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 allows 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.
Relationship Between Type 2 Diabetes And Carbs
Type 2 diabetes means that the body doesnât respond to insulin like it should. The hormone insulin helps your body utilize blood sugar, or glucose, for energy. For patients with insulin resistance or type 2 diabetes, insulin is still produced but it may be in insufficient amounts or the body doesnât use insulin properly. This causes blood sugar levels to increase. If not treated, chronically high blood sugar levels can lead to heart disease, kidney damage, nerve damage, eye damage, sleep apnea, and more.
To keep diabetes under control, you want to keep your blood sugar levels as close to normal as possible, says Osama Hamdy, MD, an associate professor at Harvard Medical School and senior staff physician at the Joslin Diabetes Center in Boston.;
âGlucose in blood comes predominantly from carbohydrates, so eating more carbohydrates increases blood glucose and reducing carbohydrates reduces blood glucose.â
Thatâs why the carb-cutting keto diet might be helpful for people with type 2 diabetes.
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.
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The Difference Between A Keto Diet And A Diabetes Diet
While keto is one of the most well-known low-carb diets today, it is not the only option for people with diabetes. Youll likely be better off working with a registered dietician and your healthcare team to create the perfect diet for your own needs.
The team at US MED recently put together an article featuring some diabetes-related dietary tips. We encouraged people with diabetes to:
Focus on eating nutritious vegetables and proteins. Fruits generally have more carbs than vegetables, but they can still be healthy.
Avoid overeating carbohydrates but continue to eat some foods in this category. Whole grains such as oatmeal or brown rice are good choices; processed grains are not.
Keep fats, oils, and sweets to the bare minimum to avoid weight gain since this can cause problems related to diabetes management.
A diet created with these tips in mind wont be as restrictive as the keto diet, and it may be the better option for people with diabetes overall.
What Is Nutritional Ketosis
Nutritional ketosis is a natural metabolic state in which your body adapts to burning fat rather than carbohydrates as its primary fuel.;At the heart of nutritional ketosis are ‘ketones’, small molecules that are made from fat in the liver, and provide energy to fuel important organs like the brain, heart, and muscles. Ketones also play a newly discovered role to reduce oxidative stress and inflammation, both of which are key underlying causes of type 2 diabetes.;
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Should I Try Keto If I Have Type 2 Diabetes
Hamdy says the keto diet isn’t harmful for the majority of type 2 diabetes patients. However he also says that “replacing carbohydrates in the diet with any type of fat, like meat or bacon, can result in a significant increase in bad cholesterol.” That’s why substituting the carbs you’re cutting from your diet with healthier proteins and fats, like olive oil, avocados, and nuts, is better than gorging on bacon, steak, and barbecue.
The keto diet also comes with a series of side effects sometimes referred to as the keto flu like headache, constipation, and bad breath. Other risks include eventually developing conditions like kidney stones and vitamin deficiencies, according to the Academy of Nutrition and Dietetics. The academy also advises against the diet for people with certain conditions, like eating disorders or those with pancreatic disease, because of the detrimental effect on the pancreas from the high intake of fat.
For his part, Hamdy recommends a modified version of the keto diet for overweight or obese type 2 diabetes patients one where carb intake is specific to the individual, unhealthy fats like saturated fat in red meat is limited, and protein intake, particularly plant-based protein like beans, is higher.
In his clinic, Hamdy says that type 2 diabetes patients have had success with weight loss and diabetes control by cutting carbs to 40% of their diet, stick with low-glycemic index carbohydrates, and increased protein.;
A Type 2 Diabetes Diagnosis Prompted This Woman To Try The Keto Diet To Get The Disease Under Control
Finding out she had diabetes was wake-up call for 49-year-old chef Staci McDonald.
As a chef, Staci McDonald has made a career out of helping people unlock their potential through their diet. So in October 2019, when her doctor informed her that she would be dead from a heart attack or stroke in a matter of months if she didnt make some changes, she was in shock.
To do what I do for a living and to have allowed my health to get this bad was embarrassing,” McDonald, 49, tells Health. I was angry and confused. And in that moment, I was distraught. I thought, If this is whats happened to me, what have I been doing to my clients?
For two years, the Los Angeles-based mother of two was already experiencing what she now realizes are some of the tell-tale signs of diabetes. She was always hungryeating every hour when she was awakeand constantly thirsty.
I actually thought it was good because I was drinking so much more water, and that new habit just meant I had to go to the bathroom more, she explains. But I was also dealing with fatigue and blurry vision for over two years, and finally I decided it was time to go see the doctor.
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Her test revealed that her blood sugar levels and other diabetes markers were so high, she was only allowed to leave after receiving insulin. They injected me and gave me some medicine to take with me, then told me that if my numbers didnt come down, I was going to the hospital,” she remembers.
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Keto Diet And Diabetes
For people with prediabetes, type 2 diabetes and type 1 diabetes, minimizing sugar as well as carbohydrate intake is typically recommended to maintain healthy blood sugar levels. The ketogenic diet is a very low-carb diet that changes the bodys fuel source; from burning glucose to burning dietary fat instead.
Making this major switch in dietary habits promotes a state of ketosis which means your body is now a fat burner rather than a sugar burner. Research as well as firsthand accounts show that this ketogenic way of eating may help some diabetics to decrease and better control their blood glucose levels.
Ketogenic diet for prediabetes
Obesity is one of the principle risk factors for diabetes and following a ketogenic diet has been shown to help with weight loss. According to;scientific article published in 2014, A period of low carbohydrate ketogenic diet may help to control hunger and may improve fat oxidative metabolism and therefore reduce body weight. Many prediabetics struggle with being overweight so a keto diet can help promote weight loss, which can help to decrease the chances of developing full blown diabetes.
Keto diet and type 2 diabetes
A keto diet and diabetes study published in 2012 in the journal,;Nutrition, compares low-carbohydrate ketogenic diet with a low-calorie diet in improving glycemia . Overall, the study finds a low-carb keto diet to be more beneficial than a low-calorie diet for obese type 2 diabetics.
Keto diet and type 1 diabetes
Research The Keto Diet And Diabetes
In 2008, researchers conducted a 24-week study to determine the effects of a low-carbohydrate diet on people with type 2 diabetes and obesity.
At the end of the study, participants who followed the ketogenic diet saw greater improvements in glycemic control and medication reduction compared to those who followed a low-glycemic diet.
A 2013 review reported that a ketogenic diet can lead to more significant improvements in blood sugar control, A1c, weight loss, and discontinued insulin requirements than other diets.
A 2017 study also found the ketogenic diet outperformed a conventional, low-fat diabetes diet over 32 weeks regarding weight loss and A1c.
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The Problem Of Type 2 Diabetes
Type 2 diabetes is marked by high blood sugar, high insulin, high blood pressure, high triglycerides, and obesityall risk factors for chronic disease. Specifically, type 2 diabetes increases the risk of heart disease, cancer, Alzheimers, andunsurprisinglydeath.
Worldwide, there are about 380 million cases of type 2 diabetes. This wasnt always the case. In the US, for instance, rates of diabetes have increased by a factor of seven in the past fifty years.;Why? American diets and lifestyles have changed. Americans now eat more sugar and move less frequently than ever before. These changes are driving the diabetes epidemic. Unlike type 1 diabeteswhich results from autoimmunity in the pancreastype 2 diabetes is largely lifestyle driven.;
Heres how type 2 diabetes develops:
- A high-carb diet combined with a sedentary lifestyle leads to high blood-sugar levels .
- Hyperglycemia provokes the release of insulin, resulting in high insulin levels .
- Hyperinsulinemia promotes weight gain because insulin is an energy storage hormone.
- Hyperinsulinemia also creates insulin resistance, the underlying metabolic issue in type 2 diabetes.
What Does A Ketogenic Diet 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. Many people with diabetes who abide by the keto diet have found that they significantly reduce or even entirely discontinue their use of insulin and other diabetes medications. A keto diet can also lower cholesterol and blood pressure.
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Is There A Link Between Fatty Liver And Insulin
The liver is the first place where sugar is stored, so surely there is a correlation between fatty liver and type-2 diabetes. It could possibly also be a link to insulin resistance.
In another study, a group of people were fed an additional 1000 calories per day of sugar over the course of one month. During this month, the participants only gained a 2% increase in body weight, yet their liver had an almost 30% increase in fat.
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Why is this? When you eat, your insulin levels rise. This causes the sugar and fat in the food you are eating to be pushed into your liver for storage. Then, when you stop eating, your insulin levels are reduced and the sugar and fat stored in the liver is then used as energy.
So, the purpose of insulin is to force fat and sugar into the liver for later use as energy. What if you already have a fatty liver?
In that case, your bodys insulin will be inefficient and it will produce even more insulin, which will lead to even more insulin resistance and a worse fatty liver.
In order to reduce this insulin resistance, a low-carb diet or intermittent fasting can both be good choices.
Enjoy Our Delicious Low
Though the keto diet may seem like a magic bullet for people with diabetes, life is rarely that simple. Instead, the best option may be eating a balanced diet designed with your nutritional needs in mind. However, if you are curious about the keto diet, ask your healthcare provider about what you should do to get started.
Are you interested in finding high-quality, low-carb recipes that have been written specifically for people with diabetes? US MED has put together a collection of these recipes for you. Our recipe database is easy to use and 100% free try it out today!
Medical Review by Shirley DeLeon, Certified Diabetes Care and Education Specialist
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Check For Ketones In Your Blood
The best way to check your ketone levels is using a ketone monitor to check your blood. The monitor works in a very similar way to a blood sugar monitor. Youll prick your finger using a lancing device, get the blood on to the test strip in your monitor and wait for the result.;
There are different types of ketone monitors on the market, speak to your doctor about which one is best for you. And remember, if you have type 1 diabetes you should get a ketone monitor for free from the NHS.;
Its also worth knowing that some blood glucose monitors have ketone checking as well. So you might not need to have two devices to check your different levels.;
Listen To Your Body And Your Doctor
If you are taking insulin, you may immediately need to lower your intake anywhere from 30-50% as soon as you enter ketosis. For those living with Type 1, this can significantly help with controlling highs and hypos.
As with any diet, precautions need to be taken. Pregnant women and those with kidney disease are not good candidates for this diet, and some people with diabetes may find that the diet increases their insulin resistance. Dairy can often spike blood sugar, so avoiding the dairy in a keto diet and taking a Vitamin D supplement might be a better option for some people. Its important to pay attention to the way your body responds and realize that no diet is a one-size-fits-all model.
The trick to reaping the benefits of the keto diet is to stay in ketosis, which means keeping your carbs at 5% or less of your calories. The 5% can fall anywhere between 20-50 grams a day. However, if an insulin shot is missed while in deep ketosis, theres a good chance you will find yourself quite sick, so its probably best to avoid the risk and keep carbs on the upper end of this spectrum.
This diet might be untenable as a long-term way of life for many people, but if you have iron willpower and the desire to try a restrictive diet that still allows you to indulge yourself with fatty meats and oils, a keto diet might very well be the way for you to help manage your diabetes while managing weight.
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The Keto Diet Can Help Type
As many people get older, or after a lifetime of poor eating habits, type-2 diabetes becomes a real health concern. When people dont manage what they eat and are prone to eating high-sugar, high-carbohydrate foods, their bodies will collect that excess energy in the form of fat.
Sometimes, if your body is no longer able to properly manage its insulin levels, you can develop type-2 diabetes. For type-2 diabetics who are looking for a way to manage, or possibly reverse, the symptoms of their disease, the Keto Diet can be a great choice.
The Keto Diet changes your primary source of energy from carbohydrates to ketones, and most practitioners of the Keto Diet notice a marked change in their overall eating habits. When you begin to eat for fuel and not as a result of sugar addictions, or because of emotional eating, your body is often able to run more efficiently.
Many practitioners of the Keto Diet notice a decrease in overall hunger. Because fat and protein take longer for your body to break down than simple carbohydrates, you feel full longer and are better able to resist the urge to overeat. For type-2 diabetics, this means being better able to control their blood sugar and what they eat, in addition to weight loss , which is often one of the underlying health issues that leads to type-2 diabetes.