Is Ketogenic diet good for Diabetes?

In Diabetes, is ketogenic diet the answer?

Before answering this question, we need to first understand what is diabetes? And what is ketogenic diet? And why is it different than other famous diets?

Ketogenic diet and diabetes:

Ketogenic diet is a high fat, low carb diet that depends on forcing your body to use fatty acids instead of glucose, this outs your body in a state called ketosis. Where it produces excess amounts of ketone bodies as a byproduct of fatty acid breakdown. This state has many benefits it starts with weight loss and doesn’t end there. (curios to know more, check this article). But is ketogenic diet safe for diabetes?

What is diabetes?

Well to make things easier, lets visualize the sugar journey in our blood! When you eat, especially carbohydrates, your digestive system breaks it down into its smallest form, that is glucose. When this glucose reaches your blood, a very important hormone called insulin is excreted from the pancreas, this hormone allows our cells to open its gates and take up all the glucose it needs! And if there is too much glucose, don’t worry insulin will turn this excess glucose into glycogen so we can use it again when we need it. Everything is like clockwork!

But diseases are the opposite of clockwork! Imagine what will happen if your body can’t produce enough insulin? Exactly! You can’t use any of the glucose that is entering your body! It keeps accumulating in your blood and causing a state called hyperglycemia! This makes you feel very thirsty all the time, hungry always and yet you are losing weight because your body still can’t take up or store all this glucose! This is the definition of diabetes type 1!

This diabetes is common in children and usually happens when an autoimmune disease hits the pancreatic cells that produce the insulin!

Ketogenic diet and diabetes type 1:

So, is ketogenic diet safe with this type of diabetes? Absolutely not! First of all, in type 1 diabetes the patient is not obese to start with! So, following a restrictive diet like ketogenic diet is too much to start with! What is more important is that you must ask your doctor! Your endocrinologist is the only one who can answer this question for you!  Well, most nutritionists will advise against ketogenic diet in diabetes type 1 because it requires meticulous management of your blood sugar levels and of course your insulin shots too. This puts you at risk of severe hypoglycemia that is fatal if not treated immediately.

Also, ketosis and ketoacidosis (one of the notorious complications of diabetes) are very much similar, but one is nutritional and benefitable while the other is an emergency state! So, if you are a clumsy diabetic it is highly advisable not to follow a ketogenic diet!

What about diabetes type 2? Is ketogenic diet safe with diabetes type 2?

Diabetes type 2 is pretty much different than diabetes type 1! What is the difference? In type 2, there is a significant amount of insulin production! but still glucose levels are high! Why is that? Because the problem is in the cells, they refuse to let the glucose inside them! This is called “Insulin Resistance”. This type is much more common than type 1! It happens more commonly in adults and also in obese children. Here obesity is a major risk factor, why? Because obesity is the main reason for insulin resistance!

So, is ketogenic diet safe with diabetes type 2? Absolutely yes! In fact, it is considered a treatment for diabetes type 2! If you treat the obesity, you treat the insulin resistance, you treat the diabetes!! A win -win situation!!

Since in diabetes type 2 your body can produce insulin, you are at less risk for ketoacidosis and its complications.

Losing the extra weight, immediately improves your glucose level and insulin sensitivity.

This is what happens when you follow a ketogenic diet. You hit ketosis, and your body starts using fatty acids instead of glucose, making your cells more sensitive to insulin, eliminating insulin resistance the main criteria in diabetes type 2. This means that ketogenic diet improves your blood sugar levels and its main indication on the short term is Random Blood Sugar while on the long term it is HbA1c. all this with a bonus of weight loss and a smaller waist size!

What about gestational diabetes? Is ketogenic diet safe?

Ketogenic diet is not advised at all in pregnant women! At risk for gestational diabetes or not! Pregnant women need all macronutrients in their diet, to give their baby all the nutrients it needs to grow up healthy. so pregnant women should stay away from restrictive diets unless recommended by their obstetrician.

So, what is the best plan?

If you are a diabetic (type 2) and want to turn your life around, lose the weight and eliminate the risk of atherosclerosis, heart failure and lower your triglycerides and cholesterol levels then dietlife.com will tell you exactly how you can do that!

Step one:

First, you go visit your doctor! He/she will ask you a few questions, take a few measurements and run a few tests to make sure you are fit for keto!

These measurements include your height, weight, Body Mass Index and may be an in-body test for the exact percentages of: fat, muscles, water in your body!

The tests are Random Blood Sugar, or fasting and post-prandial glucose level. Accumulated glycemic hemoglobin (HbA1c), lipid profile, ketone bodies levels and liver and kidney functions. All from one blood and urine sample.

Your doctor will also keep track of your exact medications and if you need insulin injections or not.

This is all necessary to have a starting point to compare week zero with all the upcoming weeks following the ketogenic diet.

Step Two:

After checking you in as fit for keto, visit a certified nutritionist. Follow their exact plan which could be as follows:

  1. Cut carbs gradually! Your ultimate goal is to go below 50 gm a day of carbohydrates but instead of doing it suddenly and risking your health, you should reduce your caloric intake from carbohydrates 10 grams weekly.
  2. Go shopping for keto-friendly food. Lost on what is keto friendly and what is not? Check this article for a full list of all keto approved ingredients. For example, you should add more of these to your shopping cart: on the protein side add eggs, Salmon and cottage cheese and on the fatty side add more avocado, cooking oils and nuts.
  3. The next thing you should go shopping for is detectors for ketone bodies levels in your blood or urine. They are crucial because you need to monitor your glucose and ketone bodies regularly to make sure you are in nutritional ketosis not ketoacidosis that is a very serious condition.

Watch out for diabetic ketoacidosis symptoms like dry mouth, frequent urination, nausea and unexplained fatigue or breathing difficulties.

To measure your glucose levels and ketone bodies and avoid all complications of hypo or hyperglycemia:

  • You can get blood test strips; they are very accurate but invasive and sort of painful.
  • Or you can get urine steps they are easy to use but not that accurate.
  • Or you can get a breath analyzer for ketone bodies measurement, it is the easiest way but it doesn’t measure glucose levels.

You can buy all these meters here.

Step Three:

Each week or every other week, you should check your weight, redesign your meal plans (to your preference and taste), make sure you are still in ketosis

Each month, check for fasting blood sugar levels and may be repeat the in-body test to make sure you are losing pure fat and are well hydrated.

After 3 months, measure your HbA1c and if it has dropped then you are on the right track for managing your diabetes.

Dietlife advice:

If you are a diabetic and have heard about the new buzz of ketogenic diet. Don’t go jumping heads first without fully understanding everything about it. You should be aware of what kind of diabetes do you suffer from, type 1 or 2? If type 1 then better avoid ketogenic diet. If type 2, do you have it because you are obese? Is it due to extra insulin resistance? Is ketogenic diet safe for me? Will ketogenic diet help? All these questions should be answered by your doctor. Your doctor will run a few tests to clear you for Ketodiet. But please make sure to commit, as yo-yo dieting could harm your condition even more!

References:

  • Abbasi J. Interest in the Ketogenic Diet Grows for Weight Loss and Type 2 Diabetes. 2018;319(3):215–217. doi:10.1001/jama.2017.20639. https://www.ncbi.nlm.nih.gov/pubmed/29340675
  • Nichola J. Davis, Jill P. Crandall, Srikanth Gajavelli, Joan W. Berman, Nora Tomuta, Judith Wylie-Rosett, Stuart D. Katz. Differential effects of low-carbohydrate and low-fat diets on inflammation and endothelial function in diabetes. Journal of Diabetes and its Complications, Volume 25, Issue 6, 2011, pp. 371-376https://europepmc.org/abstract/med/22036100
  • Goday, A., et al. “Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus.” Nutrition & diabetes9 (2016): e230.
  • Yancy Jr, William S., Mary C. Vernon, and Eric C. Westman. “A pilot trial of a low-carbohydrate, ketogenic diet in patients with type 2 diabetes.” Metabolic syndrome and related disorders3 (2003): 239-243.
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