Benefits Of A Ketogenic Diet
Ketone bodies produced from burning fat for fuel have been shown to have potent weight loss effects, help lower blood glucose levels and reduce peoples reliance on diabetes medication.
The diet has also shown evidence of having benefits on:
- Reducing high blood pressure
- Raising HDL cholesterol levels
- Improving mental performance
Read more about the benefits of ketogenic diets
In addition to that, there has been a lot of interest in therapeutic ketosis for other long-term conditions, such as cancer, epilepsy, Alzheimers disease or dementia.
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 .
What Does Ketogenic Mean
All of our cells need fuel to function. This fuel comes from three sources: fat, carbohydrates and protein, called macronutrients. Too much protein without fat puts us at risk for a handful of complications, so protein can never healthily serve as a primary source of fuel. We are left then with fat and carbohydrates as the main providers of energy the energy that allow us to do everything from breathing and blinking as we veg out on the couch to swimming the English Channel. Our cells preferred fuel comes from carbohydrates, which are easily converted to glucose, which, in turn, is readily converted to energy. This is why athletes carb load before they compete. Peak performance occurs when the body has plenty of glucose and glycogen stores available at hand. When glycogen runs out, thats when the body turns to fat. When there is no more blood sugar for our cells to consume, they seek an alternative form of energy. This energy comes from ketones, which are compounds our body produces from stored fat. So a ketogenic diet is one that is high in fat and very low in carbohydrates, resulting in the production of ketones to be used for fuel instead of glucose.
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Impact On Blood Sugar Levels
A ketogenic diet may help some people with type 2 diabetes because it allows the body to maintain glucose levels at a low but healthy level.
The lower intake of carbohydrates in the diet can help to eliminate large spikes in blood sugar, reducing the need for insulin.
Studies on ketogenic diets, including , have found that they can be helpful in controlling levels of HbA1c. This refers to the amount of glucose traveling with hemoglobin in the blood over about 3 months.
Feeling Liberated And Keeping It That Way
When she started the keto diet, Leles A1C levels were at 10 percent. Six months later, she had cut them down to 6 percent. Now no longer needing to inject herself four times per day and deal with the resulting bruises she says she feels liberated by the experience.
Im no longer on insulin, and I have cut down my medications due to keto. I never had to deal with trying to find a spot to inject or having to deal with bruises on my belly, she says. I know this may sound silly, but I have a picture of my old insulin syringes in my wallet. I look at it to remind me of what I had to do before keto. It grounds me, and when I have days of self-doubt, I remind myself how far Ive come.
That said, it hasnt been all easy.
The hardest part about living with type 2 is knowing that you have a serious chronic disease thats always following you, says Lele. There has never been a day when I dont think about my type 2 diabetes.
From monitoring symptoms of hyper- and hypoglycemia and dealing with a weakened immune system to trying to enjoy a regular meal, she says that theres always a constant reminder: When it comes to social gatherings, its almost depressing because youre obsessing about what you should, and can, eat. Its a constant battle in your head.
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How Many Days Into The Diet Do You Get Keto Flu
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What Does Ketogenic Have To Offer
The benefits of a ketogenic diet have been well documented for those living with Type 2 diabetes. Not only does the diet help manage blood sugar but it promotes weight loss as well. The results for those living with Type 1 are less conclusive. Many studies tend to address low carb diets like paleo and Atkins, which focus more on types of low carb food to eat, unlike a keto diet, which pays close attention to macronutrients and staying in ketosis. There seem to be fewer studies exploring the latter, but there is observational information that seems to indicate the diet offers a way to manage A1C levels and glycemic control. Many people with diabetes who abide by the keto diet have found that they significantly reduce their use of insulin.
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People With Diabetes Who Shouldnt Try The Keto Diet
Whats certain is this diet isn’t for you if you have kidney disease one reason being that you want to limit protein in that case, Zanini says.
Last, if you have a history of struggling with an eating disorder, work with your doctor to determine if this is the right diet for you. Despite what you may have read online, the keto diet and a personal history of binge eating disorder do not mix. In fact, Because of the severe carb limits imposed by the ketogenic diet, the risks of bingeing, compulsive overeating, and other eating disorders is much higher, says White.
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The Keto Diet For Diabetics
From the desk of Robb Wolf
Most medical professionals dont recommend a ketogenic diet for type 2 diabetes. The standard dietary advice is fairly bullish on carbs.
Meanwhile, cases of this metabolic disorder continue to spiral upwards, especially in the United States. Its a leading cause of death, and an indirect cause of many other chronic conditions.
How did we get ourselves into this mess? Researchers are still arguing the particulars, but its obvious that diet and lifestyle are largely to blame. Too much sugar, refined foods, and calories overall, plus too little exercise, quality sleep, and other important lifestyle practices.
Diet helped get us into this mess, and it may yet help us get out of it. Low-carb diets, research suggests, act as therapy for type 2 diabetes.
This isnt to say that a keto diet is the only effective anti-diabetes diet. Theres also evidence for a whole foods Paleo diet, for instance. And heck, if we are being really honest about this, a vegan diet has been shown to prevent and reverse type 2 diabetes in some folks, too.
The key similarities across these strategies is that they help people reduce calorie intake, reverse insulin resistance, and improve metabolic health. Keto is not a good fit for everyone, so its important not to be dogmatic about it. But its also important not to ignore a potentially important tool.
It makes sense. If ones metabolism cant process carbs efficiently , its logical to limit them, at least temporarily.
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Quick Tips For Going Keto
Yes and no. While the basic premise is easy to grok, in reality, it requires some planning and effort. Nothing good in life comes easy, right?
Here are some tips to get you started:
One last thing. Adapting to burning fat for energy can take 2 to 4 weeks, and maybe more if youre very insulin resistant. This doesnt mean youll be suffering for a month, but it does mean your desired benefits probably wont manifest overnight.
Hang in there. Your health is worth it.
Looking to get started with some tasty Keto recipes? Weve got thousands of Keto and low-carb recipes available in the Carb Manager kitchen. Check them out.
Disclaimer: If you have a diabetes diagnosis it is important that you consult, and work with, your doctor or healthcare provider should you choose to manage your health with the Keto diet.
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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
Effects On Lipids Mixed
Concerns have been raised regarding the ketogenic diet and adverse lipid profile changes, but the literature is inconsistent, and few publications have assessed the issue specifically in type 1 diabetes. Effects of ketogenic diets such as decreased total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels and increased high-density lipoprotein cholesterol levels have been reported.
Yancy et al, compared a low-carbohydrate diet to a low-fat diet in a randomized control trial of 120 overweight patients with hyperlipidemia. The low-carbohydrate diet led to greater decreases in serum triglyceride levels compared with patients on a low-fat diet and greater increases in high-density lipoprotein levels , but no significant differences were seen in low-density lipoprotein levels .
Using an online survey of a social media group for children and adults with type 1 diabetes who were following a very low carbohydrate diet, Lennerz et al found that 51 of 316 respondents reported having a diagnosis of dyslipidemia .
In a retrospective chart review of 30 patients with either type 1 or type 2 diabetes on a low-carbohydrate diet , ONeill reported that low-density lipoprotein levels decreased by 17%, from 155 to 130 mg/dL , and triglyceride levels decreased by 31%, from 107 to 74 mg/dL .
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Clarifications On Fat Intake In The Keto Diet
While the keto diet focuses on consuming higher amounts of fats instead of carbohydrates, its important to differentiate between different types of fat. The key is incorporating high amounts of heart-healthy fats, not saturated or trans fats. This means eating more eggs, fatty fish, avocados, olives or olive oil, nuts, nut butter, seeds, and cottage cheese. Avoid or limit processed foods alongside trans-fat, saturated fat, and fats from deli meats. Similarly, fried food is high in unhealthy fat and can lead to other problems like heart disease and health conditions.
How Does A Keto Diet Affect Blood Sugar
The premise of the ketogenic diet and diabetes is easy fewer carbs require less insulin and should result in fewer blood sugar spikes. Fewer blood sugar spikes should lead to improved time in range and better A1c values.
In addition, several studies have shown that the keto diet can improve insulin sensitivity , further reducing the need for insulin and making blood sugar control easier.
IF you can adhere to it, keto can be a very effective way to manage your blood sugars. The swings will truly start to dissipate, trendlines on CGMs will flatten, and your A1c will quite possibly drop. I had the best A1c of my LIFE while doing keto.
On the flip side, hypos can be an issue, especially early onand if you treat them too aggressively, they could knock you out of ketosis. I remember my first 3 weeks on keto, my CGM trend line hugged a blood sugar of around 80. It was glorious, but I had to reduce insulin substantially through trial and error and felt like I was low every five seconds.
When I would overtreat a low, I would sometimes push my carbohydrate amount over the keto threshold and end up OUT of ketosisnot that it is the worst thing in the world, but the goal is to remain in ketosis as much as possible.
That keto diets work in real life is exemplified by the fact that the keto diet is perhaps the most popular low-carb diet for people with diabetes and that thousands of people swear by the keto diet for good blood sugar management.
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How Many Carbs Can I Eat If I Have Diabetes
What should your daily carb intake be? Although lower is generally better, exactly how many carbs you can tolerate is somewhat individual.28
You and your friend may both have diabetes. Yet after eating an identical meal, your own blood sugar may be higher or lower than your friends an hour or two later. More importantly, one of you may now have a blood sugar level above the normal range.
Meat Meat And More Meat
So what makes Keto unlike other diets? Meat, meat and more meat. There is no meat or fish that is off limits on keto, including the usually verboten bacon. Non-starchy vegetables like Brussels sprouts and cauliflower are encouraged, as are oils, butter and lard. Cheese and Greek yogurt can also be staples of a keto diet.
However, this diet isnt for everyone. If traditional bread, pasta, rice, potatoes and/or fruit are what you live for, then you might just be miserable on keto. However, if youre open to exploring different tastes, then the good news is there are substitutes for many of these foods. Cauliflower pizza crust, rice, and even gnocchi zoodles almond flour bread and almond milk are all readily available from most stores now. A small amount of berries is acceptable, but for the most part say goodbye to apples, melons, plums and peaches. Booze and sugar are also out, but if youre living with diabetes, you likely already know how to manage these desires.
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