Can Going Keto Actually Help Manage Type 2 Diabetes?

Curated by Claudia Shannon / Research Scientist / ishonest

At times, type 2 diabetes can feel like carrying around an incessant party pooper on your back. Anytime you want to treat yourself, he’s there to swat that apple cider donut right out of your hands.

And while no one is calling T2 diabetes a party, there are plenty of ways to keep your condition from raining on your parade. One of the most promising? The Ketogenic diet.

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You’ve probably heard a lot about it, some true, some false. So — does it help? Is it just another fad? Is it true that a keto meal plan includes deep-fried cheese sticks wrapped in deep-fried bacon? No.

Read on for everything you need to know about how going keto could get that party pooper off your back.

What is the keto diet?

It’s that diet where you stuff your face with cheese and miraculously lose weight right? Sorry, no.

The keto diet was actually developed back in 1923 to help those suffering from drug-resistant epilepsy. It involves eating a high fat, moderate protein, very low carbohydrate diet to “starve” cells of traditional fuel (aka carbs), and in turn, reduce epileptic seizures.

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Eventually, people discovered that the diet had other potential health benefits, such as helping people manage chronic conditions like Alzheimer’s, Parkinson’s, cancer, and — you guessed it — type 2 diabetes.

Here’s how the high-fat, low-carb shift works:

Carbohydrates are the primary fuel source for most of the body’s processes. When carbohydrates are restricted or absent, your body is forced into a state of what it views as starvation. With fat being plentiful, your body begins to use fat as its primary fuel source.

This state is called ketosis (get it — keto?). In ketosis, fat is broken down into ketones to be used as fuel instead of the glucose (aka sugar) your body would normally get from carbs.

Because this diet promotes the burning of body fat, it frequently appeals to individuals hoping to lose weight. It’s also been shown to have positive impacts on cardiovascular health, including increased HDL cholesterol (the good kind), improved blood pressure and reduced triglyceride levels.

Keto, T2, and you

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Maintaining a healthy weight and keeping blood sugar levels in check are the hallmark recommendations for controlling diabetes. Going keto can help you kick things up a notch thanks to side effects like weight loss, improved insulin sensitivity, lower blood sugar levels, and reduced need for medication.

All you need to do is give your doctor a heads up — they can answer any questions you might have and refer you to a registered dietitian who can put together a meal plan that works for you — and follows the keto rules.

First up, carbs

5 percent of calories from carbohydrates translates to about 20–50 grams per day. Yikes!

For reference, one slice of bread contains between 15–20 grams of carbs and a medium apple has between 20–25 grams. One cup of broccoli, on the other hand, contains just 6 grams.

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It’s also important to remember that the amount of carbohydrates allowed per day is based on very personal, specific calculations based on a person’s body fat percentage, which is why it’s so important to consult with a medical pro BEFORE you hop on the keto train.

In addition to the amount of carbs you’re permitted to eat, the keto diet also limits carb types. (We know — we’re feeling personally attacked too.)

Bread, pasta, beans, legumes, and starchy vegetables (think corn, carrots, peas) are not recommended. The same goes for root vegetables, most fruits, alcohol, and processed foods in general. Sugar also gets the stanky boot (RIP Krispy Kreme).

On the plus side, lots of good stuff is permitted. Meat, poultry, fish, eggs, dairy (butter, cheese, cream), nuts, seeds, oils, avocados, non-starchy vegetables, and some fruits (mostly berries) are good to go. It’s restrictive, but not totally impossible to follow.

What to expect when you’re keto-ing

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Don’t panic — side effects should dissipate within a few weeks as your body adjusts to its new fuel source. Keto is not for everyone though, and if symptoms persist, this may not be the best eating plan for you.

Risky business: The downside of keto

Very high intake of fat, particularly saturated or trans fats, has been linked to an increased risk of heart disease. This is bad news to begin with, but doubly so considering people living with diabetes are already at higher risk for cardiovascular disease.

Hypoglycemic episodes (aka low blood sugar), and worse, diabetic ketoacidosis are potential side effects of going keto, especially for people who take insulin.

Certain nutrient deficiencies are also commonplace given the drastic reduction in nutrient-dense foods like whole grains, fruits, and vegetables.

Keto vs. other common diets

With the overwhelming popularity of keto, it’s easy to forget there are lots of other diets out there known to help people manage their type 2 diabetes. Here’s how they stack up:

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