The diabetes is a metabolic disease that has been steadily increasing since the 1970s, but has especially exploded in the 21st century . According to statistics from the World Health Organization, there were 108 million diabetics in 1980, a figure that increased to 422 million in 2014, and in 2019 it was the ninth leading cause of death with about one and a half million people dying from this disease , a 48% before the age of 70 years.
Diabetes alters the way the body processes food, products into energy. The majority of these foods and products are broken down into glucose and released into the bloodstream . Thus, once theblood sugar level rises, the pancreas releases insulin; this hormone lets sugar enter the bloodstream and cells to be used for energy. Having diabetes implies that either the body is inefficient at handling insulin or it does not produce enough of it. Both scenarios lead to excess glucose in the blood . This can lead to serious health conditions, such as heart attacks, blindness, kidney failure, strokes, and lower limb amputations .
Diabetes is often a consequence of the effect of a bad diet (too high in carbohydrates and low in fat), with a high prevalence in poor or developing countries. A change in diet (following a ceto diet or a low-carbohydrate diet) often leads to improvement in the disease .
Risk factors are:
- Family history of diabetes
- Being older than 35 years
- Overweight (BMI greater than 23 kg/m2) or obese (BMI greater than 25 kg/m2)
- Waist circumference of + 80 cm for women and 90 cm for men or adiposity in the upper body area
- Hypertension
- Recent weight gain
- Sedentary lifestyle
- Gestational diabetes
Type 2 diabetes, which accounts for 85% to 95% of all diabetes, has a latent, asymptomatic period of subclinical stages that often remains undiagnosed for several years. As a result, in many patients, vascular complications are already present at the time of diabetes diagnosis. Asian populations in general have a high risk of developing diabetes at a younger age compared with Western populations.
- Irritability
- Recurrent infections, especially in the urinary tract, genital area, skin, mouth
- Problems with wound healing
- Dry mouth
- Burning, painful, itchy feet
- Itching in general
- Reactive hypoglycemia
- Acanthosis nigricans (brown areas in the folds, in most cases in the axillary folds, crotch, elbows, and sides of the neck)
- Vision problems
- Impotence or erectile dysfunction
Classical symptoms of diabetes such as polyuria , polydipsia, and polyphagia frequently occur in type 1 diabetes, which rapidly progresses to severe hyperglycemia, and also in type 2 diabetes, with very high hyperglycemia levels. Severe weight loss is only common in type 1 diabetes or if type 2 diabetes goes undetected for a long time. Unexplained weight loss, fatigue, restlessness and body aches are also common signs of undetected diabetes. Symptoms that are mild or develop gradually may also go undetected.
There are three main types of diabetes: type 1, type 2 and gestational.
Type 1 diabetes, also known as insulin-dependent diabetes (treated with insulin injections), results in autoimmune destruction of the β cells of the pancreas . The reasons may be genetic, but also environmental, and are not clearly defined. It affects between 5% and 10% of people with diabetes and its symptoms often develop rapidly. It is usually diagnosed in children, adolescents and young adults. People with type 1 diabetes must take insulin every day. To this day, no one knows how to prevent type 1 diabetes or cure it.
Type 2 diabetes is a disease that does not allow the body to use insulin well, and thus keep blood sugar levels within normal ranges. This diabetes develops over many years and is usually diagnosed in adults (but increasingly in children, adolescents and young adults) . This disease begins with insulin resistance, then through the pre-diabetes phase -the body has an excess of 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 effect as in the case of type 1. A large part of the population affected by this disease is overweight or obese. However, people with normal weight can also have the disease.
Gestational diabetes develops in pregnant women who have never had diabetes, and usually disappears after the baby is born. Nevertheless, it increases the risk of type 2 diabetes later on. The baby is also more likely to be obese as a child or teenager, and more likely to develop type 2 diabetes later.
The effectiveness of the ketogenic diet (emphasizing fat intake over protein and sugar) has been shown to control or even reverse the effects of type 2 diabetes. In 2008, a 24-week study was conducted to analyze the impact of a ketogenic diet on type 2 diabetes. The results showed that those who ate keto foods (oil intake and minimal sugar content) had significant improvements in glycemic control and sometimes even a reduction in treatments compared to those who ate a low glycemic index diet; the results make sense considering that the ketogenic diet stabilizes blood glucose and improves insulin sensitivity. A review of the literature around keto showed that this diet is more effective in controlling blood sugar, for weight loss and reducing the need for insulin than other diets.
An important marker of diabetes is given by the A1c test, which measures blood sugar levels for the three months prior to testing . People with prediabetes or diabetes have more sugar attached to their hemoglobin, which the test calculates. A 2017 study conducted over 32 weeks showed that people on a ketogenic diet had better results in their A1c markers than those on a low-fat diet. Another previous study had already shown the same results.
It is important to note that the ketogenic diet can reverse type 2 diabetes, but not eliminate it. That is, if the poor eating habits return, so will the diabetes. If one wants to follow a ketogenic protocol while having diabetes and is already on medication, carbohydrate reduction should be done with a physician's supervision, as it will surely require a reduction or elimination of such medication.
With regard to type 1 diabetes, there is still a lack of evidence, but studies have shown a stabilization of HbA1c with a ketogenic diet nevertheless, it also had an increase in the lipid profile (cholesterol) -and some episodes of hypoglycemia, surely related to incorrect insulin dosage. Another study concerning type 1s showed that patients put on a low-carb diet needed on average to reduce their insulin doses.
In relation to women who develop gestational diabetes, there is no evidence concerning the type of diet because it is ethically very complicated to do studies in pregnant women. However, a reduction in the amount of carbohydrates is recommended by doctors and scientists who advocate low-carb, keto or ceto. The evidence is rather anecdotal and is based on the experience of doctors. Nutritional ketosis is very different from ketoacidosis pregnant women, as well as people on a ketogenic diet, may have high concentrations of ketones, which are not necessarily indicative of ketoacidosis .
In terms of the ketogenic diet, it is in no way seen as a treatment, for people with diabetes, the advice of a physician is necessary
Diabetes is a disease that affects a large percentage of the world's population and has been exploding since the late 1970s. A change in dietary pattern (favoring a diet high in fat and low in carbohydrates and proteins), linked to good medical monitoring, can remedy this condition.
Balanced recipes at all meals (lunch, dinner...) with healthy products including vegetables, fruits (consumption in moderation), fats (nuts, oils...) are beneficial for a diabetic person. The ketogenic diet, which includes recipes rich in fats and low in proteins and carbohydrates, is benign for people with type 2 diabetes. An intake of oil in the meals of a diabetic person on a cetogenic diet reduces the adverse effects of type 2 diabetes.
All the information on vegetables, fruits, oilseeds such as nuts and other foods compatible with ketogenic diets are listed in the carbohydrate counter (book written by dietitian Magali Walkowicz). This book will be able to help you and accompany you during your ketogenic diet by communicating the carbohydrate, fat and protein contents of products, to prepare your breakfast, lunch and dinner.
The ketogenic diet has been shown to be effective in controlling diabetes. The dietary change should be done with a doctor, to manage insulin doses and other treatments, such as metformin.
You can find studies and explanations about ketosis and the ketogenic diet by following this link:
As well as the difference between keto and low carb diets by following this link:
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