The newly popularized diet, Ketogenic diet has been around for almost a century. Originally used for the treatment of epilepsy in the 1920s, this high-fat and low carbohydrate diet is becoming well known for another reason.
“There’s growing research showing that the ketogenic diet is effective for managing blood sugar in people with diabetes,” says William Yancy, MD, program director at the Duke Diet and Fitness Center in Durham, North Carolina.
However, since most studies have been conducted only over a 2-3 year period, there is no way of knowing long-term impact. Regardless, this diet’s popularity is picking up steam.
What exactly is the ketogenic (keto) diet?
The core of the keto diet is low carbohydrate with extremely high fat content. Here is a macronutrient breakdown:
How could this work?
Typically the body converts glucose into fuel however with the keto diet you are converting fat into ketones – which results in a state of “ketosis.” Ketosis is a “fat-burning” state and is believed to suppress appetite.
This might sound familiar to Diabetes Educators. Prior to the discovery of insulin, an extremely low-carb and high fat diet was used to manage glucose levels in those with diabetes. This has sparked interest in scientists to research the keto diet today and it’s effects on those with diabetes
What does science say?
Many healthcare professionals are reluctant to recommend fad diets. However, there is substantial research indicating the keto diet helps with weight loss, can reduce the need for medication and in some cases, gets the A1C within target range.
“…those on the keto plan reduced their A1C from 7.6 to 6.3 percent, shed 12 percent of their body weight, eliminated their need for sulfonylurea medication, and lowered or reduced their need for insulin by 94 percent. The results were published in 2018 in the journal Diabetes Therapy.”
If people are able to lower blood sugars by decreasing carb intake, this could reduce the need for diabetes medications. Changing diet can have a huge impact on medication needs and research suggests this may be a benefit of the keto diet for those with Type 2 diabetes.
The Dangers of Keto and A1c Reduction
It is important to consider the short-term safety of those switching to the keto diet, as a swift reduction carbohydrate intake can lead to hypoglycemia. To prevent blood sugar lows, close monitoring and frequent medication down adjustments are required.
Understanding the Drawbacks
Similar to any popular diet strategy, it is important to be aware of “drawbacks” as outlined below:
Thinking Long-Term
Impact on heart health is the most-cited long term impact. Considering most calories come from fat, cardiovascular disease is a big risk.
“…people who consumed less than 40 percent of their calories from carbohydrates were significantly more likely to die from heart disease than those whose diets contained 50 to 55 percent of calories from carbs—especially if the foods that replaced those carbs were rich in animal fats and proteins.”
One way to avoid heart risk while on the keto diet, is to coach participants to be aware of which types of fats they are consuming. Encourage them to avoid bacon and butter and consume heart-healthy fats such as seeds, nuts, olives and avocados.
Although there is always a hesitation to recommending a popularized diet, the substantial research suggests that if done right, the keto diet can have positive health affects on those with diabetes.
To learn more: What You Need to Know About the Ketogenic Diet – Diabetes Forecast 2019