Ok, let’s break this down. So with this study you have a decent number of participants…I would love to see 1000, but 105 is certainly better than 20. Many ages, races and socioeconomic backgrounds were represented. There were a closer number of males versus females included in the study. Lastly, they were followed for a longer period of time, a full year.
I must tell you when looking at this link they say the American Diabetes Association Guidelines call for 60-75 carbohydrates per meal and that is simply not true. The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.
In 1993 Oldways created the Mediterranean Diet Pyramid – in partnership with the Harvard School of Public Health and the WHO – as a healthier alternative to the USDA’s original food pyramid. Today, the Mediterranean Diet is more popular than ever, with new research every month documenting its benefits, and chefs and home cooks alike embracing Mediterranean ingredients and flavors. Starting at the base of the pyramid, you’ll find:
"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."
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!
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.
Trim Portions. If you did nothing else but reduce your portions by 10%-20%, you would lose weight. Most of the portions served both in restaurants and at home are bigger than you need. Pull out the measuring cups to get a handle on your usual portion sizes, and work on paring them down. Get instant portion control by using small bowls, plates, and cups, says Brian Wansink, PhD, author of Mindless Eating. You won't feel deprived because the food will look plentiful on dainty dishware.

I agree!! I too..have /had Diabetes II..at age 66 and retired RN, we were taught for so long the WRONG way to eat and I taught that way, the high carb, grains, etc, way to eat. KETO saved me. Dropped my A1C and I feel great. The author of this page is wrong when saying 5-10 percent of our diet, carb eating, should be root veggies like ‘carrots”…so wrong. For goodness sakes, get KETO right by educating yourself, Tammy Shiflet~ Horribly wrong! There are so many studies and physicians, brain scientists, etc out here who understand what this diet is about. Read, and educate yourself….Please! Diabetes is a symptom of the Government’s education mistakes. Sugar, Wheat, Grains…horrible for us. Get with it, we live in 2018 and the information is out there; if you need a list, just ask.
My Husband and I started doing Keto July 2018. We got over weight after we got out of the Marine Corps. It has been hard to workout because I became disabled, but my diet was not good. After our friend Amber recommended your site and support group, we found a lot of helpful information to get us started on a successful journey. So far it’s been one month and we have lost 18 pounds each!
Sodium reduction is part of the DASH equation, but it’s not the only focus. Eating by DASH  recommendations also increases your intake of potassium, calcium, magnesium and fiber—all nutrients that play a role in cardiovascular health, as well as the prevention of other chronic diseases. It’s thought to be the combination of increasing your intake of these nutrients and decreasing your intake of added sugar, salt, sodium and unhealthy fats that leads to lower blood pressure and a laundry list of other long-term health benefits.
With fats being my main source of calories, my body and energy levels have never been better. When I educated myself on it and understood the science behind it, it was clear to see why my joints started feeling better, and ailments started to go away. I now have more “oil” lubricating my cells so they’re more receptive/flexible/malleable to the nutrients in my foods. People can loose weight very fast, but honestly the first 10lbs or so is a lot of water weight so that’s really nothing to write home about.
The 2-week turbocharge is a great way to kick off the plan: all the claims about resetting your body's expectations proved true for me. In the 3 months I've been on this plan I started a new job; celebrated my anniversary, Halloween, my birthday, & Thanksgiving, and now find myself surrounded by all the Christmas treats...and still find it easier than it's ever been to make conscious choices about what I eat.
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.
Where is the science? And if insolin intolerance is a diabetic problem why keep trying to regulate insolin? The stuff isn’t working because your patients are not getting better just deteriorating slower while you make more money keeping them on drugs!!!!! Your hole point is ketosis is bad cause they don’t have to see you after they adjust off the medication that keeps them having to see people like you!!! I have been eating keto for 6 months and feel amazing!!! These people are twisting the truth to keep you sick for there own pockets!!!!!!
Two years in and I am this exact same story. I do agree that if one is not insulin resistant or diabetic and has normal insulin response there are other less restrictive diets that will work. I would also add that people fail and drop out of almost EVERY diet program for one reason or another so that argument is null and void. I am under a doctor’s care and am healthier than I have been in years. My only dietary “sin” is artificial sweeteners and I am not looking back! I have not cheated at all on high carb foods and am rarely even tempted. It is doable if your motivation is there and you have support which is true for any kind of life altering decision.
It appears that a ketogenic diet is generally safe when implemented correctly. One must be careful to obtain all the necessary nutrients by eating a variety of foods, such as non-starchy vegetables, seeds, and nuts, and also consume adequate protein and essential fatty acids. Provided that the need for vitamins, minerals, amino acids and fatty acids is met, there is no reason to suspect that the ketogenic diet is unsafe.
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[25][26] It is approved by national clinical guidelines in Scotland,[26] England and Wales[25] and reimbursed by nearly all US insurance companies.[27] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][28] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][29]
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.
Klein S, Sheard NF, Pi-Sunyer S, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Am J Clin Nutr. 2004;80:257–263. [PubMed]
I read in the news that the DASH diet was supposed to be THE top-rated diet by experts, so I took a closer look with this book. I was disturbed instead by recommendations of processed low fat cheeses, low fat yoplait yogurt (so much sugar and un-pronounceable ingredients I don't even understand why this was suggested), and sugar-free Jello. I prefer a whole-foods, plant-based, low processed approach - so this diet definitely isn't for me. I think I'll keep looking.
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[18] On admission, only calorie- and caffeine-free fluids[36] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[18]
You’re a diabetic counselor and are talking about being worried about not being able to eat birthday cake? Hell I’ve been on keto since July 2016 and haven’t felt any urge to go back, simply because I feel so much better. Also the diet is really not all that restrictive, you can make desserts using stevia/erythritrol, coconut/almond flour, etc. I had ketogenic pizza the other night and it turned out great. Lots of great resources out there for food options. I’m not diabetic myself, but I used to be prone to hypoglycemia and keto has eliminated the issue since I’m not dependent on glucose. There are a lot of wrong ways to do keto though, and doing the diet correctly has a moderate learning curve.

Selecting the right food will be easier as you become accustomed to the Keto approach. Instead of lean meats, you’ll focus on skin-on poultry, fattier parts like chicken thighs, rib-eye steaks, grass-fed ground beef, fattier fish like salmon, beef brisket or pork shoulder, and bacon. Leafy greens such as spinach, kale and lettuce, along with broccoli, cauliflower and cucumbers, make healthy vegetable choices (but you’ll avoid starchy root foods like carrots, potatoes, turnips and parsnips). You can work in less-familiar veggies such as kohlrabi or daikon.

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