Is the keto diet safe for type 2 diabetics?

The Keto diet is a popular eating protocol to lose those extra inches around your waist. A high-fat diet as keto may raise skepticism regarding losing excess fat from the body, but it works. In fact, research says that the keto diet is a more effective weight loss remedy as compared to a low-fat one. The question is, does it work for individuals who have diabetes? Is the keto diet safe for type 2 diabetic patients?

The concern is legit. A high-fat keto diet puts the body into ketosis, a consequence of consuming fats. These ketone bodies from fats are used as an energy source instead of carbohydrate-derived glucose molecules. Diabetic patients are more at risk of developing ketoacidosis, a grave complication of diabetes. So the question ‘is the keto diet safe for type 2 diabetes’ is quite legit. 

Read on to get a detailed insight into the subject topic.

A brief review of the keto diet

The ketogenic diet is all about consuming foods that are high in fats, with moderate protein portions and almost nil or minimal carbohydrates. The distribution of dietary macronutrients in a keto diet is; 

• 55% to 60% fat
• 30% to 35% protein 
• 5% to 10% carbohydrates 

So a 2000 kcal keto diet limits carbohydrates amount up to 20 to 50 g per day. A medium-sized apple is about 25 grams of carbs. So you can estimate the amount of carb you will be taking while on a keto diet. 

Devised as a therapeutic module to treat epilepsy, the keto diet was first applied by Russel Wilder in 1921. Since then, it has emerged as an effective therapy protocol to treat many conditions like metabolic syndrome, diabetes type 2, etc. 

Our body’s natural source of energy is glucose derived from carbohydrates. When you consume food high in fats, this causes an energy shift from carbs to fats. Carbohydrates are not stored in the body, and any excess gets converted into fats. After a few weeks into keto, the glucose source is exhausted because you are not taking it in your diet. The body starts mobilizing fats from its stores and utilizes them as an energy fuel. This puts the body into a state called ‘nutritional ketosis,’ which brings about many health benefits.  

Keto diet lowers the bad cholesterol and improves insulin sensitivity by reducing insulin requirement in the body. This has specific benefits as regards managing type 2 diabetes. 

How keto diet benefit type 2 diabetes?

The keto diet’s long-term benefits are not known; however, the diet protocol does support type 2 diabetes. Here is how.

• A study conducted in 2013 showed that the keto diet had significant effects in managing high blood sugar levels of type 2 diabetes. The participants had improved HbA1c levels. They showed considerable weight loss and even discontinued insulin requirements. Consuming a ketogenic diet resulted in marked improvement as compared to other diets. 
• Another study conducted in 2017 seconded the observations of the 2013 study. 
• A majority of patients with type 2 diabetes are overweight and obese. Losing weight has immense health benefits for such individuals. 
• A review of 13 studies showed that following a very low-carb, ketogenic diet was more effective for long-term weight loss as well than a low-fat diet. The participants of different studies on the keto diet lost two pounds more than the participants on a low-fat diet. 
• It is essential to losing fat than mere shedding pounds on the weighing scale. Keto diet helps you lose excess fat that improves the insulin sensitivity of the body cells. Following the keto diet for eight weeks helped cut back fat stores, as proved by a study. 
• Another study showed that the keto diet improved insulin sensitivity by an impressive 75% in patients with type 2 diabetes. 
• A study conducted on women with type 2 diabetes found that following a ketogenic module for 90 days had significant effects on reducing HbA1c, a long-term measure of diabetes prognosis. 
• Keto diet helps counteract the complications of type 2 diabetes-like cardiovascular ailments, neurological disorders, and so on. 

Why are we stressing so much about the weight loss and fat loss effects of a ketogenic diet? 

Because weight loss is the essence of managing and even reversing type 2 diabetes. Excess fat is directly linked to prediabetes, type 2 diabetes, and metabolic syndrome (characterized by high blood sugar levels, high blood pressure, and increased triglyceride levels). 

Losing weight and total body fat is the key to control type 2 diabetes, and the keto diet helps you achieve the task at hand effectively. 

What is the difference between ketosis and ketoacidosis?

Ketoacidosis is a serious condition that may happen when 

• The body lacks insulin.
• There is an excess buildup of ketone bodies.

The cause of ketosis is often nutritional and may happen in normal circumstances depending upon the ratio of carbs and fats in your diet. Ketosis help lose belly fat and normalizes the HbA1c levels (The hemoglobin A1c test indicates the average level of blood sugar over the past 2 to 3 months). 

It is important to note that ketoacidosis always occurs in type 1 diabetes. That is why the keto diet is not suitable for diabetic patients with type 1. Though the keto diet lowers the HbA1c levels in diabetic patients with type 1, more research is required to prove the efficacy. 

On the other hand, nutritional ketosis helps type 2 diabetes in many ways. Keeping a check on insulin resistance, balancing HbA1c levels, and cut back on the dose of medication are some of the benefits proved by research.  

The Keto diet induces nutritional ketosis and not ketoacidosis, making it a safe protocol to manage type 2 diabetes. 

Careful monitoring of sugar levels and consulting with your physician is vital in either type of diabetes. 

Factors to keep an eye on

Though the keto diet is all about high-fat consumption yet, it is important to include healthy fats to reap the benefits. 

Consuming unhealthy saturated and trans fats can have negative impacts on your heart health. 

Including more monounsaturated and polyunsaturated fat sources goes a long way in managing type 2 diabetes with the ketogenic module. The polyunsaturated fats contain omega-3 fatty acids, which are particularly beneficial for heart health. 

Some of the good fats to eat in a diabetes-beneficial keto diet include:

• nuts as almonds, cashews, peanuts, pecans, walnuts
• vegetable oils including olive oil, peanut oil, safflower oil, sesame oil, sunflower oil
• peanut butter and almond butter
• avocado
• fatty fish like salmon, herring, sardines, trout (rich in omega-3)
• walnuts
• seeds like flaxseed and chia seeds, sunflower seeds, pumpkin seeds, sesame seeds
• canola oil
• tofu
• roasted soybeans and soy nut butter
• meat like red and white meat including seafood, ham, sausage, bacon, turkey, etc
• eggs
• grass-fed butter and heavy cream
• cheese
• avocados

Keep an eye for the following condition by following regular check-ups and consultation with your physician to follow the keto diet for type 2 diabetes. 

• low blood sugar levels
• serum triglyceride levels
• micronutrient deficiency
• liver and kidney functions
• constipation
• gall stone development