than carbohydrates do.
- High amounts of ketones in your body may also suppress the hormones responsible for controlling appetite.
Reduced Dependence On Medication
This is a huge benefit of the keto diet for type 2 diabetes. The diets glucose-lowering effect can reduce a patients need for medication.
Results from Virta Healths 2-year clinical trial showed that diabetes medicines to control glucose were reduced. These included insulin and sulfonylureas 3.
Meanwhile, metformin was continued since it helped prevent type 2 diabetes from progressing 3.
Important: A keto diet may cause hypoglycemia in diabetes patients taking insulin. It should be carried out with a doctors guidance and supervision.
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Does Keto Make Diabetes Worse
Now, with enough weight loss by any meanswhether from cholera or bariatric surgerytype 2 diabetes can be reversed. But a keto diet for diabetes may not just be papering over the cracks, but actively throwing fuel on the fire.
Ive been trying to think of a good metaphor. Its easy to come up with things that just treat the symptoms without helping the underlying disease, like giving someone with pneumonia aspirin for their fever, instead of antibiotics. But a keto diet for diabetes is worse than that, because it may treat the symptoms while actively worsening the disease. So maybe its more like curing the fever by throwing that pneumonia patient out into a snow bank. Or maybe curing your amputated finger by amputating your hand. No more unsightly finger stub! One of the co-founders of masteringdiabetes.org suggested its like a CEO that makes their bad bottom line look better by just borrowing tons of new cash. The outward numbers look better, but on the inside, the company is just digging itself into a bigger hole.
Can A Ketogenic Diet Reverse Diabetes
I cant tell you how often through the years I have been asked the question, If I lose 20 pounds, will I no longer have diabetes? Let me answer this very clearly, there is currently no cure for diabetes. Once you have been diagnosed, you have it for life. Every day, our most brilliant researchers are busy searching for a cure though. There is good news however you can manage your diabetes, get it under control, prevent all the complications of diabetes and live a normal, healthy life.
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In Nutritional Ketosis Your Ketone Level Stays Within A Safe Range
In the metabolic state induced by a keto diet, blood ketone levels generally stay below 4.0 or 5.0 mmol/L. In fact, most people rarely see levels that high unless theyre doing an extended or multi-day fast, in which case blood ketones can be as high as 6.0 or 7.0 mM.4,5
On a keto diet when someone is not fasting, ketone levels vary, but a typical range is 0.5 to 5.0 mM, although there is no formally agreed upon definition.2 Contrast this with ketoacidosis, in which blood ketones may be as high as 15-25mM. This is five to ten times higher than the range commonly seen in nutritional ketosis.2
Dont confuse nutritional ketosis and ketoacidosis just because they both have keto in their name. The difference in ketone concentration in nutritional ketosis and ketoacidosis is like the difference between a gentle spring breeze and a hurricane. Both involve wind, but theyre worlds apart in magnitude of impact. You dont want a hurricane blowing your house down, but a gentle spring breeze across the front porch is very nice.
The reason blood ketones dont continue rising ever higher on a keto diet is that they keep their own production in check. As your ketone level starts to rise, a very small amount of insulin is released. Not as much as if you were eating something sugary or starchyjust a tiny amount, which is enough to keep your ketones from reaching a dangerous level.
How To Enter Ketosis Naturally
Disclaimer: Its important to consult with your primary physician before starting a ketogenic diet, especially if you are on any medication.
Getting into nutritional ketosis isnt complicated, but it can be tough to get through the first couple of weeks.
To get into ketosis, you have to restrict your total carbohydrate intake and replace those carbs with healthy fats and a moderate amount of protein.
After a while, you will deplete your glycogen stores . Once youre out of glucose and you continue to restrict carbs, your body will begin to make ketones from fat and use those ketones as energy.
This transition period when your body is switching from using glucose to burning fat is called keto-adaptation. And it can be rough. Stick it out if you really want to see the benefits of becoming fat adapted.
The longer you stick to keto, the more efficient your body will be at metabolizing fats as its main source of fuel.
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Ketones Sound Great So Why Are People Afraid
The reason medical professionals may be concerned about people deliberately trying to achieve a state of ketosis is that ketone molecules are acidic. Your body aims to keep your blood very slightly alkaline, so if the concentration of ketones in your blood becomes too high, the fear is that your blood will become overly acidic, which is indeed a potentially life-threatening situation.
But its important to know that this almost never happens solely as a result of carbohydrate restriction in the context of a keto diet.
Except for using ketogenic diets as a treatment for epilepsy, the only exposure to ketosis that many healthcare professionals had during education and training was this harmful, out-of-control ketoacidosiswhen the blood ketone level is extremely high, the blood is dangerously acidic, and typically blood glucose is also very high. Only recently are they becoming more educated about the numerous benefits of safe, benign, nutritional ketosis.
Final Thoughts On The Keto Diet For Type 2 Diabetes
It’s been shown time and time again that you do not need to completely cut out carbs to manage diabetes effectively. And diets that include plenty of plant foods and whole, unprocessed grains, much like in the Mediterranean diet, have been well studied and are linked to increased lifespan and decreased rates of diabetes, heart disease, and cancer.
If you’re trying to keep your blood sugar levels in check, simply reducing the number of refined carbohydrates you eat can help immensely. By ‘refined,’ I mean the processed and packaged varieties, like breakfast cereals, most crackers and pretty much any sugar-laden snack food!
Including plenty of nourishing, nutrient-dense foods, like fruits and vegetables, has many health benefits, including decreased inflammation, preventing constipation, and less heart disease risk.
Although there seems to be a short-term advantage of the ketogenic diet for weight loss, the advantage seems to “shrink” at the one year mark. No significant difference in weight loss was observed at one year between a low carbohydrate diet and a conventionally “healthy, balanced” diet.
There’s also insufficient research to make firm conclusions about the ketogenic diet’s long-term effects on weight loss and other health parameters. Plus, the long-term safety is yet to be determined.
In my opinion, and based on the current research, I don’t think so.
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Is Keto Safe For Type 1 Diabetics
The short answer is maybe. The long answer is a little more complicated.
Type 1 diabetes isnt just an autoimmune condition it stops your pancreas from producing insulin at all.
This is different than Type 2, which causes a reduction in insulin production, or insulin resistance.
So, ketosis may not work with Type 1 diabetes for a couple of reasons:
However, some doctors, like Richard Bernstein, MD, who manages his own Type 1 diabetes with a very low carb approach, believe that ketogenic diets can help prevent blood sugar levels from spiking.
Halle Berry is another vocal proponent of the keto diet to help control her Type 1 diabetes and maintain a healthy weight.
Unfortunately, there arent any notable studies that prove the efficacy of the ketogenic diet with Type 1 diabetes. Definitely speak with your physician before altering your diabetes care plan.
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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Putting It All Together Into A Type 1 Diabetes Diet And Lifestyle
Having a normal life with type 1 diabetes is possible. In fact, most people with type 1 diabetes can manage the condition in such a way that they can reduce insulin requirements and improve their health and well-being.
Here is a quick recap of the diet and lifestyle:
- Determine an effective treatment plan with your doctor.
- Implement a ketogenic diet that limits dairy and wheat consumption.
- Check blood sugar levels frequently throughout the day .
- Supplement with vitamin D3 by getting sun exposure and taking a supplement every day.
- Exercise daily, but make sure you monitor your blood sugar and check for hypoglycemia symptoms.
- Get your A1C levels tested every three months to determine the effectiveness of your treatment plan.
For more on the ketogenic diet and how to get started, check out our beginners guide.
P.S. Have a look at the Keto Academy, our foolproof 30-day keto meal planner. It has all the tools, information, and recipes needed for you to succeed.
+ The food will always fit to your macros and cooking preferences!
Fat Is Safe In The Context Of Nutritional Ketosis
A common concern about following a carbohydrate restricted diet long-term is the eventual need to increase dietary fat intake. For decades now, Americans have been told to restrict fat as a way of not only decreasing the risk for obesity, but also decreasing the risk for cardiovascular disease. This theory has been refuted.Â³ Consuming high amounts of dietary fat is clinically demonstrated to be safe as long as carbohydrates are restricted. The theory that fat is responsible for heart disease and cholesterol problems has largely been disproven.â´â»â¹
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The Keto Diet And Type 2 Diabetes
As is the case for people with type 1 diabetes, the keto diet can encourage lowered blood sugar levels among people who have type 2 diabetes. This diets avoidance of carbohydrates may seem to make it a natural fit for people living with diabetes. However, you ought to be careful if you decide to follow the keto diet while living with type 2 diabetes.
For people with type 2 diabetes, the keto diet can cause dangerously low blood sugar levels. To avoid this, youll want to do blood sugar tests throughout the day and make adjustments in response to your results.
Diabetic ketoacidosis is relatively rare in people with type 2 diabetes, but high ketone levels are a risk factor. With that in mind, its important to know what to look out for if you are following a keto diet with type 2 diabetes. Specifically, if your blood sugar is above 240 mg/dL, you should use a urine strip to test for ketones.
Monitoring Diabetes On A Ketogenic Diet
If you currently have diabetes and you want to try a ketogenic diet, youll want to involve your doctor or another qualified practitioner.
Monitoring your blood glucose and ketone levels is critical, especially as youre transitioning into ketosis.
Some experts even recommend formal medical supervision in the beginning. As always, please talk to your doctor before you throw out all your carbs and dig into a jar of nut butter.
Once your body is acclimated to using ketones as energy, you should still make it a priority to regularly visit a physician to make sure the ketogenic diet is working properly for your body.
And because its likely that your diabetic symptoms will start to improve, you may need to alter your medication. Again, keep up with blood glucose and ketone monitoring and always ask your doc for the best advice.
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Diet Lowers Blood Glucose Sometimes Dangerously
Leow et al investigated the effects of a ketogenic diet in 11 adults with type 1 diabetes who self-initiated the diet before study recruitment. Mean HbA1c of study participants was excellent at 5.3%, and participants spent an impressive average of 74% of time within target range. However, many had a disproportionately high frequency and duration of hypoglycemic episodes.
Lennerz et al evaluated the effect of a very low carbohydrate diet on 316 patients with type 1 diabetes, using an online survey of a social media group. Average carbohydrate intake was 36 ± 15 g of carbohydrates per day for an average duration of 2.2 ± 2.9 years. Patients achieved good glucose control and reported high satisfaction. The rate of severe adverse events was low and included 7 patients with diabetes-related hospitalizations and 4 with DKA.
In their small, randomized crossover study, Ranjan et al compared 1 week each on a low-carbohydrate diet and a high-carbohydrate diet in patients with type 1 diabetes using insulin pump therapy. The low-carbohydrate diet group had significantly lower average daily blood glucose levels , longer time in euglycemia , less glycemic variability , lower total daily insulin dose , and fewer daily units of bolus insulin administered .
Is It Good Or Bad For People With Diabetes
The short answer here is it definitely depends on the type of diabetes that you have, but the ketogenic diet does seem to have health benefits and consequences for all types of diabetes.
As I stated earlier, and forgive me if I am blunt, forget it if you are pregnant. Momma, you need your nutrition!
For people with Type 1 Diabetes, you probably have heard of their diabetic emergency, diabetic ketoacidosis, also referred to as DKA. This can be life threatening condition for people with Type 1 diabetes and Certified Diabetes Educators spend many hours teaching preventive care for DKA. This condition should not be confused with nutritional ketosis, the fat burning state reached when following the Ketogenic diet. The two conditions are quite different.
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The Ketogenic Diet Induces An Emergency Response In The Body
The ketogenic diet is a high fat diet. When followed 100% the diet requires an individual to consume 50 grams or less of carbohydrates on a daily basis. Often people talk about becoming fat burners and having to be on the ketogenic diet long enough to adapt to fat-burning. This is a complete misunderstanding. Humans are not designed to burn fat, except for when there is an emergency. So when we create an environment in which our body has to use a resource to make energy that it would otherwise only use in the case of an emergency, we purposely create an emergency situation in our body.
Emergency situation = chronic exposure to stress hormones. 24 hours. 7 days a week. 365 days a year . The entire purpose of these stress hormones is to increase access to energy for the body. Whats this energy? SUGAR. So, purposely inducing an emergency situation in the body leads to chronically high levels of sugar in the blood. Long-term excess sugar in the blood = insulin resistance. Pre-diabetes. Or even diabetes.
Now, this high fat diet has taken an individual who already has issues with processing carbohydrates farther away from a metabolism that can process carbs well. Not even just poor tolerance of carbohydrates, but full blown insulin resistance. Now, when this individual reintroduces carbohydrates, they will experience immediate weight gain or other side effects of putting excess carbs in a body that doesnt know how to process them very well.