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Is the keto diet the best diet for type 2 diabetes?

Julie Harris, RDN |

If you live with type 2 diabetes, talking about your diet may be an everyday conversation. Our goal is to help you feel more empowered to make the changes that are right for you. We know what we eat affects blood sugar levels. And the ketogenic diet has gotten a lot of press over the past few years. Is the keto diet the right plan to follow if you have type 2 diabetes? 

What is a diet? 

Thanks to the many weight-loss plans out there, the word diet tends to be used to describe foods low in calories or plans that help you lose weight. 

Even so, there is another meaning of this word. Diet also refers to the food and drinks a person eats daily. Diet is more than meal plans. It’s about the connection to eating and nourishing the body. It involves your relationship with food, body image, family, nature, and our food communities. These factors are important when we talk about food and type 2 diabetes. 

What is the keto diet? 

The ketogenic diet is a high-fat, low-carbohydrate diet. It recommends eating:

  • high-protein foods, such as meat, poultry, seafood, dairy, nuts, and seeds.
  • It also includes non-starchy vegetables, like brussels sprouts, cauliflower, squash, and many others.
  • The diet limits high carbohydrate foods, including grains, root vegetables, fruits, and sugar.

In the early 1920s, medical doctors created the diet as a treatment for epilepsy in children. The word ketogenic means the body produces ketones. Ketones are a type of acid that your body produces when you don’t have enough insulin in your body to use glucose for energy. Instead, your body uses fat for energy and produces ketones. The primary goal of the diet is ketosis, which is when your body uses fat for energy instead of carbs.

keto diet for type 2 diabetes

How many carbs do you eat on the keto diet?

Generally, a low-carb diet is when you eat 100-150 grams of carbs per day. The keto diet goes even lower because the goal is to get into ketosis. Most people reach ketosis if they eat 50 grams or less of carbs per day.

To give you an idea of what 50 grams of carbs looks like:

  • 2 slices of bread is about 45 g of carbs
  • 1 Medium size banana has about 24 g of carbs
  • 1/2 cup of brown rice has about 24 g of carbs
  • 1 cup of pasta has about 50 g of carbs

What does science say about the keto diet? 

Some of the benefits are difficult to dispute because many people have seen rapid weight loss and blood sugar control when following the diet. Yet, these are individual results and published research is still limited. Long-term outcomes are uncertain and more research is needed.

One study showed that going low-carb could lead people to become less tolerant of glucose and actually develop diabetes. While another study focused on life expectancy when someone follows a low-carb or high-carb diet. The researchers showed that following an extreme carb diet was associated with a higher risk of death. 

Following a low-carb diet may also affect your risk for developing cancer. Researchers looked at the eating habits of 471,495 Europeans over 22 years. They found that people who ate fewer fresh fruits, vegetables, legumes, and nuts were more likely to develop cancer.  

Very few studies have been done in humans, outside of seizure prevention. Since ketosis is a hard state to maintain, the studies that have been conducted are limited to small number groups or have a significant drop-off rate.

A lot of researchers are interested in how the keto diet can be used for diabetes. We predict we’ll see more peer-reviewed studies about the effects of the keto diet on diabetes in the near future.

Can you follow the keto diet for long-term? 

It’s not easy to eat just 50 g of carbs per day. It’s a lifestyle change that often affects those that eat with you. And you can’t take days off when you’re trying to maintain ketosis. Without large peer-reviewed clinical trials, many of the benefits of the diet are based on individual outcomes.  

Is the keto diet safe for everyone with type 2 diabetes? 

This diet is not suggested if you have kidney disease (high protein intake can affect kidney functions). You should also be cautious about the keto diet if you have a high risk or history of heart disease. Cardiologists are still debating the long-term effect of low-carb diets on heart health.

Dietitians do not recommend the diet if you have an eating disorder or a history of eating disorders. Restricting your diet can make the problem worse and lead to bingeing or other excessive behaviors. It also does not allow you to follow mindful eating or Intuitive Eating principles.

Those that have medical conditions affected by fat intake, like pancreatitis, should avoid following the keto diet.

If you are considering the keto diet, we recommend that you talk to your physician and care team.

Making Changes to Your Diet

Welldoc’s Registered Dietitians believe that eating a well-balanced diet can help you manage your blood sugars and stabilize your weight. We also know there is not one best diet that works for everyone with type 2 diabetes.  

When deciding what changes you want to make to your meals, consider asking yourself these questions: 

  • Can I stick with this eating plan for the long term? 
  • Does this eating plan include a wide variety of foods? 
  • Will this eating plan help me develop a healthier relationship with food? 
  • What does my physician and care team recommend?

The information we provide at welldoc.com and welldoc.com/blog is not medical advice, nor is it intended to replace a consultation with a medical professional. Please inform your physician of any changes you make to your diet or lifestyle and discuss these changes with them. If you have questions or concerns about any medical conditions you may have, please contact your physician.