Chicken, fish, avocado, and other low-carb foods
Since carbohydrates are responsible for increasing blood sugar, the keto diet may be beneficial for some people with diabetes.

Keto Diet for Diabetics

The ketogenic diet, or keto diet for short, is a diet that is low in carbohydrates and high in fat. Since carbohydrates are responsible for increasing blood sugar, the keto diet may be beneficial for some people with diabetes.

Read on to learn more about the keto diet for diabetics and whether it may be suitable for you.

Is the Keto Diet Okay for Diabetics?

Under normal circumstances, we get most of our energy from carbohydrates. These include starchy foods like potatoes, pasta and rice, as well as the sugar found in fruit and desserts.

In the body, carbohydrates are broken down into glucose that can be used as energy for cells. However, eating too many carbohydrates can cause rapid increases in blood sugar, which is why diabetics are often advised to limit their intake of this particular nutrient.

In the keto diet, carbohydrates are kept to a minimum while fat consumption is increased. This forces the body to start using fat for energy instead of carbohydrates, a process known as ketosis. This encourages the body to start burning through its fat reserves, which can support weight loss.

Since it promotes weight loss and blood sugar control, the keto diet may be helpful for some people with diabetes. However, there are also some risks involved. The keto diet may increase the risk of diabetic emergencies such as hypoglycemia and diabetic ketoacidosis (DKA). Therefore, it is not suitable for everyone and both blood glucose and ketones must be monitored carefully if you are diabetic and on the keto diet.

How Does the Keto Diet Affect Blood Sugar?

Low carb diets such as the keto diet have been found to help stabilize blood glucose levels in people with diabetes. For example, one study published in Pediatrics in 2018 found that very low carb diets provided “exceptional glycemic control” in children and adults with type 1 diabetes.

Another 2018 study published in Diabetic Medicine found that the keto diet had a positive overall effect on HbA1c levels. However, the participants in the study were also found to be at increased risk of hypoglycemia and dyslipidemia (abnormal amounts of fat in the blood) after following this diet for an average of 2.6 years.

The keto diet helps control blood sugar as it reduces the amount of carbohydrates available to be converted into glucose. It also appears to improve insulin sensitivity and may reduce the need for anti-diabetic medication.

The Benefits of the Keto Diet for Diabetics

The main benefit of the keto diet for diabetics is stabilizing blood glucose to prevent high blood sugar levels. This is a significant advantage as many diabetic complications such as poor circulation, neuropathy and retinopathy are a result of blood glucose being too high.

In addition, there are several other benefits of the keto diet for diabetics, including:

  • Supporting weight loss
  • Reducing the need for insulin and medication
  • Reducing triglyceride levels
  • Increasing healthy HDL cholesterol
  • Improving metal function

However, the keto diet also has some risks for diabetics and it is important to exercise caution. Let’s take a look at some of the dangers of the keto diet for diabetics.

The Dangers of the Keto Diet for Diabetics

One of the biggest risks for diabetics on the keto diet is diabetic ketoacidosis. DKA is a medical emergency and if you experience its symptoms, you should seek medical attention immediately.

The warning signs of DKA include:

  • Constantly high blood glucose readings
  • Frequent urination
  • Dry mouth
  • Nausea
  • Fruity smelling breath
  • Breathing problems

Another major risk of the keto diet for diabetics is hypoglycemia. The aim of the keto diet is to reduce blood sugar, but if blood sugar falls too low, this can be a danger in itself.

The warning signs of hypoglycemia include:

  • Feeling shaky
  • Dizziness
  • Hunger
  • Irritability
  • Anxiety
  • Headache

Therefore, if you are diabetic and following the keto diet, you need to carefully monitor your blood glucose and ketone levels. If you experience the signs of either DKA or hypoglycemia, take action immediately to avoid complications further down the line. You may need to adjust your dosage of insulin or medication on the keto diet, so discuss this with your physician before starting.

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In addition to these risks, the keto diet can cause several unpleasant side effects, especially in the first few weeks. The side effects of the keto diet include:

  • Flu-like symptoms, also known as "keto-flu"
  • Bowel changes
  • Bad breath
  • Reduced energy
  • Frequent urination
  • Reduced levels of salts including sodium, magnesium and potassium

Reduced levels of salts can cause symptoms such as leg cramps, headaches and light-headedness. These problems can be avoided by staying well-hydrated throughout the day.

You should also ensure that you eat a wide variety of vegetables to support all of your nutritional needs. Add a small amount of sea salt to meals to increase your sodium levels if necessary.

What to Eat on the Keto Diet for Diabetics

On the keto diet, you consume less than 50 grams of carbohydrates in a day, along with a moderate amount of protein and plenty of fat. It is important not to eat too much protein as this can be converted into glucose by your liver.

You should also pay attention to the source of your fats. Choose healthy, natural sources rather than processed foods and meat, which is rich in saturated fat. These foods could increase your risk of developing dyslipidemia and heart disease later on.

Some of the best foods to eat on the keto diet include:

  • Vegetables, especially leafy greens
  • Avocados
  • Nuts and seeds
  • Olive oil
  • Eggs
  • Meat
  • Fatty fish, e.g. salmon, mackerel, sardines
  • Cottage cheese
  • Natural yogurt

However, everybody has different nutritional needs and there are several different variations on the keto diet. Therefore, you should speak to your physician or dietician before you start. You should also be aware that the keto diet is a big commitment and if you are unsure whether you can stick to it, you should look at alternative options.