Monday, September 26, 2022

Can Diabetics Do Keto Diet

Pro: May Improve Blood Sugars

Can I Do Keto & Intermittent Fasting If I am a Diabetic on Metformin and Insulin? Dr.Berg

Several studies have found that a very low carbohydrate “keto-style” diet promotes a more significant reduction in blood sugars and triglyceride levels. We’ve also seen more weight loss when compared to other diets.

The studies reviewed by ADA dropped the carbohydrate intake of participants to less than 40 grams per day to induce nutritional ketosis. In another non-randomized, controlled study, participants limited their carbohydrate intake to fewer than 30 grams per day. This appeared to be highly effective in improving blood sugar control and weight loss in adults with type 2 diabetes while significantly decreasing medication use. Patients underwent continued nutrition counselling and medical assistance.

Changes in blood sugar levels can occur quickly on a ketogenic diet. If you’re taking blood sugar-lowering medication, it’s important to work with a healthcare professional and Dietitian while on the diet to make sure your levels don’t drop too much as this can be just as dangerous as being too high.

While quick weight loss and lowered blood sugar levels may sound very appealing to you, there are some concerns about the keto diet’s safety and sustainability.

The Atkins Diet And Diabetes

The Atkins diet is one of the most famous low-carb, high-protein diets thats often associated with the keto diet. However, the two diets have some major differences.

Dr. Robert C. Atkins created the Atkins diet in the 1970s. Its often promoted as a way to lose weight that also controls numerous health issues, including type 2 diabetes.

While cutting excess carbs is a healthy step, its not clear if this diet alone can help diabetes. Weight loss of any kind is beneficial for diabetes and high blood sugar levels, whether its from the Atkins diet or another program.

Unlike the keto diet, the Atkins diet doesnt necessarily advocate increased fat consumption. Still, you might increase your fat intake by limiting carbohydrates and eating more animal protein.

The potential drawbacks are similar.

Aside from a high saturated fat intake, theres the possibility of low blood sugar, or hypoglycemia, from restricting carbs too much. This is especially true if you take medications that increase insulin levels in the body and dont change your dosage.

Cutting carbs on the Atkins diet can potentially aid weight loss and help you control diabetes symptoms. However, there arent enough studies to suggest that Atkins and diabetes control go hand-in-hand.

The Type 1 Diabetes Diet

A 2008 article in the Pediatrics in Review contains all the recommendations for working with children with type 1 diabetes, including the ideal diet. What do they suggest?

The recommended diet usually contains 50% to 55% carbohydrate calories, 20% protein, and approximately 30% fat. Most carbohydrate calories should be complex carbohydrates, and the fat portion should emphasize low amounts of cholesterol and saturated fats.

However, studies on how this kind of diet affects patients with type 1 diabetes are nonexistent. Interestingly, the research suggests that there may be a better diet. In fact, it is the same diet that has been found to help reverse type 2 diabetes the ketogenic diet.

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Pros Cons And Best Practices

Ask a wide range of expertshealthcare providers, dietitians, and nurseshow they feel about the ketogenic diet for diabetes and you’ll probably hear a wide range of answers. Some answers might be based on personal experience, others on scientific evidence about its efficacy, long-term benefits vs. risks, and so on.

Ask people with diabetes who’ve tried the ketogenic diet about their experience and you’ll also hear a wide range of answers. This is because a dietary approach that works for one may not work for someone else.

Ketogenic diets can serve a purpose, but their rigidity and restrictiveness may make them hard to follow and can result in other health issues if not followed properly.

Feeling Liberated And Keeping It That Way

25 Best Can Diabetics Do the Keto Diet

When she started the keto diet, Leles A1C levels were at 10 percent. Six months later, she had cut them down to 6 percent. Now no longer needing to inject herself four times per day and deal with the resulting bruises she says she feels liberated by the experience.

Im no longer on insulin, and I have cut down my medications due to keto. I never had to deal with trying to find a spot to inject or having to deal with bruises on my belly, she says. I know this may sound silly, but I have a picture of my old insulin syringes in my wallet. I look at it to remind me of what I had to do before keto. It grounds me, and when I have days of self-doubt, I remind myself how far Ive come.

That said, it hasnt been all easy.

The hardest part about living with type 2 is knowing that you have a serious chronic disease thats always following you, says Lele. There has never been a day when I dont think about my type 2 diabetes.

From monitoring symptoms of hyper- and hypoglycemia and dealing with a weakened immune system to trying to enjoy a regular meal, she says that theres always a constant reminder: When it comes to social gatherings, its almost depressing because youre obsessing about what you should, and can, eat. Its a constant battle in your head.

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Does The Keto Diet Cause Dka

Following a keto diet does not necessarily cause DKA. A keto diet leads to ketosis when your body breaks down stored fat to convert it into energy. You might think that more ketones in your blood this would increase your risk of DKA. But, this ketosis doesnt lead to DKA if your pancreas is still producing insulin, or you inject the right amount of insulin for your diabetes, and your blood doesnt become acidic. But if you are considering a ketogenic diet you should speak to your diabetes team first .

With DKA, the blood becomes acidic when ketones build up and blood glucose levels are usually high because there is no insulin. If you want to lose weight while managing your diabetes our information might help you.

Impact Of Keto On Medication

Since the keto diet helps to lower blood sugar, some people with type 2 diabetes may find that they dont need to take insulin as often. As mentioned, you still need to monitor your levels throughout the day as the diet may lead to hypoglycemia or low blood sugar. If this occurs, consuming more carbohydrates is necessary to avoid dangerous situations such as diabetic ketoacidosis.

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Could Reducing Carbohydrate Intake Play A Role In The Pathogenesis Of Type 1 Diabetes

A normal gut homeostasis is the consequence of a fine-tuned balance between intestinal microbiota, gut permeability and mucosal immunity . In this complex interplay, the alteration of one or more of these factors may contribute to the development and progression of inflammation or autoimmunity, that may result in diseases such as T1D or multiple sclerosis . Gut microbiota plays a key role in gut homeostasis, and for this reason it is currently being so intensively investigated. Clostridia are mainly butyrate-producing and mucin-degrading bacteria, with immunomodulating properties, and are generally associated with a normal gut homeostasis . De Goffau et al. observed that -cell autoimmunity is associated with a reduction in lactate-producing and butyrate-producing species, with an increased abundance of the Bacteroides genus. This finding agrees with what reported by Endesfelder et al., who suggested a protective role of butyrate in the development of anti-islet autoimmunity and onset of T1D furthermore, a reduced number of Clostridia was also observed in long-standing T1D patients .

It is known that diet influences gut microbiome and that an acute change in diet alters microbial composition within just 24 h, with reversion to baseline within 48 h of diet discontinuation . So how could a reduction in dietary carbohydrates, with a relative increase in fat or protein intake, affect gut microbiota and type 1 diabetes risk?

What Is The Keto Diet

Can The Ketogenic Diet Cause Diabetes?

Itâs a low-carb, high-fat eating plan. Most of what you eat is fat, whether thatâs unsaturated fats like nuts, seeds, and avocados, or saturated fats like butter and coconut oil. About 20%-30% of your diet is protein, either lean or fatty . Youâre supposed to strictly limit carbs, even those that are typically considered healthy, such as beans, whole grains, milk, and many types of fruits and vegetables. On the keto diet, you eat less than 50 grams of carbs a day. To put that in perspective, one medium apple has 25 grams of carbs.

How does it work? Normally, your body fuels itself from sugar, or glucose, that it gets from carbs. After a few days of the keto diet, your body runs out of glucose. So it starts burning body fat instead. This is called nutritional ketosis. It creates fatty acid substances called ketones, which your body can use for energy.

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Is A Keto Diet Safe For People With Diabetes

While there hasnt been a lot of research done on the long-term effect of following a keto diet, its generally considered safe for most people with diabetes.

The main risks when following a keto diet are related to mental health. ANY restrictive diet can potentially lead to an unhealthy relationship with food, and, in some cases, eating disorders.

If you find yourself constantly thinking about food, avoiding social situations where food is involved, or struggle with a negative body image, please seek professional help.

NOTE: Its important to stress that this risk isnt related specifically to a keto diet but dieting in general!

Reversing Type 2 Diabetes With Nutritional Ketosis

Nutritional ketosis can sustainably reverse type 2 diabetes by directly reducing blood sugar , improving insulin sensitivity and reducing inflammation . If you are able to consistently and safely maintain nutritional ketosis , diabetes reversal becomes much more likely.

Because nutritional ketosis can lead to rapid decreases in blood sugar and blood pressure, Virta strongly recommends getting medical supervision before making any dietary changes, especially if you are on medications for blood sugar or blood pressure. A physician can help you safely reduce your medications so that they donât drive your blood sugar or blood pressure too low. Both hypoglycemic and hypotensive episodes can be very dangerous, and potentially even fatal.

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Con: May Increase The Risk Of Death From Any Cause

This 2018 study of 24,825 participants of the US National Health and Nutrition Examination Survey revealed a negative link between low carbohydrate diets and total and cause-specific death, based on individual data and pooled results of previous studies over a decade. Professor Banach, the study author, said, “The findings suggest that low carbohydrate diets are unsafe and should not be recommended.”

The study divided Americans into four quartiles, from lowest- to highest-carb diets. They noticed that participants in the bottom 25% the ones who ate hardly any carbohydrates, had a 32% greater risk of death from any cause than those with the highest intakes of carbohydrates.

Additionally, the low-carb bunch had a 51% higher risk of death from heart disease and a 35% increased risk of dying from cancer relative to the top 25% of carb eaters.

And it didn’t stop there.

The data was then compared with dietary data of 447,506 people worldwide and observed that on the whole, those on low carb diets had a 15% higher risk of dying. Interestingly, those who ate a moderate amount of carbohydrates were more likely to live longer than low-carb or high-carb dieters.

How A Ketogenic Diet Works

Keto Diet for Type 2 Diabetes in Hardcover by Amy Moore

On a ketogenic diet, blood glucose levels are kept at a low but healthy level which encourages the body to break down fat into a fuel source known as ketones

The process of breaking down or burning body fat is known as ketosis

People on insulin will typically require smaller doses of insulin which leads to less risk of large dosing errors.

The diet helps burn body fat and therefore has particular advantages for those looking to lose weight, including people with prediabetes or those otherwise at risk of type 2 diabetes.

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Benefits Of A Ketogenic Diet

Ketone bodies produced from burning fat for fuel have been shown to have potent weight loss effects, help lower blood glucose levels and reduce peoples reliance on diabetes medication.

The diet has also shown evidence of having benefits on:

  • Reducing high blood pressure
  • Raising HDL cholesterol levels
  • Improving mental performance

Read more about the benefits of ketogenic diets

In addition to that, there has been a lot of interest in therapeutic ketosis for other long-term conditions, such as cancer, epilepsy, Alzheimers disease or dementia.

Its Not Just About Weight Loss

I knew how to lose weight. But managing my blood sugars were another issue, says Lele. Even though I had lost weight, my blood sugars were very high. I was taking around 100 to 110 units of insulin every day to manage my type 2 diabetes.

Eventually, she came to realize that when it comes to diabetes management, how much you eat is important, but what youre eating is highly impactful as well.

Realizing that her eating plan and medication werent enough to get her health to where it needed to be, Lele turned to the internet. On a Reddit channel, she learned all about the potential benefits of transitioning to a keto diet.

Though hesitant, her doctors allowed her to try the keto diet out and Lele hasnt looked back since.

The keto diet is a low-carb, high-fat dietary regimen which has been linked to improvements in insulin sensitivity and higher rates of weight loss both positive factors in managing type 2 diabetes. Lowering carb intake induces a metabolic state known as ketosis, through which the body produces ketones which burn fat rather than carbohydrates for energy.

The transition to keto was difficult But I wanted to really give keto a shot, especially if it helped with my type 2, Lele recalls.

After a month or two, my blood sugars improved. I cut my units down to 75 and that was a big deal for me. After showing my results to my doctors, they agreed that I should stick with keto, she says.

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Different Types Of Ketogenic Diets

The word “ketogenic” originates from the words “ketos”, meaning a substance that could be reduced to fat, and “gene”, meaning “creation”. In this context, it refers to the process of hydrolysis of fats, which converts fatty acids to ketones, using the enzyme ketone body dehydrogenase. In the presence of glucose, ketone bodies in the blood are rapidly oxidized to form carbon dioxide and water.

  • Standard ketogenic diet

    This is a very low carb, moderate protein and high fat diet. It typically contains 70% fat, 20% protein, and only 10% carbs

The Takeaway What Is The Best Type 1 Diabetes Diet

Can Doing The Keto Diet Cause Diabetes?

If we put our findings we come up with a roadmap for an ideal type 1 diabetes diet that looks like this:

  • Follow ketogenic diet
  • Restrict the consumption of dairy and wheat products to see your insulin production improves
  • Supplement with vitamin D3

Although these three dietary rules seem simple enough to follow, they will cause dramatic changes in your body. This is why it is important to work together with your doctor while you are on the ketogenic diet to see if it is effective for you.

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Con: Risk Of Lipotoxicity Causing Insulin Resistance & Type 2 Diabetes

Did you know that one of the primary causes of insulin resistance the hallmark of Type 2 Diabetes, is ‘lipotoxicity’?

This metabolic syndrome is when there is an accumulation of excess fat in the body’s tissues where it shouldn’t be like the liver, heart, pancreas, and muscles. Lipotoxicity, in turn, is thought to be exacerbated by a very high dietary intake of saturated and trans fatty acids a concept that has been well-documented by Dr. Michael Greger, MD. Therefore, a diet that reduces inflammation and cell damage is key to preventing toxic fat!

Is A Keto Diet Effective For Weight Loss

Given that the whole idea of the keto diet is to burn fat instead of carbs for energy, it seems logical that the keto diet should be effective for weight loss. While this is also often the case, its important to remember that the basic mantra of weight loss still applies:

Calories in < Calories out = weight loss.

If you eat more calories than you burn, you will gain weight no matter what type of diet you follow. To learn more about how many calories to eat, please see my post How to Lose Weight with Diabetes and follow the steps in the post How to Find Your Daily Calorie Need to calculate your optimal daily calorie intake.

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Keto Diet And Diabetes

For people with prediabetes, type 2 diabetes and type 1 diabetes, minimizing sugar as well as carbohydrate intake is typically recommended to maintain healthy blood sugar levels. The ketogenic diet is a very low-carb diet that changes the bodys fuel source from burning glucose to burning dietary fat instead.

Making this major switch in dietary habits promotes a state of ketosis which means your body is now a fat burner rather than a sugar burner. Research as well as firsthand accounts show that this ketogenic way of eating may help some diabetics to decrease and better control their blood glucose levels.

Ketogenic diet for prediabetes

Obesity is one of the principle risk factors for diabetes and following a ketogenic diet has been shown to help with weight loss. According to scientific article published in 2014, A period of low carbohydrate ketogenic diet may help to control hunger and may improve fat oxidative metabolism and therefore reduce body weight. Many prediabetics struggle with being overweight so a keto diet can help promote weight loss, which can help to decrease the chances of developing full blown diabetes.

Keto diet and type 2 diabetes

A keto diet and diabetes study published in 2012 in the journal, Nutrition, compares low-carbohydrate ketogenic diet with a low-calorie diet in improving glycemia . Overall, the study finds a low-carb keto diet to be more beneficial than a low-calorie diet for obese type 2 diabetics.

Keto diet and type 1 diabetes

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