Keto Diet and Diabetes Connection – Is it Safe?


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Around a century ago, the ketogenic diet was first used to treat epilepsy in children. These days, it is used as a diet plan by men and women all over the world not only to lose weight but also to keep in shape and optimize their mind and body. Misunderstood as just a diet plan, the keto diet is often thought to be helpful only for weight loss. However, recent research has indicated that the scope of a keto diet extends so far as to help people with diabetes as well. In short, keto diet and diabetes are strongly connected with positive effects of the ketogenic diet on diabetic people.

In this article, we will first understand type I & II diabetes, ketogenic diet, keto diet and diabetes connection, ketoacidosis, etc.

What is diabetes?

Diabetes is a medical condition in which the body has elevated blood sugar levels. This can happen due to one of two reasons and form the basis of the type of diabetes that a person develops.


In type 1 diabetes, a person’s body does not produce a sufficient amount of insulin, a hormone which lowers the levels of glucose (sugar) in the blood.

In type 2 diabetes, a person’s body doesn’t produce enough insulin for the proper functioning of the body, or the cells in the body do not respond to the insulin that is produced. Ultimately, the cells consume sugar from the blood.

While type 1 diabetes is usually inherited, type 2 diabetes is caused by a multitude of factors, including high body weight, sedentary lifestyle and excessive eating.

The former is controlled by regularly injecting insulin into the blood, while the latter can be managed through reforming one’s eating habits and lifestyle, and through proper medication.

Recent research indicates the significant contribution that a keto diet can make to the life of a person who has diabetes. Keto diets can help control insulin, triglycerides (energy-storing fat molecules), glucose, as well as body weight in people with diabetes.

When carried on simultaneously with medication and exercise, a keto diet can be a highly useful tool with which to manage the many symptoms of diabetes. Let us see how.

Symptoms of diabetes

As a result of diabetes, the overall concentration of serum blood glucose increases. Over long periods of time, this higher level of serum blood glucose leads to a higher production of insulin, increased levels of the energy-storing fat molecules called triglycerides, as well as higher body weight.

Because of the excess sugar now in the bloodstream, the red blood cells called hemoglobin become coated with sugar. These sugar-coated hemoglobin cells are called hemoglobin A1C (HbA1c, in short).

Doctors sometimes measure the ratio of normal hemoglobin to HbA1c to ascertain if a person has diabetes. If it is not managed appropriately, the high blood sugar in a diabetic person can damage blood vessels, leading to a variety of illnesses.

Unmanaged diabetes can damage small vessels in the nerves, kidneys, and the eyes, leading to complications such as kidney disease and blindness. Diabetes can also double the risk of cardiovascular diseases like coronary artery diseases and stroke. (1, 2)

What is keto diet?

Keto or ketogenic diet plan requires you to avoid sugar and carbohydrates. Carbs are organic compounds which contain sugar, cellulose, and starch.

On the other hand, the ketogenic diet plan consists of mainly fatty foods. Usually, your body runs after converting glucose into energy. In the absence of sugar and carbs, your body will look for other sources of energy such as fat and burn it at a higher rate.

In other words, when your body is deprived of carbohydrates, the liver starts breaking down the stored fats to form a substance called Ketones. Ketones can be used as a primary source to generate energy.

How can keto diet help?

We have already seen that a keto diet severely restricts carbohydrates, which automatically translates into lower levels of glucose. When the blood sugar level goes down, it is helpful for people who have diabetes. Beyond this general benefit, there are some specific ones as well.

Keto diet can reduce medication intake for diabetes

In a research study conducted over a period of 16 weeks, participants had type 2 diabetes were put on a low-carbohydrate ketogenic diet (LCKD). Their goal was to eat less than 20 grams of carbohydrates each day.

The researchers observed that the participants had a decreased level of Hemoglobin AC, as well as body weight. Moreover, their average blood glucose levels also dropped, along with their overall triglyceride levels.

The researchers then concluded that the LCKD could be very effective at lowering blood glucose (3). As a result of this, the participants could severely reduce the medication they were taking for diabetes.

Keto diet can prevent diabetes

Given that ketogenic diets are high in saturated fats, most people are skeptical about it and believe it is unhealthy. As we have already seen, research tells us that ketogenic diets are beneficial for overweight or obese people who have type II diabetes.

To determine how a ketogenic diet affects those who may be at risk of diabetes (or otherwise healthy individuals), a research study was conducted on non-diabetic subjects.

There were three kinds of diets arbitrarily given to people to follow. The first was a very low-fat diet (VLD), consisting of 70% carbohydrates, 10% fat, and 20% protein. The second had 50% carbohydrates, 30% fat, and 20% proteins, and was called the high unsaturated fat diet (HUF).

The third diet was composed of 4% carbohydrates, 61% fat, and 20% proteins, and it was called the very low carbohydrate diet (VLCARB).

At the end of 12 weeks, the researchers discovered that the ketogenic diet was the most effective in improving HDL  cholesterol, triacylglycerols, fasting, as well as fasting and post-meal glucose and insulin concentrations.

Thus, they concluded that the ketogenic diet is the most helpful one when it comes to preventing diabetes. (4)

Keto diet is more effective than a low-calorie diet plan

A 24-week long research study concluded that a ketogenic diet leads to better results when compared to a calorie-restricted diet. It leads to more significant improvements in symptoms associated with type 2 diabetes in obese subjects, such as body mass index (BMI), fasting glucose, hemoglobin A1c, and body weight (5).

In yet another 24 week-long study, it was concluded that blood glucose level, waist circumference, levels of glycosylated hemoglobin and triglycerides decreased more significantly in participants who were following the ketogenic diet as opposed to those who were following a low-calorie diet. (6)

Ketoacidosis – A potential danger of keto diet

While the keto diet is undoubtedly helpful when it comes to managing the symptoms of diabetes, or preventing it, it is important to remember that the keto diet has some side effects as well.

When you change your body’s primary energy source from carbohydrates to fat, it causes an increase of ketones in the blood. If your body starts to produce ketones at a rate higher than which it consumes them, then you may be at risk of developing diabetic ketoacidosis (DKA).

Although it is more commonly seen in type 1 diabetes, arising due to a lack of insulin, it is also a possibility for those who have type 2 diabetes. If you are ill when you are on a keto diet, that might increase your risk for DKA as well.


If you feel you might have DKA, you can use urine strips at home to test your ketone levels.

Over to you on keto diet and diabetes

If you are at risk for diabetes, or already have it and want to manage its symptoms, the keto diet might be a lifesaver for you. If you are suffering from type I or II diabetes, then you should consult your doctor before you start keto diet plan as your insulin dose might be adjusted.

As we have seen, many studies recommend ketogenic diets over low-calorie ones, as they are more effective in managing and preventing diabetes. However, there are some potential risks as well, so you must be careful to follow your diet plan and exercise regimen strictly.


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