Is The Ketogenic Diet Safe for People with Diabetes?

Is The Ketogenic Diet Safe for People with Diabetes?

If you’ve been diagnosed with diabetes, chances are you’re looking for simple yet effective ways to control your blood sugar. And, if at all possible, without the use of daily shots or medications.

As I’ve mentioned in earlier blog posts, exercise is one of the best natural ways to manage blood glucose. But perhaps the most obvious way to keep blood sugar at a safe and consistent level without insulin is to pay special attention to what you eat. And, in the case of diabetes, limiting your carbohydrate intake may be the key.

What Is the Keto Diet?

At first glance the ketogenic (keto) diet may seem like a crazy idea for type 2 diabetics. After all, many patients are put on diets to help them lose weight. The keto diet is high in fat, but it is very low in carbs, and this combination can help change the way your body stores and uses energy. With this diet your body converts fat instead of sugar into energy, which can improve blood glucose levels while reducing the need for insulin.

Ketosis VS Ketoacidosis

Ketosis and ketoacidosis are two very different things, which are often confused. But it’s very important you understand the difference.

What is ketoacidosis?

Ketoacidosis (KA) is a life-threatening condition in which your body doesn’t make enough insulin. This causes you to have dangerously high levels of ketones (substances occurring when the body uses fat stores for energy) and blood sugar. The combination of both makes your blood incredibly acidic, and this can, in turn, change the normal functioning of your internal organs such as your liver and kidneys. Patients suffering from ketoacidosis must get treatment immediately or they could slip into a coma and even die.

Ketoacidosis can develop in less than 24 hours and mostly occurs in people with type 1 diabetes. However, KA can also occur when type 2 diabetics do not manage their diet and insulin properly.

It gets a bit confusing when we talk about ketosis, which results from the ketogenic diet.

Ketosis is, in fact, a mild form of ketoacidosis, but is not harmful. When following a low-carbohydrate diet or fasting, your body naturally goes into ketosis. This is because your body has switched over and is now burning fat stores (in this instance, a good thing) instead of using sugar for fuel.

The main difference between ketosis and ketoacidosis is that with ketosis, you are making healthy choices that bring about the creation of ketones, but with ketoacidosis, your body is not working properly and the ketones in the blood are a sign of trouble.

Understanding the Ketogenic Diet

The goal of the ketogenic diet is to have the body use fat for energy instead of carbohydrates or glucose. In order for diabetics on this diet to have enough energy, they increase their fat intake. While they still get a little energy from proteins and carbs, the majority of fuel comes from stored fat and then eventually fats from foods.

It’s important to talk about the kinds of fats diabetics should be eating. With this diet, people should increase their consumption of heart healthy foods, not saturated fats. Some healthy foods that are commonly eaten in the ketogenic diet include:

• eggs
• fatty fish such as salmon and tuna
• cottage cheese
• avocado
• almond butter

Are there potential dangers on the ketogenic diet?

Though the ketogenic diet is quite safe and even beneficial for diabetics, there is sometimes a chance a patient can develop diabetic ketoacidosis. Anytime you change your body’s primary energy source from carbohydrates to fat, your blood becomes flush with those ketones we talked about. And, anytime there are too many ketones, there is a potential risk for developing ketoacidosis. However, this is most likely to occur in those with type 1 diabetes. It can still happen in individuals with type 2 diabetes, although is it quite rare.

The warning signs of DKA include:

• consistently high blood sugar
• dry mouth
• frequent urination
• nausea
• breath that has a fruit-like odor
• breathing difficulties

If you’re on the ketogenic diet, it’s a good idea to test your ketone levels to make sure you are not at risk for developing diabetic ketoacidosis. There are at home urine strips that will help you do this.

Monitoring Your Diabetes

While the ketogenic diet is straightforward, it does require careful monitoring. You should begin by having your doctor check your blood glucose and ketone levels. Once you’ve been on the diet for some time and your body has adjusted to using fat for fuel, it’s still a good idea to see your doctor once a month for testing and to determine if your medications need any adjustments. And, even though you will most likely see your symptoms improve on this diet, be sure to regularly monitor your blood glucose at home, ideally before and after meals.

I am a big fan of the ketogenic diet and many of my patients have had huge success on it. Having said that, it’s not necessarily for everyone. This should be looked at as a long-term strategy, not a short one. Some people simply find the dietary restrictions too difficult to commit to. Since yo-yo dieting is bad for everyone, and can be downright dangerous for diabetics, you should only begin the ketogenic diet if you feel you can stick to it.

As always, I encourage you to speak to your own doctor about whether or not this diet may be right for you. And, if you decide to go for it, be sure to check in with your doctor regularly to make sure your body is responding well. Those patients who do respond well to the diet will be rewarded with less symptoms and may even be able to completely get off of their medications.