Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject.
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 ; this report includes data from those 7 individuals along with data from additional participants enrolled subsequently.
A 2016 study in The Lancet Diabetes & Endocrinology journal that analyzed data from Predimed – a five-year trial including 7,447 adults with Type 2 diabetes or at risk for cardiovascular disease who were assigned either a Mediterranean diet supplemented with olive oil, the same diet supplemented with nuts or a control diet – found that people on the Mediterranean versions added the fewest inches to their waistlines. The olive oil folks lost the most weight.
I teach ADA. I saw 49 people in 8 months. All except 1 lost weight and had A1C reduction. 16 reversed their condition. All this on ADA diet. ADA works, you just have to follow it. Keto will work also, I just do not believe that it is healthy in the long term. We need more study results, and evidence that it works before we recommend that everyone should go on a keto diet. I would recommend that any of you who are on keto diet, and who are adamant that it works, and that ADA does not, should look for clinical trials and become subjects. We will need to know scientifically that it works, not just by word of mouth. And we will need to see medical evidence that it helps. If there is science behind it, I am sure that ADA will get behind it. Their are medical programs where you can be followed on a keto diet. Look for those.
"Even though it's called the Mediterranean diet, it's not really a diet," said Atlanta registered dietitian Rahaf Al Bochi, a spokeswoman for the Academy of Nutrition and Dietetics. "It doesn't tell you what to eat and not eat. It's a lifestyle that encourages consuming all food groups but gives more weight to those which have the most health benefits."
Earlier this month during a taping of HeartTalk presented by Capital Cardiology Associates, Dr. James O’Brien mentioned the Mediterranean diet. He said it was a diet that he strongly recommend for patients with heart disease. Now, being a health and fitness enthusiast and a 40-year old man with a family history of diabetes and heart disease, I am always open to ways to improve my heart health.
For people with Type 1 Diabetes, you probably have heard of their diabetic emergency, diabetic ketoacidosis, also referred to as DKA. This can be life threatening condition for people with Type 1 diabetes and Certified Diabetes Educators spend many hours teaching preventive care for DKA. This condition should not be confused with nutritional ketosis, the fat burning state reached when following the Ketogenic diet. The two conditions are quite different.
Recently, there been some controversy surrounding the Mediterranean diet and its potential benefits. In 2013, a landmark study found that people put on a Mediterranean diet had a 30 percent lower chance of heart attack, stroke or death from cardiovascular disease than people on a low-fat diet. However, in June 2018 it was reported that the initial study was flawed. Though researchers re-evaluated the data and determined the results to be the same, this is something to consider when determining with your doctor whether the Mediterranean diet is best for you.
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.
Ranging from just-juice to just-tea cleanses, these typically short-term plans can be dangerous. “Detoxes and cleanses are usually low in calories, protein, and fiber, all nutrients that our bodies need to function,” says Alissa Rumsey, RD, who is in private practice in New York City. “These plans leave you feeling hungry and cranky, causing a rebound food binge once you stop the detox.”
I am a T2D, finally fully keto starting at the end of March. I am down 28 lbs. My goal is 50, so I am feeling encouraged and fitting into smaller sizes already. In May my A1C was 5.6. This morning, according to a home test kit I purchased from CVS, my A1C is 5. I believe that is fairly accurate based on my blood sugar readings, which are staying well below 100.
If you are pregnant or are nursing, you should not follow a Ketogenic diet. You will not receive enough of the recommended carbohydrates, vitamins and nutrients necessary for yourself and your growing baby on this diet. Your obstetrician will recommend how many carbohydrates you should consume per meal and for snacks during each phase of your pregnancy. They will likely refer you to a Certified Diabetes Educator for nutritional counseling as well. Please check out The Diabetes Council’s FAQ’ About Gestational Diabetes for all your gestational diabetes related questions.
I have multiple autoimmune diseases. I fought 4 doctors, all of whom told me that adults can’t get type 1. I finally went to the Jefferson Diabetes Center. Yup! Type 1 diabetes. I’m slender, do marathons, bp 100/60, triglyceride/HDL ratio 1.08. And I STILL fought 4 doctors because of the ADA misinformation. All it takes is a simple blood test to look at antibodies. That’s all it takes, but the test is almost never run.
Wolfrum said he and his colleagues don't want to stop people from changing their diet if that's what's necessary to reach a healthy weight, but they think it's important for people to know that "the [final] verdict on the ketogenic diet is not out yet." There's still more research to be done to fully understand the long-term effects of a high-fat, low-carb diet. In the meantime, said Wolfrum, "more balanced food intake is probably the healthiest way to live."
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.
As far as the the Ketogenic Diet goes, it is a very personal decision between you and hopefully your physician. I would just recommend working closely with your physician for all the recommended lab tests to make sure you remain healthy while on the diet. That’s really the goal of any “diet” anyway, right? To get healthy? This is why we normally always recommend moderation with everything…moderation in the foods you eat along with moderate amounts of exercise equals a healthy lifestyle that will prevent diabetes or help you control your diabetes if you already have it.
As CDE’s, we individualize our recommendations for each of our patients. One person’s diet may not be appropriate for another person. For example, a six foot 6 inch tall man weighing 220 lbs of mainly muscle, who exercises 2 hours per day at the gym cannot have the same number of carbs per meal as a petite 5 foot 1 inch 75 year old lady who does not exercise.
A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.