You Are What You Eat

Everyone knows that diet and exercise play a key role in managing type 2 diabetes. As diabetes is increasingly becoming an epidemic, there has been increased interest in studying the benefits and risks of a ketogenic diet for diabetic patients. So far, studies have been controversial and it’s been difficult to compare results. There’s scant information on long-term safety but here’s what we think of the evidence available so far.

What is a Keto Diet

Keto, or ketosis, occurs when your body burns fat to produce energy instead of carbohydrates. This is something your body is naturally programmed to do… when it thinks you’re starving. Through a strict diet, you can trick your body to enter ketosis but it’s not easy. A keto diet severely limits your dietary intake of carbohydrates to 20-50 a day (FYI, an apple has 14 carbs). As you trick your body, it retaliates and, from experience, makes you feel like your eyeballs are slowly being pulled from their sockets by a sadistic demogorgon accompanied by the soundtrack of a screaming toddler layered on top of a heavy traffic orchestra. This is known as the “keto flu”. Another side effect of all the fat you burn while in ketosis is that you produce a lot of ketones. The only ways for ketones to leave your body is through your bladder or through your breath so make sure those breath mints are close by. 

Is a Keto diet good for Diabetes?

The Keto diet was originally developed for children with epilepsy and research has shown that a high-fat, low-carbohydrate diet helps with seizure control and is still currently recommended to epileptic patients. Since its original development, there’s been reports that keto diets may benefit patients with type 2 diabetes by helping people lose weight, improving glycemic control, and maybe even reducing the risk of developing diabetes. Some reports have even shown that a keto diet can reduce the need for medication. This might be linked to recent evidence that suggests that an increased carbohydrate intake plays an important role in developing diabetes and obesity. However, it’s important to note that keto diets are still new and there isn’t any evidence that suggests this diet has any long-term benefits.

On the other hand, a keto diet may increase diabetic patients’ risk of hypoglycemia along with a whole host of other side effects such as a “keto-flu”, leg cramps, loss of salts, and other short term side effects that can seem like a severe caffeine withdrawal. Long term, keto diets may increase the risk of kidney stones, bone fractures, and cardiovascular disease. 

In summary, there isn’t a clear, blanket, answer as to whether keto diets are beneficial or harmful. Currently, the American Diabetes Association, along with every other association, does not have a preferred recommended diet. A low carbohydrate diet may help with glucose control but it comes at the risk of ketoacidosis and, in children, potential growth changes. Large-scale, long-term, randomized trials are needed to see if keto diets are safe long-term and determine their efficacy.