Benefits of the Keto Diet for Type 2 Diabetes

Diabetes is a metabolic disease that affects more than 10% of the world's population. According to statistics from the World Health Organization, this disease continues to grow. In 1980, there were 108 million diabetics. In 2014 this figure more than tripled to 422 million, and in 2021 diabetes became the 7th leading cause of death worldwide with approximately 6.7 million people dying from this disease, 48% of whom died before the age of 70.

In 2022, 537 million people suffered from this disease, and the figure is only increasing: in 2030, 637 million people will be diabetic, that is to say an increase of 100 million in less than ten years.

What is diabetes?

Diabetes is a health condition that affects how the body turns food into energy. When you eat, most of the food is broken down into glucose and released into the bloodstream. 2 When blood sugar levels rise, the pancreas releases insulin. Insulin works like a “key” that allows blood sugar to enter the body’s cells to be used as energy.

When you have diabetes, your body is either inefficient at handling insulin or it doesn't produce enough. Either way, the result is excess glucose in your blood3, which can lead to serious health conditions, such as heart attacks, blindness, kidney failure, strokes, and lower limb amputation4 5 6 7 8.

The different types of diabetes

There are three main types of diabetes: type 1, type 2 and gestational.

Type 1 diabetes:

Previously known as insulin-dependent diabetes, its immune version involves autoimmune destruction of the β cells of the pancreas10. This is of genetic origin, but also environmental, and the reasons are not clearly defined.

This type of diabetes affects between 5% and 10% of people with the disease and its symptoms often develop rapidly. It is usually diagnosed in children, adolescents and young adults. Some forms of type 1 diabetes have no known etiology. Only a minority of patients with type 1 diabetes fall into this category; these people experience episodic ketoacidosis and have varying degrees of insulin deficiency between episodes. People with type 1 diabetes must take insulin every day.

To this day, no one knows how to prevent or cure type 1 diabetes.

Type 2 diabetes:

The body doesn't use insulin well and can't keep blood sugar levels at normal levels. About 90% to 95% of people with diabetes have type 2. It develops over many years and is usually diagnosed in adults (but increasingly in children, teens, and young adults).

The disease begins with insulin resistance , then enters the prediabetes phase , where the body has excess sugar in the blood but not enough to be classified as type 2 diabetes, and finally the disease itself. The etiology of this type of diabetes is unknown, but there is no cellular destruction as in type 1.

A significant proportion of the population affected by this disease is overweight or obese, but people of normal weight can also have the disease. Typically, these are people who accumulate fat in the abdomen. At least in the early stages of the disease, insulin is not necessary for type 2 diabetics, and episodes of ketoacidosis are rare and are often triggered by another illness, including infections.

Gestational diabetes:

Gestational diabetes develops in pregnant women who have never had diabetes before. Gestational diabetes usually goes away after the baby is born, but it increases the risk of type 2 diabetes later in life. The baby is more likely to be obese as a child or teenager, as well as to develop type 2 diabetes later in life.

Can Keto Help My Diabetes?

For type 2 diabetes

The ketogenic diet has been shown to be effective in controlling and even reversing type 2 diabetes. Several studies confirm that a diet high in fat and low in carbohydrates helps improve this condition, as well as help with weight loss.

A 24-week study was conducted in 2008 to study the impact of a ketogenic diet on type 2 diabetes. Participants who followed a ketogenic diet experienced greater improvements in glycemic control and medication reduction at the end of the study compared to those who followed a low-glycemic diet. The explanation for this phenomenon is simple: the ketogenic diet leads to the stabilization of blood sugar levels and improved insulin sensitivity.

A review of the literature around keto also showed that this way of eating is more effective for controlling blood sugar, weight loss and reducing the need for insulin than other diets.

An important marker of diabetes is given by the A1c test, a hemoglobin A1c test also known as HbA1c test; this measures blood sugar levels for the three months prior to the test. 20 To put it simply, people with prediabetes or diabetes have more sugar attached to their hemoglobin, and this test can calculate it.

A 2017 study conducted over 32 weeks showed that people following a ketogenic diet had better results in their A1C markers than those following a low-fat diet. Another previous study had already shown the same results.

For type 1 diabetes

In type 1 diabetes, more evidence is needed, but studies have shown stabilization of HbA1c with a ketogenic diet. However, he also had an increase in lipid profile (cholesterol) and some episodes of hypoglycemia, probably related to incorrect insulin dosing.

Another study of an endurance cyclist with type 1 diabetes showed remarkable stability of blood sugar, whereas in general, for people with this disease, maintaining stable blood sugar levels during physical exercise is very difficult. Another study in type 1 diabetes showed that patients put on a low-carb diet needed on average to reduce their insulin doses significantly.

For gestational diabetes

In relation to pregnant women who develop gestational diabetes, there is no evidence regarding the type of diet, given the ethical issues raised by doing studies in pregnant women.

However, a reduction in carbohydrates is advised by doctors and scientists who advocate low-carb or keto. The evidence is rather anecdotal and is based on the experience of doctors. In any case, it should be noted that nutritional ketosis is very different from ketoacidosis. Pregnant women, as well as people following a ketogenic diet, can have high concentrations of ketones, but they are not indicative of ketoacidosis.

Can my type 2 diabetes disappear with keto?

A very important point to consider when starting a ketogenic or low-carb diet to control your type 2 diabetes is that this diet can reverse type 2 diabetes, but not eliminate it.

That is, if the bad eating habits come back, the diabetes will come back too. One case where you have to be really careful if you want to follow a ketogenic protocol while suffering from diabetes is the case where the person is already taking medications associated with a risk of hypoglycemia, such as insulin. If this is the case, then the reduction of carbohydrates must be done with the supervision of a doctor because it will surely require a reduction or elimination of this type of medication. Since blood sugar will drop thanks to keto, as explained before, if the medication lowers it even more, it can naturally lead to a hypoglycemic attack.

Conclusion

Diabetes – in its three types, but especially type 2, the most common – is a metabolic disease that kills thousands of people each year. When you suffer from this disease, the body cannot manage insulin properly or does not produce enough, which results in excess glucose in the blood. Several scientific studies have shown that the ketogenic diet is an effective dietary pattern for controlling diabetes, thanks to the stabilization of blood sugar and the improvement of insulin sensitivity resulting from a low-carb diet.