Is following a ketogenic diet an effective way to manage diabetes? With the ketogenic (Keto) diet increasing in popularity, I often hear this question in my practice. The theory appears simple: significantly decrease my overall carbohydrate and sugar intake and I will no longer need to worry about high blood sugar. Although this theory may appear simple, the human body is very complex. But first, let’s explain how the ketogenic diet works.
A keto diet is a very low carbohydrate, high fat eating pattern. General recommendations include 70-80% of calories from fats, 5-10% of calories (or 20-30grams) from carbohydrates and moderate intake of protein. Originally developed for seizure control in pediatric patients with epilepsy, the goal of the diet is to allow your body to enter a state of ketosis. Ketosis occurs naturally during times of starvation as the body breaks down fat stores to be used for energy when glycogen stores are no longer available.
Diabetes occurs due to a lack of availability of insulin or insulin resistance. Insulin is the key to allow glucose, the building blocks of carbohydrates, into our cells. Without insulin, our bodies are not able to unlock our cells to allow this entry, therefore, causing blood sugar to increase. When diabetes is present, it is important to watch for signs of low and high blood sugar as both can be very detrimental to health and even life threatening.
According to the 2019 American Diabetes Associations Standards or Care, the best approach to managing diabetes is dependent on the individual’s personal preferences, needs and goals. This standard of care allows for flexibility in macronutrient distribution. Our bodies utilize carbohydrates as the most readily available source of energy and typical recommendations are to consume approximately 50-55% of your calories from carbohydrates or 45-60gm for women and 60-75gm for men each meal but this varies per individual. A low-carbohydrate diet may recommend 45% or less of calories from carbohydrates but there is currently no agreed upon definition for low-carbohydrate diets. Following a ketogenic diet does not allow the body to utilize this source of energy and can cause fatigue as well as restricting access to many vital vitamins and minerals. A ketogenic diet may be effective in lowering blood sugar but is not necessary for blood sugar control and may be difficult to follow. When selecting fats on the keto diet, be sure to include healthy/unsaturated fats as high levels of saturated fat intake can increase heart disease risk in those with Type 2 Diabetes. It’s important to note that anytime you are in a state of ketosis it is vital to be followed by a physician.
To ensure steady blood sugar control, it is recommended by the Academy of Nutrition and Dietetics to eat a carbohydrate controlled, well-balanced, individualized diet with a focus on intake of fruits, vegetables, whole grains, lean proteins and low-fat dairy products. Currently, Research is inconclusive on the long-term effects of ketosis on the body and one’s overall health. Although there are different beliefs regarding a ketogenic diets effect on managing diabetes, it is recommended to follow a well-balanced, carbohydrate-controlled diet to manage diabetes until long-term effects are known. No matter what type of diet you choose to follow, it is important to work with a Registered Dietitian Nutritionist who can assist with creating a plan tailored to your specific needs.
Disclaimer: This information is educational only and not providing healthcare recommendations. Please see a healthcare provider.