Still, the headlines keep coming. Men’s Health declared, “Ketogenic Diet Side Effects: How the Trendy Low-Carb Diet Can Give You Acne.” The health and fitness website Livestrong.com warned about “The Ketogenic Diet and Insomnia.” Other articles raised fears of bloat and constipation or cautioned that the regimen requires inhuman willpower from its followers.
The low-carb diet induces ''nutritional ketosis," Dr. Saslow tells EndocrineWeb, which is not the same as ketoacidosis. Ketones are a chemical your body produces when you burn stored fat; if you are on a low-carb diet you may be ''in ketosis.'' Ketoacidosis is different; it is a life-threatening condition in which levels of ketones and blood sugar are dangerously high, which may occur in people who have poorly controlled diabetes.
It is important to understand that the statement that carbohydrates are “nonessential” is not only factually inaccurate, it results in adopting a low-carbohydrate diet or ketogenic diet that increases your risk for a wide variety of chronic health conditions that may ultimately shorten lifespan, decrease your quality of life, and accelerate your risk for chronic disease.
If you are interested in trying out a ketogenic diet, it’s important to do your research about how to make sure to obtain adequate nutrition and also to be prepared to adjust (or have your healthcare provider help you to adjust) your medication doses. Many people find that their insulin sensitivity changes after starting a ketogenic diet, so it is very important to be on the lookout for changes in blood glucose trends to determine if treatment needs to be adapted.

When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common but disappear within two weeks.[17] The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar and handling illness.[18] The level of parental education and commitment required is higher than with medication.[43]
It is important to understand that the statement that carbohydrates are “nonessential” is not only factually inaccurate, it results in adopting a low-carbohydrate diet or ketogenic diet that increases your risk for a wide variety of chronic health conditions that may ultimately shorten lifespan, decrease your quality of life, and accelerate your risk for chronic disease.

Starting on a ketogenic diet can influence your exercise performance in multiple ways, both positive and negative. During the first 1-2 weeks (the “adaption period,” which I will get back to later), you will most likely see a decrease in energy and athletic performance across the board while your body adjusts to the new diet. This is perfectly normal and should NOT be a cause for concern or make you abandon the diet.
What to know about diet soda and diabetes Sugary drinks are a known cause of obesity and blood glucose problems, such as diabetes. Diet options are available, but are they good for people with diabetes? Artifical sweeteners may be linked to diabetes development. This MNT Knowledge Center article gives information on diet soda, sweeteners, and alternatives. Read now
Throughout this article, we looked at the data and the principles behind how low-carb dieting affect patients with diabetes, but we never addressed what you can do about it directly. If you’d like to learn about practical strategies that may help you reverse insulin resistance and improve your blood sugar and HbA1C levels, I recommend reading these articles:
Keep a food diary. In it, record your current daily eating habits. Write down what you eat for every meal of the day, and take note if you skip a meal. If you regularly skip breakfast, jot this down as well. Also write down any snacks you eat, even if you do this mindlessly - say, while watching TV. This diary will allow you to see where you stand right now in terms of eating practices and where you can start to make changes.[2]

Reynolds, AN. "Comment on 'An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals with Type 2 Diabetes: A Randomized Controlled Trial." Journal of Medical Internet Research. 2018; 20(5):e180, May 2018. Available at: http://www.jmir.org/2018/5/e180/  Accessed May 4, 2018.


Still, the headlines keep coming. Men’s Health declared, “Ketogenic Diet Side Effects: How the Trendy Low-Carb Diet Can Give You Acne.” The health and fitness website Livestrong.com warned about “The Ketogenic Diet and Insomnia.” Other articles raised fears of bloat and constipation or cautioned that the regimen requires inhuman willpower from its followers.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. There is some evidence of synergistic benefits when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[3]
Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.

If you are interested in trying out a ketogenic diet, it’s important to do your research about how to make sure to obtain adequate nutrition and also to be prepared to adjust (or have your healthcare provider help you to adjust) your medication doses. Many people find that their insulin sensitivity changes after starting a ketogenic diet, so it is very important to be on the lookout for changes in blood glucose trends to determine if treatment needs to be adapted.
I was diagnosed in 2004 with Brittle Type 1 diabetes, peripheral and autonomic neuropathy, and Hypothyroidism. A short time later with Gastroparesis due to the nerve damage from diabetes. Since then, I had followed every guideline and rule that the Endocrinologist and Primary Care Doctors had told me to follow. NOTHING WAS GETTING BETTER. In fact, I was gradually getting worse. So many ups and downs. Extreme highs (250-500 bgl ) to seizures from crashes (drop from 300 to 13 in no time). It was a constant battle with adjustments in insulin intake (and different insulins NPH, R, Novolog, Humalog, Lantus), carb intake, exercise and one contributing factor was the Gastroparesis. Meds were taken for the Gastroparesis but I always had side effects from meds. To my point. I was kicking a dead horse and I told them this. My sister and mom had come across the ketogenic way of eating and it dramatically improved thier lives. Mom was diagnosed way back with Type 2 and within a week or two she was off of her meds completely. I was totally interested. So, I decided to go for it on April 17, 2017. I did go through some rough patches of what they call Keto Flu. It did pass after a couple weeks. I was gaining so much energy like never before as well as mental focus. The even greater aspect of this all was, I had DRAMATICALLY LOWERED MY INSULIN INTAKE TO ALMOST NONE! My Lantus was always being adjusted from 30-40 units daily (and changed from AM to PM to splitting it to half AM, other half PM). I was on a sliding scale of Humalog or Novolog. From 4-6 units per meal and then there were the corrections throughout my day (some daily totals could be up to 40 UNITS)! Very exciting for me to only take 2 units of Lantus in the AM and daily totals of Humalog/Novolog….1.5-3 units! Other great things I began to notice, neuropathy pains were fading and finally GONE. No more nights up stinging, burning and RLS (restless leg syndrome). So, in my life, there are no questions or hardships on whether I can get off of this way of eating. It’s either do or die. If someone truly wants to have a better life, they can. The sad thing is, doctors and nutritionists aren’t being educated in the real facts. My primary care doctor isn’t willing to help me with all the labs I need nor listen. Always telling me “You need carbohydrates and insulin to live.” All that know me see the dramatic change for the better. I’m doing the Ketogenic way of eating with intermittent fasting for the rest of my life. The alternative IS NOT WORTH a lifetime of illnesses and suffering.
The main limitations of our study are its small sample size, short duration, and lack of control group. That the main outcome, hemoglobin A1c, improved significantly despite the small sample size and short duration of follow-up speaks to the dramatic and consistent effect of the LCKD on glycemia. For other effects, however, such as the rises in serum LDL and HDL cholesterol, the small sample size might be the reason statistical significance was not reached. Future studies of larger samples and containing a control group are needed to better address questions about the effect of the LCKD on serum lipids in patients with type 2 diabetes.
Have rest of frittata from Wednesday's breakfast. Serve with 2 cups baby spinach leaves, topped with 2 tablespoons balsamic vinegar, and 1 cup fat-free milk. Have one slice of whole-wheat toast topped with 2 teaspoons light trans-fat-free margarine. For dessert, have one 2-inch-square piece of baklava, a traditional Greek pastry with flaky fillo dough and walnuts. Athens Brand Frozen Baklava Pastry is available in many groceries nationwide. It's a great choice because the portions are tiny, and no baking or heating is required. (Have two squares if choosing Athens brand.)
I have been on a low carb diet for over 2 years. I was diagnosed a diabetic with a blood glucose over 400 mg/dl and an A1C of 12. I tried my doctors recommendations for about a year and took all the medications they told me to take. not much changed. they wanted to put me on insulin after a year. I told my doctor that I thought I could control my condition with diet and he said, “you are to far gone for that”.
And, it's important to recognize that both study teams acknowledge that as exciting as their findings seem, a large, randomized controlled trial is still needed to more closely assess a variety of components that may be contributing to the successes found in both studies before the findings can be recommended to anyone outside the study groups1,2  he says.

Cortisone as an oral drug is another common culprit (e.g. Prednisolone). Cortisone often causes weight gain in the long run, especially at higher doses (e.g. more than 5 mg Prednisolone per day). Unfortunately, cortisone is often an essential medication for those who are prescribed it, but the dose should be adjusted frequently so you don’t take more than you need. Asthma inhalers and other local cortisone treatments, like creams or nose sprays, hardly affect weight.
Blueberries are lousy with antioxidants, satiating fiber, potassium, and more, and according to researchers at the University of Michigan, the colorful fruits may also encourage weight loss. In a study of laboratory rats, scientists found that after 90 days the rats who received blueberry-enriched powder as 2 percent of their diet had less abdominal fat, lower triglycerides, lower cholesterol, and improved fasting glucose and insulin sensitivity, than the rats who weren’t given any blueberry-enriched powder.
And it’s not just this study, either. Several other studies have found  that keto leaves rodents unable to process carbs,[7] leads to insulin resistance,[8] and, more long-term, causes non-alcoholic fatty liver disease, which is when your liver accumulates lots of fat and begins to shut down.[9][10] Triglycerides and inflammation go way up, too.[11]

Bueno NB, de Melo ISV, de Oliveira SL, da Rocha Ataide T; “Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomized controlled trials” (2013) British Journal of Nutrition 110(7): 1178-1187. Accessed 4/23/2018 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/6FD9F975BAFF1D46F84C8BA9CE860783/S0007114513000548a.pdf/verylowcarbohydrate_ketogenic_diet_v_lowfat_diet_for_longterm_weight_loss_a_metaanalysis_of_randomised_controlled_trials.pdf
In its 2016 report “Healthy Eating Guidelines & Weight Loss Advice,” the Public Health Collaboration, a U.K. nonprofit, evaluated evidence on low-carbohydrate, high-fat diets. (The Keto diet falls under the LCHF umbrella.) Among 53 randomized clinical trials comparing LCHF diets to calorie-counting, low-fat diets, a majority of studies showed greater weight loss for the Keto-type diets, along with more beneficial health outcomes. The collaboration recommends weight-loss guidelines that include a low-carbohydrate, high-fat diet of real (rather than processed) foods as an acceptable, effective and safe approach.
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