Understanding How The Ketogenic Diet Can Be The Answer To Many With Diabetes
While the ketogenic diet is gaining widespread popularity and acceptance as an effective method for weight loss and optimizing body composition, research shows it has another major benefit: that it is an effective tool for reducing the symptoms of diabetes, and curing people of metabolic syndrome.
That a diet high in fat consumption (70-80% of calories come from fat on a keto diet) is healthy and effective for weight loss, along with helping fight diseases like Diabetes and Alzheimer’s, is counter to everything we have been taught for decades, but an overwhelming amount of evidence from research exists today that proves that is just the case.
Research shows the ketogenic diet can effectively reduce inflammation, blood glucose levels, triglycerides, insulin levels, and body weight in people with diabetes.
For Starters, What Exactly Is The Ketogenic Diet?
A ketogenic diet is a low carbohydrate, high fat diet, in which roughly 80% of your caloric intake is from fats, 15% from protein, and 5% from carbohydrates. For reference, that 5% for carbohydrates can be equated to less than 30 grams per day.
When carbohydrate intake is limited to such an extent, the body depletes glycogen stores, and then a mechanism of our body kicks in that begins converting fat stores into ketones and using them for fuel instead of glucose; a process body state known as ketosis.
“The ketogenic diet has been used for years in pediatric epilepsy and has also seen some research in the oncology setting,” Amber L. Taylor, MD, director of the Diabetes Center at Mercy Medical Center in Baltimore, told Everyday Health. “It is very low protein and carbs, essentially all fat. The body switches to making ketones as fuel, which may not be as harmful as we usually think.”
Not Just A “Fad Diet”, But A Lifestyle Change…
I would like to point out that a ketogenic diet, for it to be effective in keeping you healthy for the long-term, should be viewed as a permanent nutritional lifestyle change, not a temporary “diet” that so many fall off of once their goals are reached, and then end up gaining weight back and reverting to the level of health they had before.
Additionally, it’s growth in popularity is a result of more than just marketing and hype, based on mounting scientific evidence to back it up. If you’re under the belief it’s just a “fad diet”, watch this video of a presentation from Dr. Peter Attia, to learn more about the science behind low-carb high fat diets:
Before we talk about how a ketogenic diet can help specifically with diabetes, let’s cover some basics of it, so we’re on the same page about the disease.
Diabetes is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period of time. If left untreated, a large host of complications and conditions can result; including diabetic ketoacidosis, coma, and even death all in the short-term; and long-term complications such as heart disease, chronic kidney failure, fatty liver disease, stroke, foot ulcers, and damage to the eyes.
Diabetes results primarily from one of two reasons: either the pancreas not producing enough insulin (Type 1), or insulin resistance when the body’s cells are not responding properly to the insulin produced (Type 2).
About 10% of diabetics have Type 1, and typically occurs with sudden onset in children (usually normal weight), when the pancreas stops producing insulin. These people must inject insulin to maintain proper levels of blood glucose.
The other roughly 90% of diabetics have Type 2, occurring mostly in adults, typically obese, with gradual onset as a result of both genetics and lifestyle factors such as poor eating habits and lack of exercise. Type 2 diabetes can be managed with medication or with improving one’s dietary, lifestyle, and exercise habits.
This image from Ketogenic Diet Resource shows the “Timeline” of how a diet high in carbohydrates leads to Insulin Resistance, followed by Metabolic Syndrome, and finally Type 2 Diabetes.
Reversing Type 2 Diabetes Starts With Ignoring The Guidelines
In this TEDx Talk, Dr. Sarah Hallberg, the Medical Director of the Medically Supervised Weight Loss Program at IU Health Arnett, provides compelling evidence that a person can be “cured” of Type 2 Diabetes with a Low Carb High Fat Ketogenic Diet…
What If We’re Wrong About Diabetes? – Dr. Peter Attia
Dr. Wortman On The Ketogenic Diet For Diabetes and Other Chronic Conditions
We have a health system that doesn’t care about nutrition, and a food system that doesn’t care about health.
– Wayne Roberts ‘No Nonsense Guide to World Food’
The Ketogenic As A Treatment For Diabetes
Although challenging to adapt to the diet at first, diabetics learn that restricting carbohydrates on a low carb high fat diet makes life better because:
- Restricting carb intake results in improved control of blood sugar and insulin levels
- The diet eliminates the food which make blood sugar control difficult in the first place
- The diet helps in reversing insulin resistance, which is the root of the Type 2 diabetes
If you want to learn more about the scientific research backing the effectiveness of a ketogenic diet for diabetics, I recommend you check out these two posts:
Personal Experiences On The Keto Diet From Diabetics
It’s great to learn the science behind the diet that can greatly improve a diabetic’s life, but what about a real life story of someone’s experience on it?
Here are a couple of great blogs where Type 1 Diabetics chronicle their experiences with the ketogenic diet, how they landed on it, what they eat on a daily basis, and more:
- The Ketogenic Diet and Type 1 Diabetes: What I Eat | Living Vertical by Steve Richert
- Why I Chose a Ketogenic Diet For Diabetes Management | A Sweet Life by Dr. Keith Runyan
How do I know if I’m in ketosis? Do I need to measure ketones?
Substantial weight loss and blood glucose control can both be attained from being in a state of ketosis. But, how do you know if you’re in ketosis? The best way, especially in the beginning of becoming adapted to the ketogenic diet, is to measure ketone levels. There are three ways to do so; testing your blood, urine, or breath. Each method has its own pros & cons, and each way requires its own tools or devices to take the measurement.
I’ve prepared a complete guide here: The Best Way To Measure Ketones
But, Isn’t Ketosis Dangerous?
…When somebody asks this question, they’ve usually heard from a doctor or other medical professional that ketosis is a dangerous, life-threatening condition. If that’s the case, that person was confusing nutritional ketosis (keto-adaptation) with diabetic ketoacidosis (DKA).
Nutritional ketosis is a completely harmless process that happens as a result of a crucial evolutionary advantage the human body has.
Our brains can only function with glucose and ketones. And, since our bodies can’t store more than about 24 hours worth of glucose, we would all die of hypoglycemia if we ever had to go without food for more than 24 hours. Thankfully, however, the liver can turn fat and amino acids into ketones, with the priority of feeding the brain first.
So, the human body’s ability to produce ketones is required for basic survival.
Whereas, diabetic ketoacidosis occurs in Type 1 Diabetics when they fail to receive enough insulin, sending their body effectively into a state of starvation. Dr. Peter Attia explains on his blog Eating Academy, what happens next is this:
“While they may have all the glucose in the world in their bloodstream, without insulin, it can’t get any into their cells…The body does what it would do in anyone – it starts to make ketones out of fat and proteins. Here’s the problem: the diabetic patient in this case can’t produce any insulin, so there is no feedback loop and they continue to produce more and more ketones without stopping. By the time ketone levels (specifically, beta-hydroxybutyrate) approach 15 to 25 mM, the resulting pH imbalance leads to profound metabolic derangement and the patient is critically ill.”
“…[nutritional ketosis] has nothing to do with what a diabetic patient is experiencing in DKA, but does illustrate how poorly informed and quick to react the medical community is. DKA and nutritional ketosis (or keto-adaptation) have as much in common as a house fire and a fireplace.”
– Dr. Peter Attia
For deeper scientific & medical insight on the two terms – ketosis vs ketoacidosis – check out this post on Dr. Peter Attia’s blog Eating Academy.
Resources For Further Reading:
- Dr. Bernstein’s Diabetes Solution: The Complete Guide To Achieving Normal Blood Sugars
- The Diabetes Diet: Dr. Bernstein’s Low-Carbohydrate Solution
Other Fantastic Resources On The Topic of The Ketogenic Diet For Diabetics:
- The Ketogenic Diet and Type 1 Diabetes: What I Eat – written by a person with Type 1 Diabetes about the remarkable results they saw experimenting with a LCHF diet.
- Effective Diabetes Treatment – The Ketogenic Diet Resource always offers a wealth of knowledge, scientifically backed & cited
- Can You Manage Your Diabetes On A Ketogenic Diet – advice from the Diabetes Council on the ketogenic diet for diabetics
- How the Ketogenic Diet Works for Type 2 Diabetes – Healthline shares insight on using the ketogenic diet to ease diabetes symptoms for Type 2 Diabetics
- The Ketogenic Diet and Diabetes – Ruled.me
- Why I Chose a Ketogenic Diet for Diabetes Management – a retired physician living with Type 1 diabetes shares their experience with the ketogenic diet
- Is Ketosis Dangerous? – EatingAcademy.com author Dr. Peter Attia shares scientific knowledge on the details of ketosis