Keto Diet and Diabetes: Is This Truly a Favorable Combo?

Christine Zalnieraite

2022 Jan 25

13 min read

If there’s one diet that’s continued to grow in popularity, especially among people with diabetes, it’s the ketogenic diet, also known as the keto diet. The relationship between diabetes and the keto diet is one topic that researchers have had their lenses on over the years. Namely, many studies and research look into the diet’s benefits and how it helps people with diabetes.

The American Diabetes Association (ADA), the national institution concerned with the complications and control of diabetes, has suggested various means of effectively managing diabetes, and the keto diet is one of the recognized approaches.

The ADA isn’t the only professional entity that supports the implementation of the keto diet to control the symptoms and effects of diabetes. Physicians and other health institutions also see the ketogenic diet as a great way to manage diabetes.

However, does any relationship genuinely exist between the ketogenic diet and type 1 diabetes, or is it simply a fallacy? How about keto and type 2 diabetes? This guide aims to consider the seemingly positive relationship between the keto diet and diabetes as well as its possible dangers.

What to Expect?

  • What’s the Keto Diet?
  • How Does a Low Carbohydrate Ketogenic Diet Benefit Diabetes?
  • Types of Keto Diet
  • Research on the Benefits of Keto Diet and Diabetes
  • The Atkins Diet Similarity to the Keto Diet
  • Potential Dangers of the Ketogenic Diet
  • How to Improve the Keto Diet Effect

What’s the Keto Diet?

Source: Everyday Health

The keto diet is a low carbohydrate diet that helps people with diabetes gain the needed energy to carry out normal functioning and physical development without depending on carbohydrates. While the ketogenic diet is a low-carb diet, it’s incredibly high in fat which serves as an alternative energy source for the carbohydrates that are almost non-existent in keto meals.

While it’s evident that the last thing that a person with diabetes needs is fat-filled food, the keto diet reduces blood glucose levels drastically and doesn’t exactly increase weight at an alarming rate.

The thing about the ketogenic diet is that it’s not just a fat-filled meal. Instead, it’s a controlled diet plan with more good fats than carbohydrates to help control sugar rise, glucose concentration, and the eventual diabetes complications. More particularly, a keto diet is usually a small meal that majorly comprises good fats, a small amount of protein, and almost non-existent carbohydrates.

The relationship between keto and type 2 diabetes is highly positive. The diet doesn’t just aid blood sugar control; it also modifies how the body gets to store and use energy.

The only reason fat is a significant problem in regular food is because these types of food already have sugary carbs and too many unhealthy saturated fats. On the other hand, the ketogenic diet doesn’t include these two significant concerns as it’s majorly a good fat, small-serving diet.

How Does a Low Carbohydrate Ketogenic Diet Benefit Diabetes?

The relationship between diabetes and the keto diet can be traced back to the 1920s, when it was targeted at epileptic persons. However, its success among people with diabetes made it extremely popular and one of the most trusted diets for preventing diabetes and preventing any more complications for those already diagnosed with the condition.

Being a low carbohydrate diet, the goal of the keto meal plan is to improve blood sugar and blood glucose level, which reduces the risk of diabetes. Diabetes stems from high blood sugar and doubles as one of the most severe cardiovascular risk factors. Thankfully, leaning towards a low glycemic index diet like the keto diet can help you avoid diabetes and its associated conditions in its entirety.

Unlike other low carbohydrate diets that still incorporate a mix of carbohydrates, the keto diet reduces it to the barest minimum. It’s more of healthy fats with a low glycemic index and won’t cause any severe weight gain typically associated with increased fat intake.

Some of the primary fats in a ketogenic diet include the following:

  • Fatty fish like salmon
  • Cottage cheese
  • Avocado
  • Olive oil and olive products
  • Nuts and nut-made butter
  • Seeds

Types of Keto Diet

There are different types of ketogenic diets, with each leading to significant weight loss. Let’s examine each of them individually.

Standard Ketogenic Diet (SKD)

The SKD comprises 70% fat. The other 30% is split between protein (20%) and carbs (10%).

Cyclical Ketogenic Diet (CKD)

The CKD is simply a diet plan with consecutive keto days, followed by relatively shorter high-carb diet-focused days. An example is 6 consecutive keto diet days and 2 high-carb days.

Targeted Ketogenic Diet (TKD)

The TKD is a special low blood sugar diet that leads to quick sugar loss and weight gain. It’s an excellent diet for short-term glycemic control as it leads to rapid weight loss and diabetes control in a relatively short time.

The issue, however, is that it has a low sustenance possibility. It’s almost 80% fat, 15% protein, and 5% carbs.

High-Protein Ketogenic Diet (HPKD)

The HPKD is high in fat and protein but extremely low in carbs. For reference, it comprises 60% fat, 35% protein, and 5% carbs.

Research on the Benefits of Keto Diet and Diabetes

There have been several studies on diabetes and the ketogenic diet, especially on the ketogenic diet and diabetes type 2 relationship. The studies generally highlight positive results in that the ketogenic diet benefits people with diabetes and those vulnerable to the condition.

In this light, this section considers two significant studies to illustrate just how much people with diabetes stand to gain from the keto diet plan.

A 2008 study titled “The Effect of a Low-Carbohydrate, Ketogenic Diet (LCKD) Versus a Low-Glycemic Index Diet (LGID) on Glycemic Control in Type 2 Diabetes Mellitus” showed the ketogenic diet helps with glycemic control and improves diabetes symptoms. The results were quite beneficial to the extent that participants reduced their diabetes medications to prevent hypoglycemia.

The study lasted for 24 weeks and involved 84 obese diabetic subjects. The participants were randomly shared into two groups — the LCKD group (first set) and the LGID group (second set).

The first set of 42 participants was given a ketogenic diet which consisted of less than 20 grams of carbohydrates daily. On the other hand, the second set of 42 participants was offered a low calorie and glycemic reduced diet with up to 500 calories daily.

The chosen diet plan given to the second set was an established weight maintenance diet designed to improve the condition of a type 2 diabetes patient.

Both sets were subjected to the same routine, including types of exercise, prep talks, and the same sleeping schedule. The main goal was to see if there would be any significant difference in glycemic control, determined by the hemoglobin A1c levels.

Only 49 participants were able to complete the study. After the hemoglobin A1c measurement, both sets were observed to experience significant improvement. Also, there were improvements in weight loss, fasting glucose, and fasting insulin.

However, the first set’s results were far better as they had better hemoglobin improvement, weight loss, and other factors. In summary, the results achieved are outlined as follows:

Parameter First Set (LCKD Group) Second Set (LGIDGroup)
Hemoglobin A1c -1.5% -0.5%,
Bodyweight -11.1 kg -6.9 kg
High-density lipoprotein cholesterol +5.6 mg/dl 0 mg/dL
Diabetes Medication Medication was drastically reduced or eliminated in 95.2% of participants in this set. Medication was drastically reduced or eliminated in 62% of participants in this set.

Based on the research outcome, the keto diet was seen to control risk factors of diabetes better than the proven management plan.

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Another more recent study conducted in 2017, “An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals With Type 2 Diabetes: A Randomized Controlled Trial,” also established similar results. All participants subjected to the ketogenic diet were found to enjoy better improvements in blood glucose level, A1c, overall weight loss, and triglyceride levels.

The Atkins Diet Similarity to the Keto Diet

Source: Healthline

The keto diet is one of the most popular in the world when dealing with diabetes. The diet has undergone different changes over the years, which has led to different plan varieties being developed, as explained already. There’s, however, an entirely different diet that has on many occasions been mixed up with the ketogenic diet — the Atkins diet.

The Atkins diet focuses on a low-carb diet plan that replaces carbohydrates with other energy sources, just like the keto diet. However, it’s significantly different from the ketogenic diet, focusing on high protein instead of fats.

The Atkins diet was created by Robert Atkins, a Doctor in the 1970s, as a modification to the keto diet but was never considered an evolution of a high-fat diet. The Atkins diet plan aims to tackle diabetes significantly with a lower risk of body fat gain.

Doctors also recommend the Atkins diet as an excellent means of cutting excess carbs. The only issue with the Atkins diet is that it’s challenging to keep up with it for a long time, implying poor sustenance. This is simply because fat can serve as a better alternative energy source to protein. Moreover, keeping up with a high-protein food for a long time may induce specific mental symptoms and increase fatigue.

However, the Atkins diet plan is suggested as a good choice, especially if the goal is to keep blood sugar normal and shred fat as quickly as possible. Like the ketogenic diet, the Atkins diet plan can also lead to low blood sugar if consistently adhered to without constant blood sugar monitoring.

Potential Dangers of the Ketogenic Diet

As good as the keto diet may appear, it does have its certain downsides. Let’s examine the major ones.

Diabetes Ketoacidosis Risk Factor: Ketones Increase

While a low carbohydrate diet is perfect for you to lose weight, the high-fat content associated with the ketogenic diet increases your risk of high ketone levels.

High ketone levels predispose you to diabetes ketoacidosis, a more complicated form of diabetes. Therefore, if you plan to adopt this low-carb diet to control diabetes, it’s imperative you monitor how its effects progress so it doesn’t become counterproductive.

A Paradoxical Weight Gain

The keto diet fights off weight when it’s consistently followed through. However, this is where many people have an issue.

In the beginning, you could get carried away in the euphoria of losing weight through the ketogenic diet. However, it’s not all roses, as studies indicate that most people on the keto diet don’t maintain weight loss past the first few months.

After sticking to the keto diet for a while, many are highly likely to lose their will and return to their former diet. However, such relapse comes with a serious cost. For one, there’s a high chance your body will start holding on to sugary contents owing to consistent sugar starvation during your keto journey.

Also, there’s an associated psychological effect that makes you desire and eat sugary food more than usual due to the lack of it during your keto diet-focused period. Most people at this point are likely to gain all the weight they lost before the ketogenic diet and even more.

The Yo-Yo Phenomenon

One issue associated with keto dieting is the yo-yo phenomenon. This phenomenon is characterized by a lack of consistency in dieting — a person follows a diet plan, gives up, and starts again to form a cycle of inconsistency like a yo-yo.

The yo-yo phenomenon usually sees a person with diabetes lose weight, gain them, and lose them again in a continuous circle. The keto diet is one of the common causes of this phenomenon as it’s highly restricting. The worst thing about the yo-yo phenomenon is that it leads to unhealthy spikes and dips in blood sugar, resulting in further complications.

How to Improve the Keto Diet Effect

The keto diet is good, but it can be better. Consider incorporating the following into your daily routine to optimize the results you derive from a keto meal plan.


Source: Everyday Health

Simply put, exercise augments the effects you derive from a keto diet. As the 2008 research study in this article revealed, the participants were all subjected to moderate exercise despite being on a diet, and the results were outstanding.

The thing is, any form of exercise is a great way to control the stomps and complications of diabetes, so you can never go wrong with this option. There are different types of exercise that you can go for to support your keto diet, and they’re generally divided into three:

Moderate Exercise

This exercise includes consistent activities that make the heart beat a tad faster than usual and can trigger sweat. These include:

  • brisk walking,
  • moderate jogs,
  • climbing up and down staircases, and
  • every specifically targeted effort that triggers a more than average speed and sweat build-up.

This form of exercise is ideal for beginners who aren’t used to more intensive workouts like running. Also, you can scale up to more endurance-dependent routines over time.

Intense Exercise

This style of exercise includes:

  • running,
  • cycling,
  • swimming, and
  • resistance training.

Intense exercise works quite well for overweight people that want significant results in the healthiest way possible. However, your body must be able to tolerate this form of exercise to circumvent potential injuries.

Intermittent Fasting

The keto diet is great; however, coupling it with intermittent fasting can help you reduce blood sugar levels and other diabetes symptoms even faster.

Intermittent fasting is a weight-loss procedure that sets time windows on when you should and shouldn’t eat. Namely, it helps people quickly adapt to a two-square meal plan, eliminating hunger and late-night eating.

The most common intermittent fast plan is the 16:8 window. This implies that you’ll need to stay away from food for 16 hours and can only have your regular two- or three-square meals within the 8-hour window you’re allowed to eat.

Some common 16:8 windows are:

  • 10 am to 6 pm
  • 12 pm to 8 pm
  • 1 pm to 9 pm

For example, the 12 pm to 8 pm window means that you’ll eat your earliest meal by 12, which could be brunch, and eat your latest meal at 8 pm. As such, your body will have enough time to utilize the food before falling asleep.


While the keto diet is great for diabetes control owing to a minimal carbohydrate intake, it’s equally important you monitor your progress to avoid surprisingly low blood sugar levels. Simply put, a low-calorie diet like the keto meal plan implies a lower sugar level and potentially heightened insulin sensitivity that could lead to hypoglycemia and other complications. Hence finding a balance is vital.

Truth be told, combining the keto diet and diabetes is realistically possible for only a short period. You’ll also need to balance out with a calorie meal. However, with proper guidance from our diabetes management meal app, you don’t necessarily have to return to a poor diet. This virtual caregiver helps you gradually incorporate healthy meals into your diet, eliminating the risk of gaining back all the weight you lost.

Written by

Christine Zalnieraite

Christine is a registered and licensed dietitian (RD, LD) with more than eight years of professional experience. Christine is an expert in dietetics that includes human nutrition and the regulation of the proper individual diet. She alters patient's nutrition based on their medical condition and individual needs. Education: Master’s degree in Human Nutrition and Food Safety and two Bachelors of Science - Bachelor in Clinical Nutrition and Dietetics, and Human Nutrition and Food Safety. Also, she continues to deepen her knowledge in Ph.D. studies of Medical Science and Dietetics.

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