Is The Ketogenic Diet Suitable For Diabetics?

Is The Ketogenic Diet Suitable For Diabetics?

While keto diets are known to improve your cholesterol, blood pressure and blood sugar, is it really suitable for diabetics?

Diabetics, both Type 1 and Type 2 alike should adhere to a diet that is practical to follow long-term and one that meets all their nutritional needs. While this article gives a brief overview of the highly popularised ketogenic (keto) diet and its effects on diabetes, it will also discuss what you should consider when planning your diet.

The keto diet is a very low carbohydrate, high fat diet that is believed to have various health benefits. It involves a drastic reduction in carbohydrates and replacing it with fat. This reduction puts the body in a metabolic state called ketosis where the body uses fat for fuel instead of carbohydrates.

Related: Keto Diet

Pros and Cons of Keto

Keto Cauliflower Porridge

In a study with 349 subjects with Type 2 Diabetes, they found that the study group on the low carbohydrate diet (almost similar to keto diet) sustained long-term benefits on multiple clinical markers of diabetes and cardiometabolic health at 2 years while utilising less medication.

With that being said, although there have been many studies that showed vast improvements in blood glucose levels with this diet, others argue that there is still a need for high quality clinical trials of keto diets to assess their long-term effects and full potential in clinical medicine. Therefore, it is also important to review its potential side effects. 

Some of these adverse effects include keto flu, bad breath because of elevated ketone levels, poor sleep due to lower levels of serotonin and melatonin being produced and circulated around the brain, increased risk of kidney stones, and decreased bone density due to increased calcium excretion. 

Due to these risks, individuals with diabetes, kidney disease, heart or bone ailments should speak to their doctor before trying the keto diet. Consult a dietitian to plan balanced meals to help minimise risks of complications and nutrient deficiencies.

Keto diet aside, here are the key considerations when embarking on a diabetic diet:

Eat nutrient-dense foods

A nutritious spread of food. Photo: Getty

Eat a colourful array of nutrient-dense foods as opposed to highly processed calorie-dense foods. Nutrient-dense foods include whole-grains, vegetables, fruits, legumes, nuts, seeds, fish and leaner cuts of meats. Highly processed calorie-dense foods are deep-fried foods (fries, curry puffs), sweets, desserts, sugary drinks and highly processed meats (ham, luncheon meat, salami).

Related: 11 Easy Tips For Healthier Meals


Know your fats

A variety of nuts. Photo: Getty

Choose heart healthy fats; monounsaturated and polyunsaturated fats can help to lower the bad LDL-cholesterol. While monounsaturated fats are found in nuts (almonds, pistachios, pecans, hazelnuts), pumpkin seeds, sesame seeds, avocado and olive oil, polyunsaturated fats are found in flax seeds, walnuts, sunflower seeds, fatty fish, soybean oil and corn oil. 

At the same time, limit your intake of foods high in saturated and trans fats. Saturated fat increases insulin resistance by covering the insulin receptors. Examples are fatty meats, chicken skin, palm oil, coconut oil and milk, butter, ghee, and commercially baked goods like biscuits, chips and cakes. If the ingredient list states hydrogenated oil or vegetable shortening, it contains trans fat.

Instead choose lean protein such as beans, lentils, chickpeas, leaner cuts of beef and pork, fish, skinless chicken and duck.

Related: Healthy Eats

Watch out for added sugars

A glass of bubble tea

Limit your added sugars, which can also be hidden. Examples of these sugars are white sugar, brown sugar, raw sugar, agave nectar, maple syrup, honey, maltose, glucose, dextrose and any food that have ingredients that end with ‘-ose’. Foods that contain them are soft drinks, fruit juices, cakes, desserts, ice cream, chocolate, sweetened coffee and tea. Watch out for the festive coffees and teas!

Portion control is key

Beans and legumes. Photo: Getty

Portion control is key. Carbohydrate moderation and counting are important. Overeating sends your blood sugar skyrocketing and causes weight gain. Eat foods that make you feel fuller such as wholegrains, fruit, vegetables, beans and other legumes. 


Go for low glycemic index foods to prevent insulin spikes. 

The human body needs carbohydrates, proteins and fats to survive. Digestion reduces these to glucose, amino acids and fatty acids respectively. Depriving the body of any of macronutrients is not only unsustainable but also poses a danger to usual metabolic pathways to compensate for this deficit.

Overall, diabetics should focus on portion control, eating fresh whole foods, consuming more plant-based meals, less saturated fat and drinking water. 

Jaclyn Reutens is a dietitian and founder of Aptima Nutrition. She specialises in customized diets for weight management and lifestyle diseases like diabetes and hypertension. Get more information on her website.

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