The keto diet is an extremely effective diabetes treatment. It lowers blood sugar, improves insulin sensitivity, and promotes weight loss.
The Keto Diet: Powerful Medicine for Type 2 Diabetes
24-Oct 2021, curated from Keto Mojo
The Keto Diet: Powerful Medicine for Type 2 Diabetes
The current type 2 diabetes treatment model is ineffective. Patients are not improving; in fact, they are deteriorating. Meanwhile, the prevalence of this metabolic disorder is increasing. Recent research, however, suggests a way forward: the ketogenic diet.(1)
Diabetes can be effectively treated with the keto diet. It lowers blood sugar levels, improves insulin sensitivity, and aids in weight loss.
Fortunately, the ketogenic diet is making inroads into diabetes treatment. Following that, we'll go over how it can help with type 2 diabetes. But first, a quick rundown of the scope of the issue.
The prevalence of Type 2 Diabetes and Obesity in the UAE is amongst the highest in the world. Depending on the source, the prevalence of Type 2 Diabetes in the UAE is somewhere between 16% (11,12) and over 50% (13) with a high percentage undiagnosed cases.
The Problem of Type 2 Diabetes
High blood sugar, high insulin, high blood pressure, high triglycerides, and obesity are all symptoms of type 2 diabetes, which is a risk factor for chronic disease.
Type 2 diabetes, in particular, increases the risk of heart disease, cancer, Alzheimer's disease, and, predictably, death.(2)
Type 2 diabetes affects approximately 380 million people worldwide. This was not always the case. Diabetes rates in the United States, for example, have increased by a factor of seven in the last fifty years.(2) Why? Diets and lifestyles in the United States have evolved. Americans now consume more sugar and move less frequently than ever before. Diabetes is being fueled by these changes.
Unlike type 1 diabetes, which is caused by pancreatic autoimmunity, type 2 diabetes is primarily caused by lifestyle choices.
Here’s how type 2 diabetes develops:
- A high-carb diet combined with a sedentary lifestyle leads to high blood-sugar levels (hyperglycemia).(3)
- Hyperglycemia provokes the release of insulin, resulting in high insulin levels (hyperinsulinemia).
- Hyperinsulinemia promotes weight gain because insulin is an energy storage hormone.
- Hyperinsulinemia also creates insulin resistance, the underlying metabolic issue in type 2 diabetes.
Insulin Resistance and Its Role in Type 2 Diabetes
Insulin resistance is defined as insulin desensitization, which means that this hormone's ability to store blood sugar in muscle and liver cells is impaired.(4)
Insulin resistance causes a feedback loop. To handle the same blood-sugar load, the pancreas produces more insulin, insulin resistance worsens, more insulin is produced, and the cycle repeats. Type 2 diabetics eventually lose their ability to produce insulin, necessitating the use of supplemental insulin to keep hyperglycemia at bay.(2)
In order to reverse diabetes, the insulin resistance loop must be broken. The ketogenic diet can be beneficial.
The ketogenic diet requires you eat a certain number of daily calories based on personal factors like weight, age, activity level, etcetera. But not just any calories. The critical piece to the keto diet is the types of calories you consume. Specifically, you need to divide the daily calories into consumption of 70 to 75 percent fat, 20 to 25 percent protein, and 5 to 10 percent carbohydrates.
Eating fat, protein, and carbs in these proportions keeps blood sugar and insulin levels low. In turn, low insulin signals the liver to beta-oxidize (break down) fatty acids and produce ketones.(5)
Ketones, like glucose, can be used by cells (especially brain cells) to make energy in the form of adenosine triphosphate (ATP). The ketones are produced when the body recognizes it doesn’t have glucose to use for energy. When the body produces and uses ketones rather than glucose for fuel, this is a state called ketosis, which is a survival mechanism and backup energy program used in times of glucose scarcity.
Ketosis is also an antidote for the Standard American Diet (SAD). By eliminating carbs, the ketogenic diet does an about-face to the SAD and in doing so eliminates a major driver of diabetes (carbs/sugar).
The keto diet helps change the type 2 diabetic tides by addressing its causes:
Weight loss through calorie restriction is a pillar of current diabetes treatment. Unfortunately, the method of simply losing weight hasn’t been very effective for people with type 2 diabetes.
Why not? For one, because calorie restriction lowers basal metabolic rate.(6) When normal portions are resumed, energy expenditure stays low and the weight comes back.
The keto diet may be a better option. For instance, one study found that healthy women on keto lost more weight than women on a calorie-restricted diet.(7)
Also, high-fat diets reduce appetite-stimulating hormones like ghrelin and neuropeptide Y. These hormonal shifts prevent overeating and enable sustainable weight loss.
The main clinical indicator of type 2 diabetes is high blood sugar. This is usually measured by fasting blood glucose or HbA1c, a measure of average blood glucose.(2) Carbohydrates are the main culprit elevating blood sugar. Researchers have found that high-carb diets exacerbate hyperglycemia in non-insulin dependent diabetics.(3) A ketogenic diet restricts carbohydrate intake through its recommended macronutrients or “macros” (daily recommended caloric intake broken down into percentages of fat, protein, and carbs).
Keto diets have been shown, in multiple studies, to significantly lower blood glucose in type 2 diabetics—even to the point of reversing the diagnosis.(1) | (9)
Improved insulin function
Those with advanced type 2 diabetes often need insulin injections to maintain normal blood sugar levels. But insulin therapy is more of a bandaid than a cure, and only worsens the problem of insulin resistance.
The ketogenic diet can break the insulin resistance spiral. Blood sugar stays low, insulin levels drop, and insulin function slowly returns. In a study published in BMC Medicine, the majority of type 2 diabetics enrolled were able to drop their insulin medication after 24 weeks of ketogenic dieting.(9)
A New Model of Diabetes Treatment
The standard model for treating diabetes is shifting. According to a recent consensus report in the journal Diabetes Care, carbohydrate reduction has “the most evidence for reducing glycemia” in those with type 2 diabetes.(10)
Yet challenges remain. For instance, many patients on medications (like metformin or insulin) require medical supervision to prevent dangerous hypoglycemia on a low-carb diet. Finding this supervision isn’t easy.
A San Francisco-based company called Virta Health has addressed this problem by creating an online, doctor-supervised program for reversing type 2 diabetes. The program is designed, through a series of regular check-ins, to keep patients in nutritional ketosis (0.5 to 3.0 mmol/L).
Here are some highlights from a one-year controlled study (published in 2018) on 218 type 2 diabetics enrolled in the Virta Health program:(1)
- 60 percent of patients reversed their diabetes (average HbA1C declined from 7.6 percent to 6.3 percent)
- 94% of patients reduced or eliminated insulin therapy
- Average weight loss was 30.4 pounds
- Average triglycerides decreased 24 percent
This data demonstrates that a properly-supervised ketogenic diet can reverse diabetes. And more results are surely coming.
The Final Word
Type 2 diabetes affects millions of people. High-sugar diets and sedentary lifestyles are causing a health crisis.
Researchers are increasingly turning to the ketogenic diet to treat type 2 diabetes. The keto diet promotes weight loss, lowers blood sugar levels, improves insulin function, and even assists patients in weaning themselves off medications.
The importance of supervision in achieving therapeutic success cannot be overstated. Along these lines, Virta Health has created a remote-care program with proven results. After just one year, 60 percent of patients had reversed their diabetes through nutritional ketosis.
These findings demonstrate that type 2 diabetes is curable in many cases. Perhaps it is time to expand the scope of this treatment program.
- Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study, Diabetes Therapy
- Diabetes Mellitus Type 2, StatPearls
- Effect of high carbohydrate intake on hyperglycemia, islet function, and plasma lipoproteins in NIDDM, Diabetes Care
- Insulin and Insulin Resistance, The Clinical Biochemist Reviews
- Ketogenic Diet, StatPearls
- Effect of calorie restriction on resting metabolic rate and spontaneous physical activity, Obesity
- A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women, Journal of Clinical Endocrinology & Metabolism
- Ketosis, ketogenic diet and food intake control: a complex relationship, Frontiers of Psychology
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus, BMC Medicine
- Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report, Diabetes Care
- Prevalence of overweight and obesity in United Arab Emirates Expatriates: the UAE National Diabetes and Lifestyle Study, BMC Medicine
- Diabetes prevalence (% of population ages 20 to 79), International Diabetes Federation, Diabetes Atlas
- The prevalence of Type 2 Diabetes Mellitus in the United Arab Emirates: Justification for the establishment of the Emirates Family Registry, Journal of Diabetes & Metabolism