Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
I think the larger question is why we are seeing such a sudden rash of anti-keto stories. So many of them quote no experts sources and do not provide citations for their claims. Skeptics with little acquaintance with the diet are quoted exclusively instead. From a journalistic perspective, this lack of balance of viewpoints and the failure to back up claims with evidence falls below basic reporting standards. Offenders on this list include even the Harvard School of Public Health, which recently published more than one  unsourced, one-sided article on the keto diet (This is in addition to the Lancet Public Health article cited above, by Harvard researchers, which suggests that a low-carb diet kills you). These stories could reflect lazy reporting or they could very well be scare tactics to steer people away from the keto diet.  Why would reporters or scientists at Harvard be doing such a thing? That’s material for another post. Stay tuned.

If the liver is resistant to insulin, that's a bad sign for the rest of the body and could mean there's an increased risk of developing type 2 diabetes, the researchers said. What's more, these results are concerning because overweight patients seeking to reduce their risk of type 2 diabetes by following a ketogenic diet could unintentionally be increasing their risk for developing the disease, at least in the first few days of their diet. 
Why was the DASH diet been ranked as the best diet, the healthiest diet, and the best diet for diabetes, 8 years in a row? The expert panel of physicians assembled by US New & World Reports chose DASH because it is proven to improve health, has a balance of healthy food groups, and it actually works. And now the Mediterranean diet has jumped out in front. So delicious and heart healthy. DASH has been proven to lower blood pressure and cholesterol, and is associated with lower risk of several types of cancer, heart disease, stroke, heart failure, kidney stones, reduced risk of developing diabetes, can slow the progression of kidney disease, and now is associated with reduced risk of depression.
It sounds as if you may have been following a very strict keto protocol. I’m not, and have not followed a ketogenic diet, but am interested in it. I’ve been reading up on it a bit on the blog called Mark’s Daily Apple.* I’ve been following it for several years now, even before Mark tried keto. Based on some of his blog post, both keto related and otherwise, it seems that women do better with slightly more carbs than men. He’s written several blog post specifically for women, including one called 7 Keto Tips for Women, which you may want to read. https://www.marksdailyapple.com/7-keto-tips-for-women/ Then there is this one Where I Part Ways with the Popular Keto Movement https://www.marksdailyapple.com/where-i-part-ways-with-the-popular-keto-movement/ Perhaps the problem wasn’t the keto diet in and of itself, but that you went too low carb for you. It’s worth considering. I’ve also found this site to be pretty interesting https://peterattiamd.com/ Here’s a link to his section on keto https://peterattiamd.com/category/ketosis/ He followed a ketogenic diet for a number of years, though as of 2016 was no longer ketogenic, but definitely eating lower carb than most. (That is under Articles, on the drop down menu, click on Personal.)
Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
Walnuts are packed with tryptophan, an amino acid your body needs to create the feel-great chemical serotonin. (In fact, Spanish researchers found that walnut eaters have higher levels of this natural mood-regulator.) Another perk: "They're digested slowly," said Dr. David Katz, director of the Yale Prevention Research Center. "This contributes to mood stability and can help you tolerate stress."
The DASH Diet Weight Loss Solution is the only book with the powerful low-carb version of DASH. Based on the newest research, this plan is more powerful than the original DASH diet for lowering blood pressure and boosting weight loss, and perfect for people with type 2 diabetes, who need to limit refined carbs. For a vegetarian or mostly-vegetarian version, my new book, The DASH Diet Younger You, will help you become healthier, fitter, and younger from the inside out. And, I am pleased to share my cookbook, The Everyday DASH Diet Cookbook, which is the only cookbook specifically designed to complement the lower-carb plan from The DASH Diet Weight Loss Solution. These books will make it so easy stay on track with your DASH diet plan.
Participants were asked to follow one of three diets; a control diet that was low in fiber and minerals like potassium, calcium, and magnesium, but had a “typical American” fat and protein profile, an experimental diet that was similar to the control diet, but included more fruits and vegetables and fewer sweets, and a third diet that was abundant in fruits, veggies, low fat dairy, lean protein, whole grains, and fiber, but lower in fat, red meat, and sugar.
The risks are more long term, such as risk of nutritional deficiency (vitamin c, a, k and b vitamins) and also increased risk of bowel and possibly breast cancer cancer due to limited fibre intake. Ketosis generally isn’t recommended and it’s not exactly a state that would the body would usually be in, but it can be done safely for set periods of time.’
I’m sorry…no we don’t. Sure, more studies will happen, and more information is always good. But, we KNOW that keto works. You can argue that all you want…but in truth, facts don’t care about your feelings. There are plenty of studies, both in groups and in individuals, that prove beyond any reasonable doubt that going on a proper keto diet WILL improve your life as a diabetic, and will often allow the person to reverse diabetes completely (type 2, obviously). Not to mention the weight loss and the myriad of other health benefits it provides.

Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.


In a 24-week long intervention study, researchers recruited 84 obese subjects with type 2 diabetes and randomly divided them into two groups. The first group of 42 received a low-glycemic diet with a 500 calorie/day deficit. The second group ate a very low carbohydrate ketogenic diet with less than 20 grams of carbohydrates per day without calorie restriction.
I’ve been following a ketogenic based “Way of Eating” or almost a year now, and I’ve never felt better. Fats are the main source of calories with it—NOT protein. Fats and proteins ARE essential for the body. Carbohydrates are not. The 20g of carbs are for net carbs, NOT total carbs. This means you can have a great deal of fiber from very nutrient filled veggies that don’t spike your blood sugar.
A 2010 study in Diabetes, Obesity and Metabolism assigned 259 overweight diabetics to one of three diets: a low-carb Mediterranean diet, a traditional Mediterranean diet or a diet based on recommendations from the American Diabetes Association. All groups were told to exercise 30 to 45 minutes at least three times per week. After a year, all groups lost weight; the traditional group lost an average of about 16 pounds while the ADA group dropped 17 pounds and the low-carb group lost 22 pounds.
While the American Diabetes Association notes that many individuals with the disease or its precursor, prediabetes, employ carb counting to control their blood sugar on a regular basis, others have turned to ultra-low-carb diets as a way to manage their symptoms. These diets are highly restrictive and often limit followers to consuming no more than 20 grams (g) of carbs per day, usually with no added sugar, and, depending on the diet, increased protein and fat. Experts say they rarely have patients who ask about following a ketogenic diet or a modified paleo diet long term, but they can be useful for short-term weight loss if done properly.
In regard to serum measurements, the mean fasting glucose decreased by 17% from 9.08 ± 4.09 mmol/L at baseline to 7.57 ± 2.63 mmol/L at week 16 (p = 0.04) (Table ​(Table4).4). Serum sodium and chloride levels increased significantly, but only by 1% and 3%, respectively. Uric acid level decreased by 10% (p = 0.01). Serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001). Increases occurred in both high-density lipoprotein (HDL) cholesterol (8%) and low-density lipoprotein (LDL) cholesterol (10%) but these changes were of borderline statistical significance (p = 0.08 and p = 0.1, respectively). The following blood tests did not change significantly: total cholesterol, potassium, bicarbonate, urea nitrogen, creatinine, calcium, thyroid-stimulating hormone, and hemoglobin.
Today’s healthy pasta meals have roots that stretch back to ancient times. Thousands of years ago, people ground wheat, mixed it with water to make a wheat paste, dried it, and then boiled it to go with meals. Today’s consumers welcome pasta to their tables for its versatility and convenience, just as nutrition scientists recognize pasta meals for their place in healthy eating patterns, such as the “gold standard” Mediterranean Diet and the traditional Latin American diet.  Read more
Of the 28 participants enrolled in the study, 21 completed the 16 weeks of follow-up. Reasons for discontinuing the study included unable to adhere to study meetings and unable to adhere to the diet; no participant reported discontinuing as a result of adverse effects associated with the intervention. All but one of the 21 participants were men; 62% (n = 13) were Caucasian, 38% (n = 8) were African-American (Table ​(Table1).1). The mean age was 56.0 ± 7.9 years.
While reading the weekly meal plans I could close my eyes and picture enjoying the tastes of these dishes while soaking in the awesome summer weather on the patio with my girlfriend, with a glass of my favorite California red wine. “The diet also recommends four ounces of red wine in the evening with your meal. Red wine contains flavonoid which helps reduce your risk of developing cardiovascular disease. That’s my favorite part,” shared Susan.
I know it is hard when you have been taught something, and believed it, and taught it to others…only to be shown that what you have been taught is not the end all be all that you were led to believe. It sucks. But, you can choose to ignore the truth, and continue to follow the incorrect path. Or, you can look at the facts, and realize that what you have been taught is not the truth…and you can take a new path, which will lead many to wonderful new lives.

You sound weak I have given up all carbohydrates and fast acting insulin and had no issue with it ( real food is so delicious and satisfying)… and I don’t miss bread pasta and sugar at all… your mind is poisoned. It also has an added side effect , I now have no fat on my body. You uneducated money grubbing doctors and the sugar industry are the real problem here. My endocrinologist didn’t even bother to tell me about nutritional ketosis at all. I eat 80 to 85% good saturated fats out the 4000 calories I consume each day… not that difficult getting rid of crap sugar and carbs… these “doctors “ are lying to us and no one cares! It’s really disgusting …. I have no problem living without sugar…. and no studies done at all.. what the hell are these doctors doing, it seems pretty obvious to me$$$$.
The Mediterranean diet has been shown to reduce the risk of heart disease. It’s also associated with a reduced incidence of cancer, Parkinson’s and Alzheimer’s diseases. This diet emphasizes eating primarily plant-based foods including fruits, vegetables, whole grains, legumes, nuts, olive and canola oil, fish and poultry. It also encourages getting plenty of exercise, enjoying red wine in moderation and focusing on meals with family and friends.

On day 2, cook a cup of oatmeal with an ounce of chopped walnuts and 1/2 cup of sliced apples for a breakfast high in fiber and protein; sprinkle in a teaspoon of cinnamon and maple syrup. Have this breakfast again on day 5, but vary the add-ins -- try 1/2 cup of strawberries with thinly sliced almonds. If you like milk with your oatmeal, opt for unsweetened almond or soy.
As far as weight loss is concerned, I have heard great things from many who have switched to eating the Mediterranean way. Some were able to see results in just a few weeks…feeling better and losing a moderate amount of weight. From my personal experience, the only time I wasn’t eating the Mediterranean way was during my early years in college. I attended college in Michigan, and naturally, I ate whatever was available in the school cafeteria. Freshmen year, I gained nearly 30 lb. But lost it all without much effort in 2 months, when I returned home that summer and started to eat Mediterranean again. It’s important to say that the Mediterranean lifestyle is really a way of living, and one we commit to longer term, not necessarily a quick diet for the sake of losing weight. I always mention too that I have no medical or professional background to lend in the area of weight loss. If that is priority, a registered dietitian or someone with that kind of experience would be of help.
Now I have to say, I am not a supporter of rigid plans, however it is important to eat at somewhat regular times so you don’t end up feeling very-very hungry at any particularly moment of the day. Having said that, I also think it is important to be able to actually feel hunger, and look forward to eating a meal.  While adding a snack here and there is good to keep blood sugar and hunger levels in balance, snacking can also backfire. Many times we eat a snack without being hungry or we depend on ready-made snacks such as granola bars, juices, smoothies etc. which not only add quite a few calories but also are a processed food with all that entails.
Think of it as intermittent fasting 2.0 – only a bit more complicated. Ready? Here goes. There are three windows: one to get you started, one to help you reach your goal weight and a maintenance plan. You eat within a 12-hour, 14-hour or 16-hour window depending on which phase you’re in. But what you eat counts, too. The ‘green light’ lists of foods changes with every phase. Still there?
Either there are very few participants in the studies, they don’t have an even number of males vs. females, or they don’t last but a few months. One study only looked at 28 people; only 21 completed the study and 20 of these participants were men. On top of this, they were only followed for 16 weeks. Okay, so we see that 20 men can limit their carbohydrates severely for 4 months and lose weight which automatically makes their A1c come down. Great! So, the real question is, how long can these 20 men stay on this diet for the rest of their lives? How long would you like to go without eating any fresh fruit? I’m craving some now, so I’m taking a break to go grab a snack now!
The DASH diet was created when researchers were looking for ways to effectively reduce hypertension, but this was over 20 years ago! Though it’s still often marketed as a treatment for high blood pressure, the DASH eating plan is really an ideal way to eat for overall health, weight maintenance, and chronic disease prevention. In fact, studies suggest that DASH lowers risk for heart disease, type 2 diabetes and metabolic syndrome, and some cancers.
A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed; 24% occasionally prescribed the diet as a last resort; 24% had only prescribed the diet in a few rare cases; and 16% had never prescribed the diet. There are several possible explanations for this gap between evidence and clinical practice.[33] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[30]
Thanks for posting this Edward. While I agree that the thought of a lifetime without any sweets or any grains sounds miserable, it’s even more miserable every time I see a number above 120 on my meter, which is guaranteed to happen every time I eat even a few bites of one of those foods. Yeah, it’s stressful (and cortisol is just as much of a pain as T2D), but I want a better life and a life off of drugs. I was on three orals and two shots of insulin daily.

“As soon as you start consuming a normal amount of carbohydrates again, you immediately go out of ketoacidosis or the fat burning state”. I am sure you know the difference between nutritional ketosis and ketoacidosis yes? One is the natural fat burning state, and the other is toxic. Right now i am in ketosis but not ketoacidosis. One has a natural balance of Ph level, the other not. Once you make that statement, i have a sick feeling i am not getting the right information here.
It usually takes three to four days for your body to go into ketosis because you have to use up your body's stores of glucose, i.e., sugar first, Keatley says. Any major diet change can give you some, uh, issues, and Keatley says he often sees patients who complain of IBS-like symptoms and feeling wiped out at the beginning of the diet. (The tiredness happens because you have less access to carbs, which give you quick energy, he explains.)
Ketones are frequently produced in healthy individuals–sometimes this is due to fasting (even just overnight), or as a result of eating a very low carbohydrate diet. With normal blood glucose levels, the ketone concentrations observed during ketosis are generally not harmful. The ketones are simply a byproduct of fatty acid metabolism, serving up an alternative energy source when glucose stores are low.
In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[54]
Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]
Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.
A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
In her book, Susan highlights one of the major problems with dinner time today: quality time. Does everyone else remember when dinner time was family time? When we would all sit down together, share our day, talk, laugh, and leave when the meal was done? Susan and I shared our childhood dinning experiences when we discussed her call for embracing the the Mediterranean lifestyle — incorporating exercise, relaxation, and family meals back into our daily routines. This book is looking for someone who is looking to make a lifestyle choice. The way that you eat, sitting down with your families at the dinner table. No more meals on the go, no more meals with the TV. I wanted to bring back the importance of food in our households,” noted Susan.
Popularized by the documentary Forks Over Knives, the Ornish diet is a low-fat, plant-based diet plan based on whole grains, vegetables, fruits, and legumes. It's based on a lacto-ovo style of vegetarianism, allowing only egg whites and nonfat dairy products. It's packed with vitamins, fiber, and lots of filling plants to keep you satiated. Some studies have shown it can reverse heart disease and have beneficial effects on other chronic health conditions. (BTW, there is a difference between a vegan diet and a plant-based diet.)
Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat [3]. A similar diet was advocated by Dr. Frederick Allen of the same era [4].
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (approximately 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[47]
Dr. Reynolds reviewed numerous research studies on ketogenic diets,6 and he has found that most studies show that the drop in blood sugar is typically short-term—only lasting during the initial three months or so—but does not last.  "So it is very hard to encourage ketogenic diets when we have no evidence that they work over longer periods of time," he tells EndocrineWeb.
The herbs and spices associated with the Mediterranean diet shine at dinner. Meal options include fish like grilled salmon or pan-seared trout, seasoned with lemon and dill; chicken baked with a little olive oil and rosemary; grilled lamb chops with mint; mussels cooked in a tomato, garlic and wine broth; chili made with ground turkey, kidney beans and cayenne, or vegetarian-style with a mix of beans; and scallops sauteed with mushrooms and leeks. Have a 4-ounce serving of protein, and fill the rest of your plate with cooked veggies, like cauliflower, broccoli, brussels sprouts, or green beans.
Thank you for your wonderful comments Marcia. To share more about me personally with you all…I am not a completely non-diabetic Certified Diabetes Educator. I found out I had Prediabetes 15 years ago when I became a Diabetes Educator. I tested my own A1c and found it was 5.8%. The incredible news? There have been years when my A1c dropped to a normal level of 5.4%…out of the prediabetes range. My last A1c in May was 5.8%, so I still have Prediabetes 15 years later, but not diabetes, and without any medication, just the sensible diet I’ve discussed and exercise, so I really am living with this. I feel it everyday, I wonder what my A1c is going to be just like you every 6 months when I go to have it drawn.
The DASH diet has sometimes even been described as an Americanized version of the famous Mediterranean diet, according to the official DASH diet website. But as healthy as the DASH diet is, it's certainly not restrictive. It includes an eating plan rich in fruits, vegetables, low-fat and nonfat dairy, lean meats, fish, poultry, nuts, beans, seeds, heart-healthy fats, and limited amounts of whole grains. These delicious and nutritious foods join forces together to help your overall health improve. An added perk? You can also shed some unwanted pounds on the DASH diet — especially if you follow the DASH Diet Weight-Loss Solution plan.
I have patients that have lost tons of weight on keto. They do go off some meds. I also have people who eat a moderate amount of good carbohydrates, and they have lost tons of weight, and been taken off meds, had improved markers, even reversal. I think both approaches work, as I have seen in practice. Many people cannot stay on a keto diet forever. I for one, prefer to have some carbohydrates. I try to pick the right ones. If this works for you, then just be sure to have some medical supervision, which it sounds as though you are doing.
The final possible culprit behind stubborn weight issues may be the stress hormone, cortisol. Too much cortisol will increase hunger levels, bringing along subsequent weight gain. The most common cause of elevated cortisol is chronic stress and lack of sleep (see tip #10), or cortisone medication (tip #9). It’s a good idea to try your best to do something about this.

Be choosy about carbs. You can decide which ones you eat, and how much. Look for those that are low on the glycemic index (for instance, asparagus is lower on the glycemic index than a potato) or lower in carbs per serving than others. Whole grains are better choices than processed items, because processing removes key nutrients such as fiber, iron, and B vitamins. They may be added back, such as in “enriched” bread.


A study recently published in the New England Journal of Medicine found that people who followed a Mediterranean diet for two years lost more weight than low-fat dieters and maintained their 10-pound loss. "You don't feel hungry," explains Meir Stampfer, MD, DrPH, a coauthor of the study and a professor of epidemiology and nutrition at the Harvard School of Public Health, in Boston. Don't believe us about protein's fill power? Dr. Stampfer suggests this little experiment: "One morning eat white toast and jam for breakfast. The next day have scrambled eggs." The egg meal, Dr. Stampfer promises, will leave you more energetic and a lot less hungry at 11 a.m.
The purpose of this study was to evaluate the effects of a low-carbohydrate, ketogenic diet (LCKD) in overweight and obese patients with type 2 diabetes over 16 weeks. Specifically, we wanted to learn the diet's effects on glycemia and diabetes medication use in outpatients who prepared (or bought) their own meals. In a previous article, we reported the results observed in 7 individuals [10]; this report includes data from those 7 individuals along with data from additional participants enrolled subsequently.

“Intermittent fasting can be really challenging if you have an ever-changing schedule,” adds Hultin. “If you're traveling and crossing time zones, it could be very difficult to follow. It might be best for people with more stability in their lives.” Intermittent fasting isn’t safe for people with type 2 diabetes, children, pregnant or lactating women, or anyone with a history of an eating disorder.

Thank you for your wonderful comments Marcia. To share more about me personally with you all…I am not a completely non-diabetic Certified Diabetes Educator. I found out I had Prediabetes 15 years ago when I became a Diabetes Educator. I tested my own A1c and found it was 5.8%. The incredible news? There have been years when my A1c dropped to a normal level of 5.4%…out of the prediabetes range. My last A1c in May was 5.8%, so I still have Prediabetes 15 years later, but not diabetes, and without any medication, just the sensible diet I’ve discussed and exercise, so I really am living with this. I feel it everyday, I wonder what my A1c is going to be just like you every 6 months when I go to have it drawn.

When foods are processed, their potassium levels actually decrease. So, choosing whole or minimally processed foods can improve blood pressure regulation from both a sodium and a potassium perspective. In addition, you’ll usually decrease your intake of saturated fat, added sugars, and overall calories—all of which can help you lose weight, and keep it off for good. 
The keto lifestyle sounds daunting, but it really is not. One thing many fail to mention is the hormonal shifts that occur that regulate your appetite. Give this a little time, and you will be astounded at how easy it becomes to pass on the stuff you found addictive previously. There are many factors that influence one’s success or failure, and the key is to get the information and support you need, and to stick with it long enough to see the benefits. I fine this way of eating completely sustainable, and I’m in for life.
A systematic review in 2018 looked at sixteen studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence inferior to studies on children. Health issues include high levels of low-density lipoprotein (LDL), high total cholesterol, and weight loss.[23]

The DASH diet is especially recommended for people with hypertension (high blood pressure) or prehypertension. The DASH diet eating plan has been proven to lower blood pressure in studies sponsored by the National Institutes of Health (Dietary Approaches to Stop Hypertension). In addition to being a low salt (or low sodium) plan, the DASH diet provides additional benefits to reduce blood pressure. It is based on an eating plan rich in fruits and vegetables, and low-fat or non-fat dairy, with whole grains. It is a high fiber, low to moderate fat diet, rich in potasium, calcium, and magnesium. The full DASH diet plan is shown here. The DASH diet is a healthy plan, designed for the whole family. New research continues to show additional health benefits of the plan.
This drug is an injected variant of a satiety hormone called GLP-1. It slows down how quickly the stomach empties and tells the brain that you don’t need to eat yet – a great idea for losing weight. As a bonus this drug works fine while one is on the keto diet and it works even better with intermittent fasting – for a rapid weight loss with no hunger.
The Mediterranean Diet was identified in the 1960s as research continued to show populations from Mediterranean regions, particularly Southern Italy, the isle of Crete, and Greece, were considerably healthier, with less incidence of disease and longer lifespans than seen in other regions. Studies indicated that the way these populations ate seemed to be the common denominator and through research, the Mediterranean diet was formally born.

We all have different meanings for “quality of life” for me it means feeling good, with energy, no bloating, no heartburn, on my weight, normal glucose levels… for you it means having “white stuff” to eat, enjoy it while you eat it and then feeling bad about it, ’cause if you’re a diabetes educator you know (or at least you should) the harm it does to your body! I’m glad no one believed this biased article! It means everyone out there know what is real and what is not…
Either there are very few participants in the studies, they don’t have an even number of males vs. females, or they don’t last but a few months. One study only looked at 28 people; only 21 completed the study and 20 of these participants were men. On top of this, they were only followed for 16 weeks. Okay, so we see that 20 men can limit their carbohydrates severely for 4 months and lose weight which automatically makes their A1c come down. Great! So, the real question is, how long can these 20 men stay on this diet for the rest of their lives? How long would you like to go without eating any fresh fruit? I’m craving some now, so I’m taking a break to go grab a snack now!
Lele says that it’s important to remember that, while keto is a “high fat” diet, the goal is to use your body fat as an energy source, not the fat that’s on your plate. “You don’t need to necessarily add more fats to your diet to adhere to keto. For instance, if your dinner consists of avocado, bacon, and eggs, you really don’t need to add butter to that to make it ‘more keto’,” she says.
1- Eliminate fast foods. For many of us living in America, this is one of the tougher adjustments and may take some time. To start with, try swapping a fast-food meal with a homemade one. For example, if it’s chicken wings you crave, make them Greek-style like in this recipe! Or if it’s sweet potato fries (my personal guilty pleasure), try baking them in olive oil with a sprinkle of Mediterranean spices like in this recipe. And So on!
Ketoacidosis (KA) is a life-threatening condition in which your body doesn’t make enough insulin. This causes you to have dangerously high levels of ketones (substances occurring when the body uses fat stores for energy) and blood sugar. The combination of both makes your blood incredibly acidic, and this can, in turn, change the normal functioning of your internal organs such as your liver and kidneys. Patients suffering from ketoacidosis must get treatment immediately or they could slip into a coma and even die.
Remember that on some days, you may eat a few more or a few less servings than recommended for a particular food group. That's generally OK, as long as the average of several days or a week is close to the recommendations. The exception is sodium. Try to stay within the daily limit for sodium as much as possible. Also note that the values for nutritional information may vary according to specific brands of ingredients you use or changes you make in meal preparation.
We are all supposed to be eating 5 servings of fresh fruit and vegetables per day. That provides you with all the essential vitamins and nutrients needed to run a healthy body along with the protein you choose to consume alone with them. I guess if you can fit those into a Ketogenic diet and make that work for you for a lifetime, I would have to say that is absolutely wonderful! I just know, I have a lot of willpower and I only made it 1 year back when I tried. It was just too restrictive. I see too many stories like that. The blogger I wrote about, all the studies, most participants had dropped out at 6 months. No study I have seen has shown anyone who has stayed on it for 10 years, 15, 20, 30, 40 years. If you know one, please let me know!
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.

"What I don't like about any commercial diet is that the focus is not on your actual food choices," Hogan said. "It's about calories or points or numbers, and that really takes away from your ability to be in tune with your hunger cues and your fullness cues and what you're really craving. If we become more in tune with those things, we naturally consume how much the body needs. Paying too much attention to numbers takes away from that."
Sure, nuts aren’t known for being low in calories, but they have an array of other properties—namely a high protein and fiber content—that makes them ideal for weight loss. A study published in the Journal of the American Heart Association, Circulation, found that consuming 1.5 ounces of almonds daily (as opposed to a carb-dense muffin) along with a heart-healthy diet, helped to improve cholesterol and lipid profiles among the research participants. The study also found that eating almonds reduces belly fat, too.
Eating out is possible on the DASH Diet, but proceed with caution. Restaurant meals are notoriously salty, oversized and fatty, so you’ll need to be conscientious if you dine out. NHLBI suggests avoiding salt by shunning pickled, cured or smoked items; limiting condiments; choosing fruits or vegetables instead of soup; and requesting the chef find other ways to season your meal. You can also drink alcohol moderately on the DASH Diet.
Other down sides: There’s an initial period where your body is adjusting to its new carb-free existence, and many people experience symptoms like fatigue, brain fog and nausea for a few weeks. You also end up deficient in important micronutrients, like folate, calcium and potassium, which is why most ketogenic devotees recommend taking multivitamins. Personally, I recommend my clients follow a diet that in its ideal state provides all of the nutrients you need through real, whole foods.
The NY Times Best Sellers, The DASH Diet Action Plan and The DASH Diet Weight Loss Solution, provide real life solutions to make it easy for people to follow the DASH diet. They each have 28 days of meal plans, recipes, guidance for weight loss, how to eat at restaurants, fast food places, etc. and still stay on track. It shows you how to stock up your kitchen for the DASH diet, and how to read food labels to make good choices. And, of course, the meal plans and recipes are all low sodium/low salt. The books show you how to add exercise and other lifestyle changes to help lower blood pressure. The books help you design your own personal "DASH Diet Action Plan" and your own "DASH Diet Weight Loss Solution."
If not managed correctly, high blood sugar in diabetics can damage blood vessels and lead to a variety of illnesses. Unmanaged diabetes doubles the risk of cardiovascular diseases such as coronary artery diseases and stroke. [3, 4] Diabetes can damage small vessels in the eyes, kidneys, and nerves and lead to complications such as blindness and kidney disease. [4]
There are many physiological reasons for eating enough carbohydrates throughout the waking hours to maintain a steady blood glucose level…a couple of important reasons are to minimize the hepatic release of glucose (from the liver) and to help prevent hypoglycemia which can be very dangerous and lead to hypoglycemic unawareness over a short period of time. Each person is different of course..if you aren’t taking insulin, or pills that lower your blood glucose levels, you may not have to worry about low blood sugars. The reality is, most people with diabetes do; it can be very dangerous for some to not get enough carbohydrates at each meal.
There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.[7]

I can tell how passionate you are about this subject. As you can see on one of my reply’s above, CDE’s do not recommend the same number of carbs for every person we see; we use an individualized approach. It varies depending on the person’s height, bone structure/muscle mass, amount of weight they may need to lose (or gain) and the amount of exercise they may or may not do per day/week.
A small, randomized crossover study published in the Journal of Diabetes Sciences and Technology found that after three months, people who followed a modified, low-carb paleo diet saw greater reductions in their A1C, their triglycerides, their diastolic blood pressure, and their weight than those who followed a traditional diabetes diet. (The approach also increased their levels of LDL, or "good” cholesterol.) The diabetes diet in the study involved consuming no more than 6 g of salt per day, reducing saturated fat and total fat intake, and upping intake of veggies, fiber, whole grains, fruits, and veggies. Compared with the diabetes diet, the paleo diet involved eating less dairy, beans, potatoes, and cereals, and more veggies, fruit, meat, and eggs.
One study from 2005 followed 22 people with Type 1 Diabetes for 12 months. The difference here however is they consumed 70-90 grams of carbohydrates per day versus the restrictive less than 20 grams per day on the Ketogenic Diet. Remember my motto? Moderation is the key! The results were positive; less hypoglycemia, insulin requirements were reduced and their A1c dropped from 7.5% to 6.4%.
Thanks to its flexibility, easy-to-understand system, and group support, Weight Watchers came out way (weigh?) ahead, winning "best weight loss," "best fast weight loss," and "best commercial diet" in the U.S. News & World Report rankings. (Oprah's endorsement probably didn't hurt either!) They recently revamped their signature plan to include "free" foods like chicken breasts and fresh produce so you'll never feel hungry even while dropping pounds. In addition, their app makes tracking your food a piece of cake—which you're totally allowed to have on the program, by the way. (Even better news: Research supports the fact that Weight Watchers is one of the best weight-loss diets.)
4. Better eyesight. The diet could help stave off or prevent macular degeneration, the leading cause of vision loss after age 54. The condition, which affects more than 10 million Americans, destroys the part of your retina responsible for the clear central vision you need to read, drive, and recognize faces. A recent study linked eating fish and vegetables to a reduced risk of getting it early, and the omega-3 fatty acids in fish can lower the risk of the disease altogether. What's more, the lutein in green leafy vegetables cuts your chance of cataracts and boosts retinal health, says Dr. Willett.
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.)
Below is a quick graphic of a meal plan on the traditional Mediterranean diet, it is the same meal plan that I also follow. Under the graphic you can find details, tips and links to the recipes. I provide a variety of choices for meals that you can mix and match with links to the recipes. For more ideas just head over to the Recipe Index and you will find a large selection of Mediterranean recipes.
When it comes to managing diabetes, it is reasonable that reducing carbohydrate intake can help to lower and stabilize blood glucose levels. The positive effects of the ketogenic diet on diabetes control have been demonstrated in animal models, as well as in humans. We recently reported on several studies that demonstrated substantial metabolic benefits.
Consequently, researchers have widely discredited the hCG diet, which involves using hCG injections, pellets, sprays, or drops, and consuming  as few as 500 calories daily. The diet is problematic not only because there’s a lack of research on hCG supplements, but also because the calorie requirement is dangerously low, potentially leading to nutrient deficiencies, fatigue, hormone imbalances, blood clots, and other issues. Thus, most experts agree the hCG diet is not safe for anyone, the Mayo Clinic notes. (35)

Sharon M. Nickols-Richardson, PhD, RD, , Mary Dean Coleman, PhD, RD, Joanne J. Volpe, Kathy W. Hosig, PhD, MPH, RD, “Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet,” The Journal of Pediatrics: Vol 105, Issue 9: 1433–1437; September 2005. http://www.sciencedirect.com/science/article/pii/S000282230501151X.
On the flip side, hypos can be an issue, especially early on…and if you treat them too aggressively, they could knock you out of ketosis. I remember my first 3 weeks on keto, my CGM trend line hugged a blood sugar of around 80.  It was glorious, but I had to reduce insulin substantially through trial and error and felt like I was low every five seconds.
The diet that brought ‘lectins’ into the mainstream - a plant-based protein found in the likes of legumes (lentils and beans), nightshade veg (tomatoes, potatoes and aubergine), eggs and grains. The man who popularised the lectin-free diet – Dr Steven Gundry – describes them as ‘toxic’. In his book that brought a lectin-free lifestyle to the masses – The Plant Paradox – he cites them as the source of modern ailments from obesity to gastrointestinal disorders.
Close the Kitchen at Night. Establish a time when you will stop eating so you won't give in to the late-night munchies or mindless snacking while watching television. "Have a cup of tea, suck on a piece of hard candy or enjoy a small bowl of light ice cream or frozen yogurt if you want something sweet after dinner, but then brush your teeth so you will be less likely to eat or drink anything else," suggests Elaine Magee, MPH, RD, WebMD's "Recipe Doctor" and the author of Comfort Food Makeovers.
DASH stands for "Dietary Approaches to Stop Hypertension." The diet was developed out of a study by the National Institutes of Health after researchers noticed that vegetarians tended to have lower rates of high blood pressure. Understanding that sodium intake affected blood pressure, researchers also believed that these levels may also be impacted by other nutrients in plant-based diets.
Epilepsy is one of the most common neurological disorders after stroke,[7] and affects at least 50 million people worldwide.[8] It is diagnosed in a person having recurrent unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy may occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory (not yielding to treatment) when two or three anticonvulsant drugs have failed to control it. About 60% of patients will achieve control of their epilepsy with the first drug they use, whereas about 30% do not achieve control with drugs. When drugs fail, other options include epilepsy surgery, vagus nerve stimulation and the ketogenic diet.[7]
Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
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