Diabetes and Ketosis: Friends or Foes?

Diabetes and Ketosis: Friends or Foes?

The Keto diet has definitely become a mainstream topic in the health and fitness industry with many claims of fat loss, managing triglycerides, and cholesterol, regulating appetite, and even managing glucose levels, improving insulin sensitivity, and thus helping people with diabetes better manage their health condition.

Today we’ll look at this topic under the lens of this specific population: people with diabetes and if the Keto diet is a positive option to help them manage their disease and if it is even safe. 

PROVEN BENEFITS OF THE KETO DIET FOR DIABETES

The keto diet appears to have beneficial effects on type 2 diabetes, which is characterized by high blood sugar and insulin resistance. These chronic high blood sugar levels can damage healthy cells, including nerves, the retina of the eyes, the kidneys, and others. 

There are some proven benefits of a keto diet that can help people with diabetes manage their condition and prevent other associated health concerns like obesity, high cholesterol and triglycerides, high blood pressure, and others. By helping decrease triglyceride levels in the blood, control blood glucose levels and fasting glucose, and regulate appetite and overall caloric intake thus helping with weight management and fat loss.

And in addition to those, a ketogenic diet has been shown to lower hemoglobin A1c  (a marker of average blood sugar levels) in people with type 2 diabetes and those with metabolic disease.

A 24-week study in 2008 showed that patients with type 2 diabetes and obesity who followed the ketogenic diet saw greater improvements in glycemic control and reduced medication compared to those who followed the control diet.

One study comparing the effects of a keto diet and a regular balanced diet in people with type 2 diabetes found that both groups experienced reductions in body weight, BMI, waist circumference, triglycerides, total cholesterol, LDL, HDL, fasting blood glucose, fasting insulin, and HbA1C; but the ketogenic diet improved metabolic markers more than the isocaloric control diet.

However, most of the participants reported that they wouldn’t be able to adhere to the ketogenic diet in the long run. This is quite important because adherence to the protocol and sustainability should be one marker of it being effective, otherwise, the benefits will not be long-term and consistent and will come associated with the inherent health risks of a strict diet protocol like Keto.

HEALTH CONCERNS AND SAFETY

There are some important safety concerns that should be taken into consideration since this approach is a very restrictive diet that eliminates a whole macronutrient almost entirely, or to a very low daily level, achieved through a highly restrictive diet of under 50 grams per day of carbohydrates. This not only  makes the diet hard to follow for some people but also carries the following cautions:

• If not monitored by a professional the keto deit can result in an increase in cholesterol and LDL (the bad one), due to poor meal choices, reduced fiber intake, or an increased caloric intake.

• As mentioned before adherence to the program can be difficult due to the restrictive nature and some unpleasant side effects like nausea, constipation, and vomiting; low energy levels, bad moods, nutrient deficiencies, and others.

• People with diabetes are already at risk of developing Ketoacidosis which is a dangerous and potentially lethal condition, A nutritional-induced state of ketosis can potentially lead to euglycemic ketoacidosis (with normal blood glucose levels) if not monitored appropriately.

• Hypoglycemia: the diet might help regulate your blood glucose levels and lower A1c levels, but that may mean you’re at a higher risk of your blood sugar going too far low especially if you’re already taking medication for your diabetes. 

• There is research showing that ketone bodies in the blood might be able to cause vascular damage similar to high glucose levels. This is particularly dangerous to patients who already have some form of high blood pressure, vascular and coagulation affections, or heart disease.

MAIN TAKEAWAYS

This is definitely a delicate topic that doesn’t have a definitive answer and is highly dependent on every individual cause. However, there are a few guidelines that you should consider if you have diabetes and are interested in using a keto diet as part of your arsenal to manage your conditioning:

• It is extremely important to consult your doctor before starting a new nutritional regime, even more so with a delicate intervention like the Keto diet for a chronic condition like diabetes.

• If you and your doctor decide together to give it a try, seek the help of a professional in nutrition and keto for your specific population to be as safe as possible and get continuous feedback and monitoring.

• You can help this process by keeping a journal or some form of tracking your symptoms, blood sugar levels, energy levels, weight, blood pressure, and any other relevant data you can gather to asses if the intervention is granting the positive effects you were looking for in the first place.

• Maintain an objective view when reviewing your logos and the results you’re getting and be prepared to move on if you’re not getting what you were looking for or you are experiencing unwanted side effects.