The ketogenic diet — or the “keto” diet for short — has been around for decades. Most popularly, doctors have assigned the keto diet to help control seizures in people with epilepsy, according to the Epilepsy Foundation. But in recent years, people have begun turning to the diet in hopes of losing weight and, in some cases, better managing type 2 diabetes. Studies show that metabolic processes are altered when people consume a diet high in fat, such as meat, and low in carbohydrates, such as bread and pasta. The body shifts into a natural metabolic state called ketosis, during which it burns fat rather than carbs for energy, according to a February 2014 review published in the International Journal of Environmental Research and Public Health. Although carb intake varies depending on which version of keto is at hand, people following the plan typically limit the intake of carbohydrates to less than 5 percent of their daily calories, notes the Chicago Academy of Nutrition and Dietetics.
The food options available on the DASH diet closely mirror the eating plan recommended in the US Department of Agriculture’s MyPlate, with a focus on whole foods, such as fruit and veggies; fat-free or low-fat dairy; whole grains; and lean meats, like fish and poultry. (3) Meanwhile, the plan requires cutting back on, or preferably eliminating, processed foods, like sugary drinks and packaged snacks, and limiting red meat, which in excess has been linked to poorer heart health and heart failure, according to a study published in the journal Nutrition, Metabolism and Cardiovascular Diseases. (4)

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!


Normal dietary fat contains mostly long-chain triglycerides (LCT). Medium-chain triglycerides are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[3] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhoea and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[3]
Mike, that’s exactly right! With T2, we no longer have the option of eating carbs, sugar and all the good stuff. Why can’t dieticians and the ADA recognize that and quit trying to shove all those carbs down our throats? I don’t get it… I seriously don’t. And I think the author of this article would do an about face is she actually had diabetes. It’s amazing the amount of people who claim to be experts that seriously don’t get it!! It I had Celiac Disease, I couldn’t eat gluten… at all. Why is the same not recognized for diabetics? Our meters show us when we are eating too many carbs. Its VERY clear as the number goes very high. What do the professionals not get about that? It’s been the most amazing thing about this whole process for me and I just can’t believe how biased people are against a very low carb diet for managing diabetes. You think that because people can’t maintain that kind of diet for long term makes it OK to go ahead and be against it? Did it ever occur to any of the professionals that by recommending a low carb diet it might actually encourage people to maintain it? Instead, you are giving them excuses and reasons to eat way too many carbs!! Last August 2016 I was diagnosed with T2, with an A1C of 12.7. My last blood test showed an A1C of 6.2 (July 2017) and I had reduced some of the meds I was originally on. I am still working on lowering my numbers. The whole process has been a slow progression to keto and I had to stumble on the whole thing myself through my own research. I tried vegan at first and quickly realized that I was eating too many carbs. Then I went low carb but knew I could do better. When I tried the Keto diet, my numbers went much lower. You get over the sweet addictions. You get over the bread addictions and you find suitable substitutions. You do what you have to do. But by not recommending an ultra low carb diet simply because you don’t think people can do it is ridiculous! It is basically telling people that they can’t possibly manage their own lives… they can’t possibly make their own, good choices. And then, because you are the authority, you are giving them reasons to not even try. You defeat them before they even begin. It just amazes me!

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 ketogenic diet is a medical nutrition therapy that involves participants from various disciplines. Team members include a registered paediatric dietitian who coordinates the diet programme; a paediatric neurologist who is experienced in offering the ketogenic diet; and a registered nurse who is familiar with childhood epilepsy. Additional help may come from a medical social worker who works with the family and a pharmacist who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.[5]
3. Diabetes prevention. In a new Annals of Internal Medicine study, 215 type 2 diabetics were asked to follow either a low-fat or a Mediterranean diet. After four years only 44 percent of the Mediterranean group needed diabetes medication -- but 70 percent of the low-fat eaters did. The Med dieters also lost more weight. Other research shows that the diet helps people with pre-diabetes lower their blood sugar enough to avoid developing full-blown type 2 diabetes.
“This is a great way of eating that I highly recommend to many clients, and I even model in my own life,” says Elizabeth Shaw, RDN, who is in private practice in San Diego and is the co-author of Fertility Foods Cookbook. “Since the premise of the diet is designed to help people who have high blood pressure, low-sodium foods are recommended. But considering that most Americans exceed their daily sodium levels anyway, it’s not surprising that dietitians recommend this style of eating for treating many different conditions, such as heart disease and obesity.”
I started on a strict keto diet one year ago, and it has been the easiest diet I have ever been on. I was prediabetic before the diet, and now am not. My triglycerides are lower ( in normal range) and my good cholesterol is high. I am at lower than normal risk for heart disease because of my cholesterol ratios. I was not overweight to start with, am not now….and have not changed my weight at all. So the good effects are due solely to the diet change and not weight loss, which the author implies throughout the article that it is the weight loss that causes the good effects….not so. I am a veterinarian and believe in good medicine. This diet makes sense biochemically for those with diabetes or prediabetes.
Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD, “Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women,” JAMA. 2007;297(9):969-977. http://jama.jamanetwork.com/art icle.aspx?articleid=205916.

Many CDEs actually have diabetes…it’s what draws them to choose this career…to help others with diabetes, to share their knowledge. Most already wear an insulin pump and continuous glucose sensors (CGMs) also. When I first became certified on each new pump and CGM, I would wear them (and check my BG 4-6 times per day) for 2-3 weeks, not only to learn the technology really well, but to gain a sense of how my patients must feel having to wear them 24 hours per day. Since, I’ve started a 6 month old baby on a insulin pump and CGM all the way up to a 89 year old…there are no boundaries for people with diabetes!
The problem is: it flies in the face of the way we have been taught. Our society (as an American), and our medical community, have preached for years that FAT is bad, and you should limit it. However, recent FACTS beg to differ. So many people rail against the keto diet because they just feel that it can’t be good…after all, you eat so much fat on it, it can’t be good for you! Facts are facts…they don’t care about your feelings. Fat is not the enemy. Sugar is.
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.
Several recent studies indicate that a low-carbohydrate diet is effective at improving glycemia. A few studies have shown that in non-diabetic individuals, low-carbohydrate diets were more effective than higher carbohydrate diets at improving fasting serum glucose [13,14] and insulin [6,14-16], and at improving insulin sensitivity as measured by the homeostasis model [6]. One of these studies also included diabetic patients and noted a comparative improvement in hemoglobin A1c after 6 months (low fat diet: 0.0 ± 1.0%; low carbohydrate diet: -0.6 ± 1.2%, p = 0.06) [6] and 12 months (low fat diet: -0.1 ± 1.6%; low carbohydrate diet: -0.7 ± 1.0%, p = 0.019) duration [5]. In a 5-week crossover feeding study, 8 men with type 2 diabetes had greater improvement in fasting glucose, 24-hour glucose area-under-the-curve (AUC), 24-hour insulin AUC, and glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet [7]. In a 14-day inpatient feeding study, 10 participants with type 2 diabetes experienced improvements in hemoglobin A1c and insulin sensitivity as measured by the euglycemic hyperinsulinemic clamp method [8]. Hemoglobin A1c also improved in an outpatient study of 16 participants who followed a 20% carbohydrate diet for 24 weeks [9].
I’ve been type 2 for about 15 years was pretty stable with diet and Metformin for 10 years. But eventually started trying more aggressive treatment like Victoza and without fail in 4 years I was on slow acting insulin. I lost weight lowered carb intake to 40mg or less in the morning my breakfast has been no carbs. People need to realize every diabetic is different you must manage it how it keeps you with good A1C levels. I myself got off insulin for a year and half but my fasting levels slowly increased again. Reversing diabetes is not possible. Reducing the effects is possible and more likely the better you monitor yourself and do what you need to do. Depending on medications or diets or counting carbs will all help but not cure the diabetes. These all are things that reduce its ability to affect your health negatively.
Eat Breakfast Every Day. One habit that's common to many people who have lost weight and kept it off is eating breakfast every day. "Many people think skipping breakfast is a great way to cut calories, but they usually end up eating more throughout the day, says Elizabeth Ward, MS, RD, author of The Pocket Idiot's Guide to the New Food Pyramids. "Studies show people who eat breakfast have lower BMIs than breakfast-skippers and perform better, whether at school or in the boardroom." Try a bowl of whole-grain cereal topped with fruit and low-fat dairy for a quick and nutritious start to your day.
As always, I encourage you to speak to your own doctor about whether or not this diet may be right for you. And, if you decide to go for it, be sure to check in with your doctor regularly to make sure your body is responding well. Those patients who do respond well to the diet will be rewarded with less symptoms and may even be able to completely get off of their medications.
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.
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.

Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[18] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[3]
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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