Ketogenic diets to control type 2 diabetes

Ketogenic diets have been used since 1924 in pediatrics as a treatment for epilepsy. A ketogenic (keto) diet is one that is high in fat and low in carbohydrates. The design of the ketogenic diet is to switch the body’s metabolic fuel from burning carbohydrates to fat. With the ketogenic diet, the body metabolizes fat, rather than sugar, into energy. Ketones are a byproduct of that process.

Over the years, ketogenic diets have been used to treat diabetes. One rationale was that it treats diabetes at its root by reducing carbohydrate intake, which in turn reduces the need for insulin, thus minimizing insulin resistance and associated metabolic syndrome. In this way, a ketogenic diet can improve blood glucose (sugar) levels while reducing the need for insulin. This point of view presents ketogenic diets as a much safer and more effective plan than injecting insulin to counteract the consumption of carbohydrate-rich foods.

A ketogenic diet is actually a very restrictive diet. On the classic ketogenic diet, for example, you get about 80% of your caloric requirements from fat and 20% from protein and carbohydrates. This is a marked departure from the norm in which the body runs on energy from sugar derived from carbohydrate digestion, but by severely limiting carbohydrates, the body is forced to use fat instead.

A ketogenic diet requires the intake of healthy foods made from beneficial fats, such as coconut oil, grass-fed butter, organic grass-fed eggs, avocado, fish such as salmon, cottage cheese, avocado, almond butter and raw nuts (raw pecans and macadamia). People on ketogenic diets avoid all bread, rice, potatoes, pasta, flour, starchy vegetables, and dairy products. The diet is low in vitamins, minerals and nutrients and requires supplementation.

The low-carb diet is often recommended for people with type 2 diabetes because carbohydrates break down into blood sugar, which, in large amounts, causes blood sugar to spike. Therefore, for a diabetic who already has high blood sugar, eating additional sugar-producing foods is like being in danger. By shifting the focus from sugar to fat, some patients may experience a drop in blood sugar.

Switching the body’s primary energy source from carbohydrates to fat leaves behind the byproduct of fat metabolism, ketones in the blood. For some diabetic patients, this can be dangerous as the accumulation of ketones can create a risk of developing diabetic ketoacidosis (DKA). DKA is a medical emergency that requires immediate medical attention. Signs of diabetic ketoacidosis include high blood sugar, dry mouth, polyuria, nausea, fruity breath odor, and difficulty breathing. Complications can lead to diabetic coma.