The Keto Diet and Diabetics

Share with Friends & Family


These days the Keto Diet seems to be a popular choice for weight loss. This got me thinking about the Keto diet and diabetics.

I know many diabetics would love to find an effective weight loss diet that also delivers maximum nutrition while working with their diabetes medications.

I also wondered whether it made a difference if you have Type 1 or Type 2 Diabetes since they have many of the same symptoms.

When our grandson was diagnosed with Type 1 Diabetes 11 months ago, our daughter was concerned about the possibility of Alex gaining weight from his insulin as she had heard this often happens.

With him already at a heightened risk of heart disease and stroke adding additional weight could increase those risks further.

We had heard of the Keto diet and wondered if it could be something we could use as part of our grandson’s diabetes management plan.

What is the Keto Diet

The Ketogenic (Keto) Diet is a low carb, high-fat eating plan.

About 20 – 30% of the diet is a lean protein like chicken breast or fatty like bacon.

The fats consumed can be unsaturated like nuts, seeds, avocados or saturated like butter or coconut oil.

The Keto Diet and Diabetics - keto breakfast

This diet severely restricts carbohydrates by only consuming about 50 grams of carbs per day (1 medium apple has 25 grams of carbs).

Normally the body gets fuel from the sugar(glucose) it gets from the carbs we eat. Once we have been on the Keto diet a few days the body runs out of sugar causing the liver to produce fatty acids called ketones. The body now burns fat for fuel rather than sugar. This is called nutritional ketosis and is a common weight loss diet.

People following a ketogenic diet should avoid processed foods and focus on consuming natural foods.

Be sure to include the following types of healthy foods:

  • Low-carb vegetables – eat non-starchy vegetables at each meal. Beware of starchy vegetables such as potatoes and corn.
  • Eggs – eggs are an excellent source of protein and are low in carbohydrate content
  • Meats – Fatty meats are OK but should only be eaten in moderation being cautious not to consume too much protein. When combining high levels of protein with low levels of carbohydrates it may cause the liver to convert the protein into sugar raising blood glucose levels.
  • Healthy Fats – avocados, olive oil, nuts, and seeds. Although this diet contains mostly fats it is important to choose the healthy options rather than the less healthy bacon, sausage, red meat, and fried cheeses.
  • Fish – a very good source of protein. Try to get wild fish rather than farmed if possible as they are healthier fish.
  • Berries – Berries offer a good source of fiber, vitamins, minerals, and antioxidants that are OK on a keto diet just not in excess.

The main problem with the ketogenic diet is that it can be difficult to follow long term.

Ketosis vs Ketoacidosis

It is critical for diabetics or their caregivers to understand the difference between nutritional ketosis and diabetic ketoacidosis. Both involve ketones but there are some very significant differences.

Diabetic Ketoacidosis is a very dangerous condition that occurs when the body does not have enough insulin and ketones build up too much making the blood acidic. This is more common in Type 1 than Type 2 and symptoms can include:

  • excessive thirst
  • frequent urination
  • confusion
  • weakness
  • fatigue

Nutritional Ketosis occurs as a result of dietary choices and has much lower and safer levels of ketones. This process can actually happen naturally in everyday life depending on the number of carbs and protein eaten. This state can lead to weight loss, particularly belly fat, and may lower A1c for many diabetics.

The Keto Diet and Type 1 Diabetes

Traditionally Type 1 Diabetes requires monitoring carbohydrate intake and offsetting it with the appropriate amount of insulin The Keto Diet and Diabetics - injectioninjected into the body following each meal.

Taking insulin is a significant part of managing type 1 diabetes, diet can greatly affect how much insulin is required.

It is well-known that side effects from insulin injections can include:

  • weight gain
  • hypoglycemia
  • sore or bruised injections sites
  • swelling

It makes sense to try to minimize them.

Eating fewer carbs can lead to fewer insulin injections and less severe blood glucose swings which naturally results in better overall health.

Some people have found the Keto diet helps manage both type 1 and type 2 diabetes because of the low-carb nature of this diet.

When following the Keto diet, the body creates ketones from fat for the body to use as fuel instead of glucose.

In fact, some studies have shown great improvements in HbA1c tests and other studies have shown a decrease in insulin dosage while following a low-carb diet.

These studies are promising but is important to work closely with your health care team if you have type 1 diabetes and are considering trying the Keto Diet.

The Keto Diet and Type 2 Diabetes

Some people with Type 2 Diabetes find a ketogenic diet helpful because it allows the body to maintain blood glucose levels at a lower, healthier level.The Keto Diet and Diabetics - Onetouch tester

The lower consumption of carbohydrates can help eliminate large spikes in blood sugar reducing the need for medications including insulin. However, with insulin-dependent diabetics, it also increases the risk of hypoglycemic events(Lows).

Studies on ketogenic diets including this research from 2018 have found the diet to help control HbA1c levels.

The ketogenic diet helps the body burn fat which is very beneficial when trying to lose weight. It seems that being overweight and having either Prediabetes or Type 2 Diabetes are closely related.

Research has shown that people who begin to follow the keto diet show an improvement in blood glucose level management and some have experienced noticeable weight loss.

The ketogenic diet can also offer these benefits:

  • lower blood pressure
  • improved insulin sensitivity
  • reduced medications
  • increase HDL or “good” cholesterol
  • decrease LDL or “bad” cholesterol
  • drop in insulin dosage required

Is the Keto Diet Safe

Because the ketogenic diet involves switching the body to a different source of energy it can lead to some adverse effects.

These dietary restrictions may lead to symptoms similar to withdrawal, such as:

  • keto-flu, a short-term group of symptoms that resemble those of flu
  • constipation
  • leg cramps
  • energy loss
  • mental fog
  • increased urination
  • headaches

These are usually only temporary until the body adjusts to the new fuel source.

Long term effects may include:

  • development of kidney stones
  • increased risk of bone fractures
  • risk of an increase in hypoglycemic episodes
  • children may experience stunted growth and bone erosion

There is currently a lack of evidence proving the long-term safety and effectiveness of the keto diet. Researchers are calling for more primary studies before recommending this diet.


So what is my conclusion about the keto diet and diabetics?

I would certainly recommend talking with your health care team before any dietary changes.

Because this diet can alter the blood glucose levels so much it is imperative to increase your monitoring of blood glucose levels.

For Prediabetics or Type 2 Diabetics, it may be able to help achieve near-normal blood glucose and A1c levels. This is why it is so important to work closely with your doctor as you will likely need to make changes to your medications or in some cases stop taking certain medications.

For Type 1 Diabetics I would not recommend the ketogenic diet. While some low carb recipes can be a useful tool to reduce carbs in a high carb meal, you need to really be mindful of the fact that there is a significant increase in the risk of hypoglycemic episodes.

With our grandson, we may sometimes use keto recipes but we do not follow a strict keto diet for him.

We all eat quite healthy most of the time but do indulge in fast food once in a while. He is a 5-year-old kid after all and still gets to have his McDonald’s once in a while for a treat, we just closely monitor his blood glucose levels afterward and give an appropriate dose of insulin to compensate.

As always I strongly recommend working closely with your diabetes health care team in finding the appropriate diet plan for you whether you are trying to lose weight or just eat more healthily.

Thanks for dropping by. If you have personal experience following the keto diet feel free to share your experiences in the comment section below.

Share with Friends & Family

2 thoughts on “The Keto Diet and Diabetics”

  1. Thank you for picking up on this topic. My husband is a type 2 diabetic, he was diagnosed a couple of years ago. He is extremely disciplined, so does not have excess weight and he is very aware of the food he can or can not eat. However, I am in a constant search for ways to drop the medications. I’ve never thought of Keto as a possibility and at the beginning of your post I thought-maybe. I’m grateful to you for going into depth with your research and finding out the risks also, which I think are too high in the long run. So, I’ll advise him to read your article, but also to follow your example-use Keto recipes occasionally, but not as a constant dietary regime. All the best to all of you.

    • Thanks for the comment. We found with our grandson that using selective keto recipes works great for us. For a healthy everyday diet I would consider more of a Mediterranean Diet. So far that seems to be the best I have found. I will continue my research though.


Leave a Comment