Is Keto Good for Diabetics? Type 1 Diabetes and Keto

Increasingly more evidence suggests that a low-carbohydrate diet has profound benefits for metabolic health, but is keto good for diabetics? 

Yes, a low-carb ketogenic diet is an effective strategy to support blood sugar control and can help reduce the risk of diabetic ketoacidosis in individuals with type 1 diabetes.

Let’s look at the importance of limiting carbohydrate intake for diabetics and discover how to safely and effectively implement a ketogenic diet to manage diabetes. 

What is keto?

Keto restricts dietary carbohydrate intake to no more than 50 grams of carbs per day while obtaining the majority of daily calorie requirements from healthy fats.  

A typical macronutrient distribution on keto is around 70 to 80 percent fat, 15 to 25 percent protein, and 5 to 10 percent carbohydrates. 

This eating pattern pushes the body to utilize fat as its primary energy source instead of relying on sugars and carbohydrates for fuel. 

The breakdown of fat releases ketones, a group of organic acids that serve as a highly efficient fuel source. When ketones start circulating in the bloodstream, the body enters a state known as ketosis.

Ketosis has impressive benefits for metabolic health, supports steady blood glucose levels, promotes weight loss, and has been associated with improved cognitive health and a lower risk of neurodegenerative conditions. 

Because keto restricts carbs, it keeps blood sugar and insulin levels stable and minimizes blood sugar spikes, which can help individuals with diabetes achieve consistent glycemic control.     

Watch the video below to learn why individuals with type 1 diabetes should follow a low-carb diet.   

Is keto good for diabetics?

Yes, keto is an excellent dietary pattern for people with diabetes, as it can help improve blood sugar control and reduce the need for diabetes medications.

However, the health benefits of keto vary with different types of diabetes.

Keto for type 1 diabetes

Type 1 diabetes is generally diagnosed during childhood and is characterized by defective beta cells in the pancreas, most commonly linked to an autoimmune disease.  

Beta cells produce insulin, a critical metabolic hormone that facilitates blood sugar absorption into cells. However, type 1 diabetics don’t produce insulin, which can cause extremely high blood sugar levels in response to consuming carbs and sugar.  

Elevated blood sugar, also known as hyperglycemia, in individuals with type 1 diabetes can lead to serious health complications. This explains why they have to rely on insulin injections or insulin pumps to maintain blood sugar control. 

The keto diet naturally promotes balanced blood sugar levels. This can help prevent hyperglycemia and associated health issues, including ketoacidosis, a potentially life-threatening condition that primarily affects people with type 1 diabetes.  

A study published in Pediatrics investigated the effects of a ketogenic diet in individuals with type 1 diabetes. The authors conclude, “Exceptional glycemic control of type 1 diabetes with low rates of adverse events was reported by a community of children and adults who consume very low carbohydrate diets.”

Keto for type 2 diabetes 

In contrast to type 1 diabetes, caused by a lack of insulin, type 2 diabetes is primarily a result of insulin resistance, where the body's cells don’t respond effectively to insulin. 

Insulin resistance is typically caused by excessive intake of carbohydrates and physical inactivity and is the primary driver of obesity and metabolic syndrome.

When cells become unresponsive to insulin, blood sugar can’t be used to generate energy. This triggers more insulin release to compensate for the lack of cellular glucose uptake. 

Insulin is an anabolic hormone, meaning it promotes fat storage, which explains why many individuals with type 2 diabetes are overweight or obese and find it difficult to lose weight.  

The American Diabetes Association (ADA) released a report stating that more than 38 million U.S. adults, which represents almost 12 percent of the population, have type 2 diabetes. 

Following a low-carb diet such as keto is a highly effective strategy to help prevent, manage, and even reverse diabetes. 

Restricting carbohydrates not only promotes fat-burning and weight loss but also keeps insulin levels low. Over time, steady insulin levels can increase cellular insulin sensitivity, which improves blood sugar control and reduces diabetes symptoms and associated long-term health risks.

Research published in Frontiers in Nutrition confirms this, highlighting that limiting carbohydrates is a highly effective and safe dietary approach to managing type 2 diabetes.

In addition, keto improves long-term health outcomes in those with insulin resistance and can reduce the reliance on diabetes medication to maintain blood sugar balance.

Ketosis vs. ketoacidosis

While ketosis and ketoacidosis may sound similar, they’re fundamentally different metabolic states.

Ketosis is a natural metabolic state that occurs when the body burns fat to generate energy. 

It’s characterized by elevated levels of ketones in the blood, which serve as an alternative energy source.

In contrast, ketoacidosis is a dangerous and potentially fatal condition caused by excessively elevated ketone concentrations. 

It primarily affects type 1 diabetics and is typically caused by missed insulin doses, faulty insulin pumps, or incorrectly calculated insulin requirements. 

Lack of or inadequate insulin dosages, especially in combination with carb-rich foods, can quickly lead to abnormally high blood sugar levels that can’t enter cells and fuel the body. 

This triggers rapid fat breakdown to provide an alternative energy source, resulting in large amounts of ketones entering the bloodstream. 

Because ketones are acidic, elevated levels can alter the blood’s pH level. This can disrupt various crucial physiological processes, including heart and lung function, bone demineralization, and nerve impulse transmission.

Ketoacidosis can develop quickly, leading to symptoms such as excessive thirst, frequent urination, severe dehydration, fatigue, breath with a fruity odor, and difficulty breathing. If left untreated, it can progress to severe complications, including coma and death. 

If you have type 1 diabetes and show signs of ketoacidosis, it’s crucial to seek medical care immediately for prompt treatment, including insulin therapy and electrolyte replacement.    

When is ketosis dangerous?

Ketosis isn’t associated with health risks for most people, particularly when achieved through a nutritious and well-planned ketogenic diet.

Although ketosis has been linked to several health benefits for individuals with type 1 diabetes, it’s crucial to ensure proper insulin therapy to avoid blood sugar fluctuations and ketoacidosis. 

It’s recommended to consult a healthcare provider to discuss the ketogenic diet and evaluate insulin dosages, which may change in response to a low-carb diet.  

In addition, it’s important to achieve ketosis with a nutrient-dense, high-fat diet rich in whole foods. This will promote fat burning while providing the body with essential vitamins and minerals.

Eating high-fat processed foods with little nutritional value isn’t a good way to trigger ketosis and can lead to nutrient deficiencies linked to various adverse health effects. 

Benefits of ketosis 

During ketosis, the body burns fat to generate energy, which explains why many individuals have lost significant amounts of body weight when following a ketogenic diet. 

In addition to weight loss, ketosis supports steady energy levels as fat is a sustainable fuel course. In contrast, carb-rich diets trigger blood sugar fluctuation, leading to fatigue and energy crashes. 

Ketosis promotes stable blood sugar and insulin levels. This can help manage and prevent insulin resistance, a primary cause of common chronic health conditions, including diabetes, obesity, and metabolic syndrome. 

Ketones have neuroprotective properties that support cognitive health and have been linked to a lower risk of neurodegeneration, which may help lower the risk of Parkinson’s and Alzheimer's disease.   

A study published in Nutrients reviewed a large number of studies and summarized that the ketogenic diet is linked to various impressive health improvements, including:

• Weight loss   

• Enhanced glycemic control  

• Anti-inflammatory effects 

• Improved blood lipid balance  

• Suppressed hunger and cravings  

• Diverse intestinal microbiome 

• Better endurance performance 

The authors also discuss the ketogenic diet’s potential to increase longevity and its utility as a supplemental cancer treatment.

Monitoring your blood sugar and ketone levels

Monitoring blood sugar and ketone levels is crucial for individuals with type 1 diabetes. 

Unlike type 2 diabetics, whose bodies release insulin in response to carbohydrate intake, type 1 diabetics have to carefully manage insulin dosages.

Consuming a very low carbohydrate diet can cause dangerously low blood sugar levels, especially if too much insulin is administered. In contrast, not taking enough insulin can lead to elevated blood sugar concentrations, greatly increasing the risk of ketoacidosis. 

In addition to monitoring blood sugar, it’s recommended to use ketone testing to track ketone concentrations. 

Ketone blood, urine, and breath tests are widely available and provide valuable insight into blood ketone levels. Ketone testing not only helps establish if you have entered ketosis but can also indicate ketoacidosis risk, allowing for prompt intervention and insulin adjustments. 

Optimal fasting blood glucose levels are set between 80 to 130 mg/dL (4.4 to 7.2 mmol/L). Blood ketone concentrations associated with ketosis typically range from 10.8 to 27 mg/dL (0.6 to 1.5 mmol/L).

Blood glucose levels greater than 250 mg/dL (13.9 mmol/L) and blood ketone concentrations of more than 54 mg/dL (3 mmol/L) indicate ketoacidosis and require immediate medical attention. 

Tips for healthy ketosis

Healthy ketosis refers to a well-planned and nutritious ketogenic diet in combination with regular monitoring of blood glucose and ketone levels. 

This approach ensures that the benefits of ketosis are maximized while minimizing any potential risks, particularly for those with type 1 diabetes.

Here are three tips to trigger and maintain healthy ketosis.

1. Follow Healthy Keto®

Compared to other low-carb diets that only limit carbs, Healthy Keto® focuses on nutrient-dense whole foods such as non-genetically modified (GMO) vegetables, grass-fed beef, wild-caught fish and game meat, pasture-raised eggs, and organic full-fat dairy. 

This ketogenic diet plan helps maintain ketosis while providing essential vitamins, minerals, and antioxidants that support overall health. 

By emphasizing high-quality, whole foods, Healthy Keto not only facilitates fat-burning but also minimizes your exposure to potentially harmful GMO crops, modified food starches, refined seed oils, and artificial preservatives. 

2. Maintain electrolyte balance 

Ketosis can lead to temporary dehydration and electrolyte imbalances, which can cause fatigue, headaches, irritability, and muscle cramps. 

Drinking plenty of water and replenishing lost electrolytes with a high-quality electrolyte powder can help overcome keto-flu symptoms associated with dehydration.  

3. Take B vitamins  

B vitamins are essential cofactors in metabolic pathways that convert fats into energy, which is crucial for triggering and maintaining ketosis.

Research published in Cureus suggests that individuals with diabetes are at increased risk of inadequate B vitamin levels. 

Nutritional yeast is an excellent source of B vitamins and offers additional essential nutrients, including trace minerals, amino acids, and glutathione. Incorporating nutritional yeast into low-carb meals can support energy-making processes, maximizing the health benefits of ketosis. 

Key takeaways

Is keto good for diabetics? Yes, the ketogenic diet is suitable for individuals with type 1 and type 2 diabetes. 

A low-carb diet can support steady blood sugar control, enhance metabolic health, promote a healthy body weight, and may reduce the need for diabetes medication in some people.

However, it’s important that type 1 diabetics carefully monitor blood sugar and ketone levels to ensure they’re in safe ranges and not at risk of hypoglycemia or ketoacidosis. 

FAQ

1. Is keto suitable for diabetics?

Yes, a low-carbohydrate ketogenic diet is considered safe and effective for individuals with both type 1 and type 2 diabetes. 

Keto helps maintain steady blood sugar levels, which supports better overall metabolic health and minimizes diabetes-related health risks, such as ketoacidosis, weight gain, and neurological issues.  

2. Does keto fix insulin resistance?

Keto has been found to improve cellular insulin signaling, which helps manage and, in some cases, even reverse insulin resistance. 

3. How many carbs should someone with diabetes have a day?

General healthcare guidance suggests that diabetics should consume a balanced diet consisting of around 180 grams of carbohydrates per day.

However, the ketogenic diet limits carbohydrates to no more than 50 grams daily, which keeps blood sugar levels stable and has been found to be an effective and safe strategy to manage diabetes.

4. Is ketosis safe?

Yes, ketosis is safe when achieved through a nutritious ketogenic diet focusing on minimally processed whole foods. 

Ketosis is a natural metabolic state that shifts the body into using fats instead of carbohydrates as the primary energy source, which can support weight loss, promote metabolic health, and enhance cognitive functions.

5. Is ketoacidosis dangerous? 

Ketoacidosis is a dangerous and potentially life-threatening condition characterized by excessively elevated ketone concentrations in the blood. This can change the blood’s pH, which impacts crucial physiological functions such as breathing and heartbeat regulation.

It primarily affects type 1 diabetics and is typically caused by insulin deficiency due to missed doses or insulin pump failure.

Sources

1. https://pubmed.ncbi.nlm.nih.gov/29735574/ 

2. https://diabetes.org/about-diabetes/statistics/about-diabetes 

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8319397/ 

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8153354/

5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146464/