Is following a ketogenic diet an effective way to manage diabetes? With keto increasing in popularity, I hear this question in my practice a lot. The theory appears simple: if you significantly decrease overall carbohydrate and sugar intake, you can control high blood sugar, right? Although it may sound straightforward, the human body is very complex. Let’s explain how the ketogenic diet actually works.
A keto diet follows a very low carbohydrate, high fat eating pattern. General recommendations suggest 70-80% of calories come from fats, 5-10% of calories (or 20-30 grams) from carbohydrates and that protein intake is moderate. Originally developed to control seizures in pediatric patients with epilepsy, the diet drives your body to a state of ketosis. Ketosis, which occurs naturally during times of starvation, forces your body to break down fat stores for energy.
Diabetes is caused by a lack of availability of insulin or due to insulin resistance. Insulin allows glucose, the building blocks of carbohydrates, into our cells. Without insulin, our bodies aren’t able to unlock our cells to allow this entry, causing our blood sugar to increase. When diabetes is present, it’s important to watch for signs of low and high blood sugar as both can be very detrimental to health, and in some cases life threatening.
According to the 2019 American Diabetes Associations Standards or Care, the best approach to managing diabetes depends on the individual’s personal preferences, needs and goals. This standard of care allows for flexibility in macronutrient distribution. Since our bodies utilize carbohydrates as the most readily available source of energy, typical recommendations say you should consume approximately 50-55% of your calories from carbohydrates, which may be 45-60 grams for women and 60-75 grams for men each meal (but this varies per individual). A low-carbohydrate diet may recommend your calories from carbohydrates be 45% or less, but there’s currently no agreed upon definition for low-carbohydrate diets.
Following a ketogenic diet doesn’t allow the body to utilize this source of energy, can restrict access to vital vitamins and minerals and cause fatigue. A ketogenic diet may be effective in lowering blood sugar but is not necessary for blood sugar control and may be difficult to follow. Choosing the right types of fats while eating keto (high-fat) is also critical for those with diabetes; high levels of saturated fat intake can increase heart disease risk in those with Type 2 diabetes, so it’s important to go for healthy, unsaturated fats.
In general, it’s very important to note that you should consult with your physician before changing your eating habits and only enter a state of ketosis while under their guidance and monitoring.
To ensure steady blood sugar control, it’s 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. Although there are different beliefs regarding the impact a ketogenic diet has on diabetes, current research is inconclusive on the long-term effects of ketosis on the body and one’s overall health. It’s 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’s important and helpful to work with a Registered Dietitian Nutritionist who can help you create a plan tailored to your specific needs.
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Disclaimer: This information is educational only and not providing healthcare recommendations. Please see a healthcare provider.