Before you rush out and start a keto diet for your diabetes, read this article!
If you’re diabetic, transitioning to a keto diet can be very dangerous. I’ll walk you through the right way diabetics should keto.
If you’ve been following the media’s hype train for the last couple of years, you’ve no doubt come across the keto diet. In the context of diabetes, the keto diet is also gaining traction. And lots of it.
Even medical reports have begun touting the amazing benefits the keto diet has on diabetes. (1) All of this popular press has lead many to think the keto diet is a cure-all. Especially in the context of diabetes – just go keto and you can reverse your diabetes.
Now, I’m not here to derail the keto hype train. I’ve seen the keto diet improve diabetes many times. Keto for diabetes can be amazing.
But it can also be incredibly dangerous. If you have diabetes, you need to make sure you keto properly. I’ll show you how today!
The keto diet?
Your body comes equipped with two ways to produce energy. I like to think of it as though you have both a gasoline and electric engine under your hood.
The gasoline engine is analogous to running on glucose. This how the majority of you get your energy. Your body digests carbohydrates into glucose which is then used as fuel to power your brain and body.
The electric engine is analogous to running on ketones. The keto diet is all about running on ketones. Instead of glucose, your body uses ketones as its fuel source.
For a deeper dive into the nuances of the keto diet, check out this post.
How a keto diet can improve diabetes
If you’re diabetic, your body struggles to regulate its blood sugar. Ergo, switching from running on sugar (glucose) to running on ketones seems like the perfect solution. Don’t get me wrong, keto can – and often does – have a profoundly positive effect on your blood sugar.
This isn’t just my opinion. Research also shows keto diets improve blood sugar control for diabetics. (2) The challenge, of course, is to remain on a keto diet over the long-term. When you fluctuate back and forth between using glucose and ketones for fuel, you can find yourself in trouble.
Most importantly, the transition phase from running on glucose to running on ketones can be incredibly dangerous for those of you with diabetes. I’ll explain why below!
Why starting a keto diet is dangerous for diabetics
Your body will preferentially run on glucose over ketones. This means that so long as you have a source of glucose, your body is going to be using that for energy. When you start to keto, you restrict your carbohydrates to a very low level. This drops your blood sugar since you’re no longer consuming enough carbohydrates (glucose) to fuel your body and brain.
In response to carbohydrate restriction, your liver converts fatty acids into ketones. Your body switches from running on glucose to running on ketones. It’s as though you go from running your gasoline engine to running your electric engine.
Running on glucose is safe for diabetics. Running on ketones is safe for diabetics. The challenge is the transition from running on glucose to running on ketones.
As you move towards a keto diet, you eat fewer and fewer carbohydrates. This should lower your blood sugar.
What happens if you add a dose of insulin when you’ve got low blood sugar?
No bueno. That’s what.
Adding a dose of insulin when you’ve got low blood sugar is a surefire way to put yourself in a diabetic coma. This occurs due to already low blood sugar (hypoglycemia) made worse by a dose of insulin. This can cause a loss of consciousness and is most certainly life-threatening.
The solution:
To prevent any negative effects while transitioning towards a keto diet, I urge you to work with your medical doctor. Consider purchasing a real-time blood sugar monitor like the Freestyle Libre. The Freestyle Libre will allow you to check your blood sugar at any moment – all without ever pricking your finger.
When you start decreasing your carb intake, you’re going to need less insulin. By continuously monitoring blood sugar, diabetics can move towards a keto diet much more safely. This will prevent the excessive use of insulin and help you avoid any potentially life-threatening situations.
But before you start cutting your carbs, there are more complications for diabetics wanting to keto. In the next section, we discuss the effect diabetic medication has on a keto diet.
Should you follow a keto diet if you’re on diabetic medication?
Some of the more commonly prescribed medications for type II diabetes is called SGLT2 inhibitors. You may know these drugs by the following names:
- Canagliflozin (Invokana)
- Dapagliflozin (Forxiga)
- Empagliflozin (Jardiance)
SGLT2 inhibitors work by preventing your kidneys from reabsorbing glucose. (4) The resulting effect is a lowering of your blood sugar. These medications can have incredibly positive effects on your blood sugar. But they add a level of intricacy when adopting a keto diet.
Are you familiar with diabetic ketoacidosis?
Ketoacidosis is a life-threatening condition that can occur in both type I and type II diabetes. Ketoacidosis is characterized by having elevated blood sugar levels, elevated levels of ketones in your blood, and a low blood pH. (5)
In ketosis, you will have a small number of ketones in your blood. You’ll also have balanced blood sugar levels. In ketoacidosis, both your blood sugar and ketones will be profoundly elevated. Diabetic ketoacidosis requires medical treatment.
Research suggests that those taking SGLT2 inhibitors are at increased risk of ketoacidosis when following a low-carb or keto diet. (6) My recommendation is to avoid adopting a keto diet if you’re taking SGLT2 inhibitors.
If you are taking SGLT2 inhibitors and you still want to take better control of your health and blood sugar, I recommend starting with a Mediterranean diet. A Mediterranean diet will help you gain better control over your blood sugar while not putting you at risk for developing ketoacidosis.
The key takeaway regarding the keto diet and diabetes comes down to medical supervision. If you’re taking medication to control your diabetes (insulin, sulfonylureas, meglitinides, or, SGLT2 inhibitors) I urge you to avoid starting a keto diet on your own. Get medical supervision.
Another possible solution is a digital program I created called Stop Feeding Fatigue. Stop Feeding Fatigue will help you to identify exactly which foods are causing irregularities in your blood sugar. By the end of the course, you’ll know precisely which foods to eat and which foods to avoid. Best of all, it’s tailored to your unique needs. There are no templates here!
Keto diets for diabetes can be incredibly effective. But they can also be incredibly dangerous. Do your keto diet safely – get supervision from a medical professional experienced in keto for diabetes.
Important considerations for diabetics that want to keto
A common practice in ketogenic diet circles is something called carbohydrate re-feeds. Carb re-feeds are when a ketogenic dieter intentionally moves him/herself out of ketosis by having a meal high in carbohydrates. This then moves the individual back into burning glucose for fuel.
Carbohydrate re-feeds are thought to promote metabolic flexibility – the ability for your body to easily adapt to running on either ketones or glucose. Personally, I’m a big fan of carbohydrate re-feeds. I do them weekly.
While carbohydrate re-feeds can be healthy for the general population following a keto diet, those with diabetes are not going to want to experiment with carb re-feeds.
Diabetes is a disease characterized by the body’s inability to regulate blood sugar. Ketosis removes the stress of having to regulate blood sugar. When a diabetic reintroduces carbohydrates, blood sugar irregularities will return.
Thus, in order to reverse diabetes, one will need to strictly adhere to a ketogenic diet indefinitely. For some, this is no issue. For others, intense dietary restriction – like that found on a keto diet – can result in yo-yo dieting.
Going back and forth with nutrition change has been shown time and time again to be unsuccessful. You need to find a nutrition plan that you can adhere to over the longterm. This becomes even more important for diabetics.
One of the best solutions I’ve found to end yo-yo dieting for good is my digital program, Stop Feeding Fatigue. You’ll learn how to craft a personalized nutrition plan that balances blood sugar and amps up your energy. All with a very modest effort output on your part.
Keto for diabetes: key takeaways
- If you have diabetes (type I or II), do not start a keto diet without first consulting with your family doc.
- If you’re taking medication to manage your diabetes, do not start a keto diet.
- Instead, start by following a Mediterranean diet. This may decrease or remove your need for medication. You can then follow a keto diet without risk.
- Check out my Stop Feeding Fatigue program if you want to regulate your blood sugars without radical dietary changes.
- Diabetics need to avoid carbohydrate re-introduction.
- Make sure the keto diet is sustainable for you over the long-term. Then, commit to it 100%.
Ok, now you know how diabetics can safely adopt a keto diet.
It’s time for me to hear from you!
What steps have you taken to improve your blood sugar?
Leave your replies in the comments section below.
