Is the keto diet good for diabetics

Diabetes and keto

Photo: Shutterstock / By Maya Kruchankova


Reader's question: Is the ketogenic diet suitable for diabetes.


To answer this question, one must first look at what type of diabetes is present. Is it type 1 diabetes or type 2 diabetes?

Type 1 diabetes is an autoimmune disease in which the pancreas of those affected cannot produce any or only little insulin. Type 1 diabetics are therefore dependent on insulin injections.

Type 2 diabetes is a chronic metabolic disease in which the level of glucose ("sugar") in the blood is increased. The cause is insulin resistance of the cells - they do not react (or only to a limited extent) to the signal from insulin and therefore do not allow the "sugar" into the cells. The drug metformin is often given to lower blood glucose levels.

As the disease progresses, the pancreas becomes damaged and gradually loses the ability to produce insulin. Then a type 2 diabetic also has to inject insulin.

If you want to eat ketogenic as a diabetic, be sure to speak to your doctor. Because most likely your medication will have to be adjusted after a certain period of time - for example the metformin or insulin dose.

A ketogenic diet will help keep blood sugar levels consistently low so that the damage that can result from the ever-increasing blood sugar level can be avoided.

With the right diet, ideally combined with some exercise, you can reverse type 2 diabetes in the early stages. The positive influence on your metabolism works particularly well if you lose any excess weight. With the ketogenic diet, excess pounds are particularly easy to shed - without cravings and without the yo-yo effect. This greatly improves metabolic health (the health of your metabolism).

As soon as the blood sugar level is constantly lower, the metformin dose can and should be corrected downwards so that there is no hypoglycaemia (metformin would further reduce the blood sugar level, which is already low due to the ketogenic diet).

As a diabetic, you have to listen to your body even more closely than someone without a disease. Make sure that you do not slip into hypoglycaemia due to incorrectly adjusted medication. An even supply of energy and only a low intake of carbohydrates with carbohydrates, which come mainly from high-fiber vegetables, are the first basis for this. Talk to your doctor about whether you can reduce the dose of medication.

As a diabetic who needs insulin, you should approach the ketogenic diet with particular care. Both type 1 and type 2 diabetics in the later stage of the disease can require insulin. As a diabetic, you are probably familiar with the term ketoacidosis. Many doctors even lump ketoacidosis together with ketosis, which is factually wrong.

Ketosis is a physiological (i.e. natural / healthy) metabolic state in which the amount of ketone bodies is slightly higher than normal. Ketosis can be achieved through fasting or a ketogenic diet. In ketosis, for example, you have ketone body concentrations of 3-6 mmol / l. In healthy people, the values ​​cannot go much higher.

Because: Insulin is the antagonist of ketone bodies!

You probably know that insulin increases when you eat sugar. But did you know that ketone bodies also attract insulin? When the ketone level in the blood rises, the insulin level rises too. The insulin causes some of the ketone bodies to be excreted in the urine. In healthy people, the ketone body level is always kept in the physiological (i.e. healthy) range. He can't go any higher.

It is different when the pancreas no longer produces insulin. The ketone body level rises, but does not attract insulin. Suddenly the ketone body level no longer has a natural limit, no antagonist. This is why ketoacidosis can occur if there is an absolute lack of insulin (that is, if the pancreas can no longer produce insulin). These are ketone body concentrations of over 25 mmol / l - as high as they can never be in healthy people.

Therefore, as a diabetic who needs insulin, you not only have to check your blood sugar levels, but also your ketone body concentration. Your insulin dose needs to be adjusted to regulate both blood sugar and ketone bodies.

That sounds complicated at first - so do your research well and please talk to your doctor about the planned change in diet. In the long term, as a diabetic who needs insulin, you will benefit from a ketogenic diet - blood sugar remains consistently low and the insulin dose can be reduced. For a moderate start, I recommend trying a moderate low carb diet (with 50-100 g carbohydrates per day) and later a moderate ketogenic diet (with 30-50 g carbohydrates per day). Just see how you feel about it and how your values ​​change.

Take a look at the exciting interview with Bettina Weiselbach from "Low Carb: Diabetes Type 2 - not with me" and learn more about her success story.