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The ketogenic diet, or keto for short, is popular among health enthusiasts. The diet consists of low-carb, high-fat foods. The keto diet is a potentially helpful way for people with diabetes to manage blood sugar levels since this diet greatly restricts carbohydrates, which can impact blood sugar. It may also aid in the reversal of prediabetes. Some associated risks should be considered before trying the complete keto diet.
This article discusses the benefits and risks of adopting the keto diet if you have diabetes and other ways to limit carbs to improve your blood sugar levels.
Keto Diet for Diabetes: Weighing the Benefits and Risks
Research has found that the keto diet can help to control blood sugar levels significantly in people with diabetes. It also improves lipids, or fats, in the blood. Other potential benefits of the keto diet for diabetes include:
While many markers of health in a person with diabetes can be improved while following a ketogenic diet, eating this way while you have diabetes can lead to an increased risk of developing:
Emergency Symptoms of DKA
Diabetic ketoacidosis is a severe complication of diabetes and can occur in people who adopt the keto diet. It develops when the body lacks the insulin to break down sugar to fuel your cells. Instead, the liver utilizes fat for fuel, releasing acids known as ketones. When there are too many ketones built up in the body, it can lead to dangerous symptoms. The following symptoms require a visit to the emergency room:
- Fast and deep breathing
- Dry skin and mouth
- Flushed face
- Breath that smells like fruit
- Headaches
- Muscle aches and stiffness
- Fatigue or feeling extremely tired
- Nausea and vomiting
- Stomach pain
How a Diabetes Keto Diet Works
The ketogenic diet is strict. It eliminates or significantly reduces the number of carbs a person consumes in their diet. Instead, people on the ketogenic diet get most of their calories from fat, so energy production breaks down fat for fuel instead of glucose.
When overall glucose levels are lowered, people with diabetes can better manage their blood sugar levels. People with diabetes are already told to restrict their intake of carbohydrates and other foods that cause spikes in blood sugar, such as added sugars. Because of that, the keto diet has been considered a viable low-carb option for people with diabetes.
Prediabetes and the Keto Diet
Some research has found that people with prediabetes, which is the warning stage before diabetes develops, can adopt the keto diet and reverse prediabetes. In some cases, type II diabetes could also be reversed using the keto diet.
Considerations and Possible Dangers
While the research is promising for the keto diet and diabetes, there are some possible dangers, such as the ones mentioned above.
Hypoglycemia is one of the possible dangers to consider. When your blood sugar drops to dangerously low levels because of reduced carb intake, it can lead to severe health effects such as a loss of consciousness or seizures.
When those signs develop, emergency medical treatment is required. Before that, though, other symptoms can warn you that your blood sugar is dangerously low, such as:
- Feeling jittery or shaky
- Excessive hunger
- Feeling dizzy or lightheaded
- Fast or irregular heartbeat
- Headaches
- Changes in vision or speech
- Confusion
- Irritability
People with diabetes and a history of heart disease should be wary when starting a keto diet. During the first stages of the diet change, fat levels rise due to an increased consumption of healthy fats. That can lead to higher levels of cholesterol, which can cause adverse effects in people with heart disease or those at an increased risk of developing heart disease. That said, the research is conflicting. Some studies have found that the ketogenic diet does not adversely affect the risk of developing heart disease over time.
The ketogenic diet may also increase the risk of a person developing non-alcoholic fatty liver disease. However, since these results were found during animal studies, the results may not be identical in humans.
When to Avoid the Keto Diet if you Have Diabetes
A person with type 1 diabetes should take caution when exploring the keto diet to manage their condition because it can increase the risk of diabetic ketoacidosis. This complication arises more in people with type 1 diabetes. Because of that, people with this type of diabetes should be closely monitored when starting the keto diet.
Dietary Restrictions
The keto diet is incredibly restrictive and limits more foods than it allows. Because of that, it can be difficult to maintain long-term.
People on the keto diet must eat more of certain foods and eliminate or eat less of others, as outlined here:
| Eat More | Eat Less/Eliminate |
| Fish | Grains (cereals, crackers, rice, pasta bread, beer) |
| Seafood | Bananas |
| Cheese | Raisins |
| Avocado | Dates |
| Poultry | Mangoes |
| Eggs | Pears |
| Nuts and seeds | Corn |
| Olive and other healthy oils | Potatoes (all varieties) |
| Plain Greek yogurt | Beets |
| Dark chocolate | Honey and syrups |
| Berries | Chips |
| Bell peppers | Gluten-free baked goods |
| Broccoli | Beans |
| Cauliflower | Legumes |
| Green beans | Juices |
| Spinach | Sweetened yogurts |
| Zucchini | Baked goods (cakes, pies etc.) |
The goal of the ketogenic diet is to stay below a certain number of carbs per day. That number may vary depending on the person, but typically, less than 50 grams of carbs should be consumed each day.
Keto vs. Mediterranean vs. Atkins Diet
While keto, Mediterranean, and the Atkins diet are all considered low-carb, they are not the same. The keto diet is the most restrictive, allowing a very low number of carbs per day.
On the other hand, the Mediterranean diet focuses heavily on eating whole foods that provide the body with as many nutrients as possible. This diet allows for more carbohydrates, but they should come from healthier sources, such as higher-carb fruits or vegetables and whole grains.
The Atkins diet, another low-carb option, also allows for more leeway when choosing what to eat. The keto diet is high in fats, low in carbs, and moderate in protein, whereas the Atkins diet eliminates carbohydrates but allows as much protein as a person can healthily consume.
All three diets can help manage blood sugar levels for people with any type of diabetes.
Choosing the Diet That’s Right for You
No one diet is best for people with diabetes because people are not all the same. Because of that, when you choose the diet you want to try, you should speak to your healthcare provider about the benefits and the risks. It’s also worth noting that while the keto diet does help to stabilize blood sugar in people with diabetes, it is incredibly restrictive. In contrast, the Atkins and Mediterranean diets offer more variety of foods you can eat. Choosing the proper diet for you will come down to many factors and your current state of health.
Easier Ways to Count Carbs
Counting carbohydrates can be complex and overwhelming, especially if you are new to it. According to the Centers for Disease Control and Prevention, the task is easier if you:
- Know the measurements: Carbohydrates are measured in grams, and one serving of carbs equals 15 grams. Most foods, such as potatoes, have more than one serving of carbohydrates. Knowing how many grams are in each serving of food, you can easily keep track throughout the day.
- Know what constitutes a carb: Carbs are fibers, sugars, and starches. Any food that falls into this category counts as a carb. That said, there are “good” and “bad” carbs. For example, sugar in soda is considered a “bad” carb, whereas carbs from starchy vegetables are considered “good.”
- Know how many carbs per day you should have: If you’re on the keto diet, you can only consume less than 50 grams of carbs daily. However, a typical low-carb diet is less than 125 grams. You can work with a healthcare provider to decide how many daily carbs work best for you.
Over time, counting will become easier because you will get to know how many carbs are in what foods and what you can consume in a day to stay under your carb allowance. Other ways you can make carb counting easier include:
- Downloading carb-counting apps
- Determine how many carbs are in the foods you eat most and stick to the same daily diet so you don’t have to think about it
- Get help from a dietician or nutritionist
Meeting with a Dietician or Nutritionist
If you are stuck on incorporating a low-carb diet into your life, you can meet with a specialized medical professional who works solely on nutrition. Together with your primary care provider, they can create a meal plan that works for you and keeps you under your carb limit.
Summary
The keto diet is a viable option for managing blood sugar in people with diabetes. However, it isn’t the only low-carb diet option available. It also comes with several adverse risks that can potentially be life-threatening. The diet is also highly restrictive, which could be hard for some people to stick to.
Ultimately, the type of diet you choose to help manage your diabetes is up to you and your healthcare provider. Before starting any new diet, including the keto diet, you should speak to your primary care provider about the benefits and risks associated with the diet and your personal state of health.
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