The Ketogenic Diet for Type 2 Diabetes – A Beginner’s Guide
If you have type 2 diabetes, you might have already heard that the keto diet could help you manage your symptoms, and even sometimes put the disease in remission. Is this true, and if yes, what’s the best approach to keto for people struggling with type 2 diabetes?
Is it safe to do keto if you are (type 2) diabetic?
Are there any potential risks or side effects?
Are there any studies that look into the effect of keto on diabetic patients?
If you have been diagnosed with type 2 diabetes or with a pre-diabetic state, we’re sure you have lots of questions on whether keto can help and whether it’s the right diet for you. Which is why we have put the following article together – read on to find the answers.
What Causes Type 2 Diabetes? What Role Do Carbs Play In That?
Type 2 diabetes is currently affecting around 9% of the world adult population, and the numbers are on the rise (having increased four times over the past 30 years alone). It’s a condition that nowadays is more and more often diagnosed in teenagers and children, which happened only rarely a few decades ago.
There are different theories on the reasons why type 2 diabetes is affecting more and more people, ranging from linking it to the obesity epidemic to poor dietary choices, to excessive sugar consumption.
The causes of type 2 diabetes are not yet 100% clear, as it’s a complex disease with a multitude of factors that play a role. Nevertheless, two major contributing factors that can be easily pinpointed are insulin resistance (often quoted as a precursor to type 2 diabetes) and being overweight, and they often develop together.
What is Insulin?
Insulin is a hormone produced by the pancreas to help glucose in your blood, which initially comes from the food you eat, to go into your muscle, fat, and liver cells, where it is used for energy (1).
Insulin plays the extremely important role of regulating your blood sugar and transporting circulating glucose into your cells. Sometimes this process is disrupted, and that’s usually when your cells become resistant to the effects of insulin and therefore glucose builds up in your bloodstream, making your blood sugar levels dangerously high.
This, in turn, forces your pancreas to produce more insulin, but eventually your beta-cells (responsible for the production of insulin) lose the ability to keep up with your body’s increased needs.
Inactivity, family history, the way your body stores fat, age, and race can all be risk factors. Additionally, excessive sugar (and carbohydrate) consumption, especially when combined with an excess of calories, can contribute to developing insulin resistance (2, 3).
Meaning: if you’re eating too much and if a big part of your calories come from foods with added sugar, you’re increasing your risk of developing type 2 diabetes in the long run.
Hyper-palpable, highly processed foods that provide no nutrition but come at the cost of hundreds (and sometimes even thousands) of calories that are high both in carbs and in fat are one of the worst choices when it comes to helping your body maintain healthy blood sugar levels.
They are also one of the contributing factors to both adult and childhood obesity, which, in turn, is a risk factor for developing insulin resistance, eventually followed by type 2 diabetes.
Eating too many processed carbs leaves your blood sugar levels fluctuating, sometimes dangerously so. The most common symptoms of unstable blood sugar levels include fatigue, brain fog, and increased thirst, especially after eating a high-carb meal.
Feeling sleepy after a large high-carb meal? Your blood sugar had rapidly increased right after the meal and is now crashing. In fact, one of the strategies to increase your insulin sensitivity – and this shouldn’t come as a surprise to anyone who has spent time reading about the keto diet – is cutting down carbs.
How Can Type 2 Diabetes Be Managed With Keto?
Diabetes is often accompanied (and preceded) by insulin resistance and chronically elevated blood sugar levels, on top of the excessive weight. The good news is, the keto diet can help with all of these things, and can, therefore, be an excellent way for you to manage type 2 diabetes signs and symptoms.
A study with 10 obese patients who had type 2 diabetes reported a 75% improvement in insulin sensitivity after following a low-carbohydrate diet for 14 days (4).
While you cannot “cure” the disease (there is no cure for type 2 diabetes at the moment), many people experience reversing its symptoms with a well-formulated ketogenic diet plan, or at least managing it much better.
The exact results will depend on plenty of factors, including how advanced your diabetes is, for how long you have had it, how your body responds to keto, dietary adherence, and more.
Keto can also be very beneficial for pre-diabetic states – if you catch warning signs early enough, you might be in the position of significantly lowering your risk of developing type 2 diabetes later on, as long as you’re keeping your carbs low. Which is also why testing for diabetes is so important, on top of maintaining healthy body weight and remaining active.
Weight Loss Benefit
Successfully losing weight is one of the main reasons why more and more people turn to keto, and for people having type 2 diabetes managing their weight and keeping it within a healthy range is essential.
Losing weight will help you manage your symptoms better, and according to a study from 2015, a build-up of fat in the pancreas is one of the reasons people develop type 2 diabetes (8).
Losing the excessive fat stored in the pancreas (we’re talking about grams here, as the volume of the pancreas in diabetic patients is 50 ml) – which is achieved through overall weight loss – can help significantly improve diabetes’ symptoms.
Keto’s positive effects for patients with type 2 diabetes go well beyond weight loss, though. One of the most important effects of this way of eating is being able to achieve a better control of your blood sugar levels and keeping them at healthy levels, in turn being able to lower medication significantly (9).
In fact, better glycemic control from keto often comes even before weight loss, which only goes to illustrate how drastic the change can be (10).
Achieving a better blood sugar control with keto is not only the result of having a smaller amount of carbs available from food, but also from improving baseline insulin sensitivity; i.e. you’re not only helping your body by providing it with less glucose, but also by giving it the tools to handle glucose better.
Compared to a low-fat diet, the keto diet leads to better results in the management of metabolic syndrome, which is another form of carbohydrate intolerance and is also one of the major risk factors for type 2 diabetes (11).
Additionally, in people with insulin resistance, a bigger amount of glucose is sent to the liver (as it cannot be absorbed by the cells), where it gets converted to fat, which, in turn, is associated with non-alcoholic fatty liver disease (12).
If carbs are reduced significantly, there isn’t any excess glucose to be transformed into fat, which, in turn, improves insulin sensitivity and lowers the risk (or improves the symptoms) of type 2 diabetes.
Other Benefits of The Ketogenic Diet
On top of the above, a well-formulated ketogenic diet can help you with the following:
- lowering triglyceride levels
- improving blood pressure
- improving your cholesterol profile
All of these can be very beneficial for both type 2 diabetes patients and the general population alike, and will lower your risk of heart disease and of complications from type 2 diabetes.
Is It Safe To Do Keto If You Have Type 2 Diabetes?
Diet control will definitely have a beneficial effect for anyone struggling with type 2 diabetes.
Nevertheless, if you’re a medicated diabetic patient, changing your diet should be done under medical supervision – as demonstrated above, the keto diet can help you lower your blood sugar levels significantly, which, in turn, would require a lower dose of medication in order to avoid suffering from hypoglycemia (i.e. blood sugar levels that are too low).
The positive changes related to blood glucose management begin manifesting themselves relatively quickly after starting keto (in a matter of days, or less), so before you start keto, discuss with your doctor the possible outcomes and how these should be managed.
Even if your current doctor isn’t on board and doesn’t feel confident recommending keto to you or helping you with switching to keto, nowadays there are more and more doctors who understand the positive effects keto can have for type 2 diabetes patients and are knowledgeable on the matter, so try finding someone who is. A good way to do that might be to reach out to local keto communities and ask for recommendations.
Blood glucose monitoring is essential when doing keto, so make sure to keep an eye on your blood sugar levels to make sure that they’re within the target range.
Successfully managing or even reversing the symptoms of type 2 diabetes as a long term strategy is possible as long as you’re staying keto (or at the very least, low carb). Here’s a list of foods you can eat on keto.
If you go back to your previous eating habits, you’d still be at risk of seeing your symptoms progressively worsen and needing to increase medication.
If Your Symptoms Improve, Could You Lower Your Medication?
Changing the dose of your medication or stopping your medication in case your symptoms improve drastically should be done under medical supervision. That being said, if you’re seeing an improvement in your symptoms, you will definitely need to be taking a lower dose of meds, so keep your doctor informed about the improvements you’re seeing and follow his advice.
Studies have demonstrated that a ketogenic diet can definitely help patients control their type 2 diabetes symptoms sufficiently well as to reduce the amount of medication they’re taking (13).
Anecdotal evidence from hundreds and thousands of people with type 2 diabetes from different online forums, communities and Facebook groups follows the same trend. Many people see their symptoms improve significantly, allowing them to lower the amount of meds they’re taking or stop them completely. There are many keto success stories you can read on the internet.
Again, this is something you don’t want to rush into, and you definitely should not do it on your own. Always discuss any possible changes in your medication with your doctor.
If you’d like to get in touch with others who have managed to successfully lower their meds, there are plenty of people who would be open to discussing their experience with you – just reach out for them in one of the many keto Facebook groups.
If you’re pre-diabetic or have been diagnosed with type 2 diabetes, one of the best strategies out there seems to be to start following a ketogenic diet – or, at least limit your carbs significantly. It could greatly help you with the management of your symptoms and will most likely drastically improve your blood sugar levels.
Keto can help you tremendously as long as you stick to it, but it is not a miracle cure for type 2 diabetes – and you shouldn’t expect it to be. It can be an excellent strategy to help you deal with diabetes, but it cannot completely undo the metabolic damage that has led to developing type 2 diabetes in the first place.
Additionally, diabetes is a very complex disease with plenty of factors to consider, so before changing your diet, do consult with your doctor. If they aren’t well-informed on keto, there are plenty of medical professionals out there who are – you might just need to shop around.
That’s particularly important if you’re taking any medication for your diabetes. You shouldn’t change the dosage or stop taking your medication without supervision. If your symptoms improve, your doctor will be happy to see your progress and put you on less medication than before.
What is your experience with type 2 diabetes and keto? Share your comments in the comment section below – we’d love to hear from you.