Dka Or Desired Ketosis
Differentiating DKA from desired nutritional ketosis for a patient following a ketogenic diet poses a challenge when interpreting monitored test results. According to Volek and Phinney, blood ketone levels ranging from 0.5 to 3.0 mmol/L are expected in nutritional ketosis, with the upper end being optimal . Although such levels are not high enough to indicate DKA, they can be a warning sign. As such, the clinical picture should be considered. Patients should be educated regarding symptoms of DKA, including nausea, vomiting, and difficulty breathing.
Safety ranges of serum ketone levels.
Based on data from reference .
Diligent and more frequent blood glucose monitoring should be a mainstay in patients with diabetes on a ketogenic diet. Although euglycemic DKA is possible while following a ketogenic diet, blood glucose levels above 250 mg/dL may be seen and are a sign of potential DKA.
Glucose monitoring can also be helpful for preventing hypoglycemia, a potential consequence of reduced carbohydrate intake. Clinical studies indicate that a continuous glucose monitor can be a useful tool in reducing hypoglycemia.,
The Difference Between Type 2 And Type 1 Diabetes
Lets clear up any questions you may have regarding type 1 and type 2 diabetes.
The type of diabetes we are focusing on for this article is type 1 diabetes. It accounts for about 510% of all cases of diabetes. Being an autoimmune disease, it turns the bodys immune system which normally fights harmful bacteria and viruses against the insulin-producing cells in the pancreas. Eventually, the immune system destroys the pancreass ability to produce insulin. The result is blood sugar levels that are out of control and wreak havoc on the body.
Type 2 diabetes, on the other hand, is a result of insulin resistance rather than insulin deficiency. Insulin resistance occurs when the cells no longer respond to insulin signaling. The pancreas responds by secreting more insulin, which increases insulin resistance in the cells. This vicious cycle creates chronically high blood sugar levels.
Type 2 diabetes is commonly caused by overfeeding on calories and carbohydrates and inactivity, not by an autoimmune issue. However, both type 1 and type 2 diabetes have many similarities including their symptoms, long-term complications, and the diet that helps best with their treatment.
What Is A Ketogenic Diet
A ketogenic diet is primarily used for weight loss where you eat more fats and fewer carbs. Carb intake is typically restricted to 50 grams a day to as little as 20 grams a day, requiring you to eliminate such things as grains, candy, pastries, potatoes and sugary soft drinks from your diet. The goal is to shed pounds quickly by depleting the body of glycogen and water.
In the long term, a keto diet suppresses appetite, which leads you to consume fewer calories and thus maintain your desired weight.
Potential cons of a keto diet are:
Recommended Reading: Type 2 Adult Onset Diabetes
Type 1 Diabetes And The Ketogenic Diet
Updated May 1st, 2022 Written by Craig Clarke
For thousands of years, something has been sneaking up on children and robbing them of their ability to control their blood sugar levels. The culprit is an autoimmune condition called Type 1 Diabetes, and its incidence has been increasing in both the United States and in other western countries.
But there is no need to worry. This sneaky disease has left us with enough clues to diagnose it, manage it, and potentially reverse it. This can be done by type one diabetics following the keto diet.
Is The Keto Diet Bad For You
Both Condon and Kleinman said they wouldnt recommend the keto diet to their patients because it is ultimately not realistic or sustainable. The diet restricts fresh fruits and vegetables, whole grains and low fat dairy that can help with long term weight loss and overall health.
Theres not one diet thats good for everyone, Kleinman said. Do your research, consult a dietitian, discuss with your doctor, and make sure youre being safe.
Call the Health and Nutrition Experts atUChicago Medicine Ingalls Memorial at to discuss nutrition counseling programs offered to meet your personalized needs.
Don’t Miss: Diabetes Injection Pen For Weight Loss
I Tried The Keto Diet To Manage My Diabetes This Is What Happened
Health and wellness touch everyones life differently. This is one persons story.
When Lele Jaro received a diagnosis of type 2 diabetes in 2006, she didnt leave the doctors office with a complete understanding of how the condition would influence the rest of her life, or fully equipped with the tools shed need to manage it.
When I found out I had type 2, I didnt really know how to feel about it. I was so young and, to put it bluntly, naïve about the whole diagnosis, she recalls. They gave me medication, some information what to eat if you have diabetes, and that was it.
Her doctor told her that shed probably been living with the condition since she was in her teens. The symptoms of type 2 diabetes creep up slowly without you really knowing the damage that its already doing to your body, she says.
I thought it was something I could eventually overcome. It wasnt until I got pregnant at 29 when I realized that type 2 diabetes is a serious, chronic disease, she says.
After working out and following her doctors diet recommendations, she managed to lose about 60 pounds by 2008.
But when it came to actually managing her diabetes, relying on weight loss simply wasnt cutting it. Though she followed her doctors advice, it became increasingly clear to Lele that shed need to take matters into her own hands and develop a means by which to manage her diabetes that didnt leave her reliant on medication.
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.
You May Like: Diet For Insulin Resistance To Lose Weight
How To Start The Keto Diet If Youre Living With Type 2 Diabetes
If you decide to start the keto diet, dont go it alone.
Youll also find heat-and-eat keto meals that you can order online at Factor. Subscribe and you get a complimentary session with a registered dietitian.
Above all, if youre interested in trying keto to manage diabetes, talk with your diabetes medical team including your endocrinologist and a registered dietitian who is also a certified diabetes care and education specialist before trying this eating plan. Start the diet slowly, cutting carbohydrates gradually, Zanini recommends. Dramatic reductions could lead to hypoglycemia, especially if youre on oral diabetes medications or insulin.
Regularly test both your blood sugar and ketone levels to prevent serious side effects. Doing so is very important for avoiding DKA, says Sylvia White, RD, CDCES, who works in private practice in Memphis, Tennessee. Warning signs of DKA include consistently high blood sugar, high ketone levels, dry mouth, nausea, vomiting, and frequent urination and complications can cause a diabetic coma.
Possible Health Risks On Keto Diet For Diabetes
While the keto diet has numerous health benefits, it is not magic or a miracle to cure diabetes. According to a recent study, one of the challenges of keto diets is that they support a lower vegetable, fruit and grain intake with an increased intake of fat which can be detrimental.
Some short-term side effects of keto, such as the keto flu, occur when your body adjusts to the diet.
It involves fatigue, constipation, difficulty sleeping, dizziness, headaches and nausea. However, you can prevent these symptoms by adequate hydration and electrolyte intake. Other possible health risks include nutrient deficiencies, digestive issues, low blood pressure, kidney disease, and high cholesterol.
Don’t Miss: Va Disability Rating For Diabetes
Keto Diet Pills And Diabetes
Several supplements are available to people who are following the keto diet. Here are a few of these supplements and what you should know about each one:
- Ketone supplements/ketone esters work to boost the availability of energy to the body. These primarily consist of BHB salts, which combine the ketone body beta-hydroxybutyrate with sodium and potassium. These salts put ketones in the bloodstream, meaning the body doesnt need to burn body fat to access ketones. While valuable for athletes, these supplements are not ideal for people with diabetes interested in weight loss.
- Magnesium helps keep sodium and potassium levels in check, especially in the early days of a persons keto diet. Unless it impacts kidney function, excessive magnesium should not be a problem.
- MCTs, AKA medium chain triglycerides, are a dietary fat source touted by some researchers as being ideal for ketone development. This fat source can help people follow a keto diet while eating more carbs than they could otherwise. However, the jury is currently out on whether or not MCTs are better than other fats regarding weight loss.
- Cinnamon has been theorized to help boost insulin response and increase the speed of glucose metabolism. Because of this, some people on the keto diet have started eating cinnamon before meals. Still, we should note that research has not proven that cinnamon affects insulin sensitivity.
Contemplating The Keto Diet For Yourself
“Those with type 1 diabetes should avoid a ketogenic diet,” warns Joseph Galati, MD, a hepatologist at the Liver Specialists of Texas in Houston, “Many patients with type 1 diabetes have some degree of renal impairment, and handling the build-up of ketones and acids in the body may cause too much stress on the kidneys. Of course, any pregnant women with diabetes, especially those requiring insulin should avoid such an extreme diet given the low glucose levels will be a constant threat.”
As for individuals with type 2 diabetes, Dr. Galati says, “a very low carbohydrate diet could be tolerated, albeit with extreme caution. Transitioning to a ketogenic diet will require several lifestyle changes as well as careful monitoring of both your food intake and glucose levels and adjustments to your medications. Also, you should increase your water consumption.”
For those who want to follow a ketogenic-type diet, Dr. Reynolds says it is important to first talk to your doctor and to discuss your goals so you can be sure that this approach is suitable for you given your medical and health history. Ongoing monitoring is needed if you do decide to adopt this very carb approach to eating. Seeing your doctor regularly is important to make sure that your blood pressure, lipids, blood sugar, mood, and medications are within normal ranges as you lose weight. Adjustments are likely going to be necessary from time to time.
Don’t Miss: What Is An Insulin Pump
Diets In The Real World
As expected, when food was delivered, participants stuck to both diets relatively well, scoring an average of 7.5 on a 10-point adherence scale. When participants had to provide their own food, adherence on both diets dropped about two points on average.
The one thing everybody did pretty well was limiting added sugar and refined grains. That was the main message for both diets, Gardner said.
The keto diet was more polarizing, he said. What we were hearing is that some people just couldnt do the keto because it was too restrictive. Yet a few may have found it simpler, at least initially, to focus just on avoiding carbs, according to Gardner.
Theres no reason to restrict heart-healthy, quality carbohydrate foods.
When the research team checked in with the participants three months after the trial, on average, they had maintained lower blood glucose levels and weight loss. Notably, they were eating closer to a Mediterranean diet than to a keto diet. Even the participants who had followed the keto diet nearly perfectly during the trial largely gave it up afterward.
The takeaway, Gardner said, is that there was no additional overall health benefit to cutting out legumes, fruits and whole grains to achieve an ultra-low-carb diet. For people with diabetes or prediabetes, the less restrictive Mediterranean diet was similarly effective in controlling glucose and likely more sustainable.
Keto Diet And Diabetes Precautions
Does keto raise blood sugar? Most people see improvements in their blood sugar levels when following a keto diet, but some individuals may notice a rise in fasting blood glucose after being on a very low-carb diet. Let your doctor know if this occurs.
Is a low-carb diet safe for diabetics? A low-carb diet like the keto diet can be safe for some diabetics if followed appropriately while being monitored by their doctor. Its also essential that diabetics continue to follow their doctors 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 ketogenic diet. Ketosis takes place when glucose from carbohydrate foods is drastically reduced, which forces the body to find an alternative fuel source: fat. 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 , when they dont take sufficient amounts of insulin or when they are sick, dehydrated, or they experience physical or emotional trauma.
Read Also: How Do You Treat Low Blood Sugar
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.
When Do Ketones Build Up
Youre most at risk of a build-up of ketones if you dont inject enough insulin or if you miss a dose of insulin. Its important to know that sometimes you need more insulin than usual and need to check for high blood sugars more regularly, like when:
- youre not feeling well
- you have had an injury or surgery
- youre pregnant
- youre having your period.
All of these times are just part of normal life and that can be a reminder that diabetes is always there in the background. If youre struggling to cope with your diabetes you can have a chat with us on our helpline. We can support you when youre feeling down or tired with managing your diabetes.
Also Check: How Do I Know If My Glucose Meter Is Accurate
How To Stay On Track
Success doesnt happen overnight, and I know that working hard will eventually get me to my goals, says Lele. And when it comes to finding motivation, being a mother certainly helps: My son helps me stay on track. I need to get healthier for my son to make sure Im always here for him, she says.
If youre interested in trying out the keto diet, or are already following the regimen, Lele suggests keeping the following in mind:
Are People Born With Diabetes Type 1
Multiple causes, including genetics and some viruses, may cause type 1 diabetes. Adults may acquire type 1 diabetes, which often manifests during infancy or adolescence.
All I know is after taking this product for 6 months my A1C dropped from 6.8 to 5.7 without a struggle. By that I mean I watched my diet but also had a few ooops days with an occasional cheat and shocked my Dr with my A1C test. Since then I have also had finger checks that average out to 117-120. Im still careful but also thankful my numbers are so good!
Possible Benefits Of The Ketogenic Diet For Type 2 Diabetes
Heres how the keto diet may help if youre managing type 2 diabetes: With a higher protein and fat intake, individuals may feel less hungry and are often able to lose weight, since protein and fat take longer to digest than carbohydrates, says the Manhattan Beach, Californiabased Lori Zanini, RD, CDCES, the author of Eat What You Love Diabetes Cookbook. It may also help keep your energy levels up.
The diet may offer additional benefits. A review published in January 2021 in BMJ suggests that a low-carbohydrate diet like keto may help bring a person with diabetes into remission, which is defined as having an A1C test result of less than 6.5 percent or fasting glucose of less than 7.0 mmol/L, with or without the use of diabetes medication. That remission is not extremely likely, and whether it is permanent is unclear long-term diet adherence is typically required for maintenance of remission.
Frontiers in Nutrition Frontiers in Nutrition