Type 2 diabetes is a condition that impacts blood sugar control. A ketogenic, or keto diet, is a high fat, moderate protein, and very low-carbohydrate diet that may help some people manage their blood sugar.
Everyone has different dietary needs. Healthcare professionals and registered dietitians now individualize diet plans based on a person’s eating habits, preferences, and target weight and blood sugar levels.
In this article, we look at if the keto diet works for the management of type 2 diabetes.
Limiting the intake of carbohydrates is the central concept of the keto diet.
The idea is to limit carbohydrate-rich foods that could raise a person’s insulin levels. Typically, the carbohydrate intake on a keto diet ranges from
To follow the keto diet, people might consider developing a diet plan with
A keto diet may consist of the following types of food:
- Low carb vegetables: These include leafy greens and broccoli.
- Eggs: Eggs are low in carbohydrates, as well as an excellent source of protein.
- Meats: The keto diet allows for poultry, beef, and pork, as they are rich in high-quality protein.
- Healthful fat sources: These include avocados, olive oil, nuts, and seeds.
- Fish and shellfish: These are sources of protein.
- Dairy: Unsweetened dairy products are acceptable in a keto diet.
- Berries: These are sources of fiber, vitamins, minerals, and antioxidants that are okay to consume on the keto diet in the right quantity.
The keto diet severely restricts carbohydrates, forcing the body to break down fats for energy. Ketosis is the process of using fat for energy. It produces a fuel source called ketones.
Foods containing carbohydrates, such as bread, rice, pasta, milk, and fruit, are the main fuel for many bodily processes. The body uses insulin to help bring glucose, also known as blood sugar, from the blood into the cells for energy.
However, for people with diabetes, insulin is either absent or does not work properly. This disrupts the ability of the body to use carbohydrates effectively, and in turn, causes sugar levels to be high in the blood.
Eating a high carb meal could lead to a rise in blood sugar, especially in someone with diabetes. Diet is important for both type 1 and type 2 diabetes.
Scientists have looked into the
- improving blood sugar control
- stopping or reducing diabetes medications
- losing weight
- reversing diabetes
Does keto work for managing type 2 diabetes?
A keto diet could help
The diet’s lower intake of carbohydrates may help minimize large fluctuations in blood sugar, which could better impact several clinical markers of blood sugar control.
Researchers noted that while some studies show that low carb diets could improve glycemic control and aid weight loss, studies typically only lasted 6–12 months. Overall, dropout rates in the keto diet groups were as high as 54%.
HbA1c is a clinical measure of blood sugar control that tests the amount of blood sugar traveling with hemoglobin in the blood over about 3 months and is an important component of type 2 diabetes management.
However, a study in
These conflicting studies are why experts caution against suggesting there is a keto diet advantage for type 2 diabetes over other common dietary strategies, especially over a longer term.
Scientists continue to study the impacts of a keto diet on people with type 2 diabetes, including the underlying mechanisms that may explain the observed benefits.
There are some groups of people who should not follow a keto diet, including people:
- pregnant or lactating
- with a history of or current diagnosis of an eating disorder
- with kidney disease
- taking certain medications, such as SGLT-2 inhibitors
- with pancreatitis
- with liver failure
- with disorders of fat metabolism
The keto diet could lead to a variety of
- weight loss
- a reduced dependency on anti-diabetic medication
- lower blood pressure
- an improved insulin sensitivity
- improvements in high-density lipoprotein (HDL) cholesterol, without increasing low-density lipoprotein (LDL) cholesterol
- improvements in triglycerides
- improved quality of life
- improved feelings of fullness
Impact on medication
As keto diets could help reduce blood sugar levels and weight, people with type 2 diabetes, who follow a keto diet, may be able to reduce their need to take anti-diabetic medication.
A study published in
People may find the keto diet hard to maintain long term. As people add carbohydrates back to their diet, they will need to increase their diabetes medication in turn.
Hypoglycemia occurs when blood sugar levels fall below 70 milligrams per deciliter (mg/dl).
Consult with a healthcare professional about proper medication adjustments before starting a keto diet.
Impact on weight
The keto diet helps the body burn fat. This is beneficial when trying to reach or maintain a moderate weight. It may be helpful for people whose excess weight has influenced the development of prediabetes and type 2 diabetes.
Even light-to-moderate weight loss through diet and exercise might support glycemic control, overall well-being, and better energy distribution throughout the day in people who have type 2 diabetes,
However, the restrictive nature of the keto diet can make it difficult to follow for a long time. People will typically find it more beneficial to follow a moderate diet and lifestyle program that is sustainable long term.
Is keto safe for people with type 2 diabetes?
The keto diet may be one possible blood sugar management option for some people with type 2 diabetes.
As the keto diet involves a shift in typical eating habits and the body switching to a different energy source, it might lead to some adverse effects.
Short-term side effects
Following the keto diet could result in short-term side effects, including:
- keto-flu, a short-term group of symptoms that resemble those of flu
- noticeable changes in bowel habits, such as constipation or diarrhea
- uncomfortable leg cramps
- a noticeable loss of energy
- mental fogginess
- frequent urination
In most instances, the side effects are temporary and could last a few days to a few weeks.
Long-term side effects
Long-term effects might include the
Other complications might include:
- an increased
risk of dyslipidemia, an imbalance of lipids
- an elevated risk of fatty liver disease
- more frequent hypoglycemic episodes
Some researchers have suggested that since a keto diet often involves additional fat, there might be a
People with diabetes already have an
There is a lack of evidence about the long-term safety and effectiveness of the keto diet, and healthcare professionals have called for
Ketosis is the desired state of the body using fat instead of carbohydrates for fuel when nutritionally altering the diet as part of the keto diet. In ketosis, the liver has broken down enough fat to produce ketones that circulate freely in the bloodstream.
Ketosis is a metabolic process that doctors generally consider safe for most people if managed properly. Ketosis is not a medical condition.
Ketoacidosis is a potentially life threatening medical complication. The body essentially believes it is starving and rapidly breaks down fat into ketones. When ketones become dangerously high, the blood can become more acidic.
Ketoacidosis is a complication of type 1 diabetes, but it can also occur in people with uncontrolled diabetes and people with alcoholism.
Some isolated reports of ketoacidosis occur when people with type 2 diabetes follow a keto diet with
If symptoms of ketoacidosis appear, seek medical attention immediately.
The main problem with the keto diet is that it can be
When it comes to managing diabetes, there is no one right diet. The key is following an eating plan that meets personal preferences and needs and keeps clinical health targets, such as blood sugar levels or weight, in check.
To assess the benefits of the keto diet for type 2 diabetes, scientists suggest that benefits need to be present over a
That is why additional long-term studies in larger samples of more diverse research participants are necessary.
A person may wish to seek medical supervision while following this diet. A person should always try to talk with a doctor or dietitian before making significant changes to their diet, including when trying a keto diet.
Health authorities in the United States do not recommend the keto diet to manage type 2 diabetes.
It may be better for people with type 2 diabetes to focus on:
- following a healthful, balanced diet with plenty of fresh fruits and vegetables
- spreading the intake of carbohydrates out evenly throughout the day
- eating smaller meals more often rather than a large meal once a day
A healthcare professional can help individuals with type 2 diabetes choose the plan that best fits their lifestyle.
Discover more resources for living with type 2 diabetes by downloading the free T2D Healthline app. It provides access to expert content on type 2 diabetes and peer support through one-on-one conversations and live group discussions. Download the app for iPhone or Android.