What is the link between ketones and diabetes? Ketone is a chemical produced by the body when fats are broken down for energy. Ketone testing is important for people with diabetes, because high levels can lead to diabetic ketoacidosis (DKA), when acid levels become too high in the blood and the person loses consciousness. Find out when and why to do ketone testing. Read now
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Despite its explosive popularity, there’s a lot of confusion about what the ketogenic (keto) diet really is. “Many people think they’re following a keto diet when they’re really just consuming a low-carbohydrate diet,” says Patti Urbanski, MEd, RD, CDE, a certified diabetes educator with St. Luke’s Hospital in Duluth, Minnesota. “So one person’s ‘keto diet’ may look very different than another’s.”
As per heartburn, studies done have shown that a ketogenic diet can have beneficial effects for those who have Non Alcoholic Fatty Liver Disease. A 2006 paper published in the Journal of Digestive Diseases and Sciences found that ‘Six months of a low-carbohydrate, ketogenic diet led to significant weight loss and histologic improvement of fatty liver disease’

Many people and even some doctors confuse nutritional ketosis with (diabetic) ketoacidosis. Ketoacidosis occurs in uncontrolled diabetes when the pancreas cannot secrete enough insulin to exert its action in cells, so blood glucose levels and blood ketones both skyrocket to dangerously high levels. Ketoacidosis has nothing to do with nutritional ketosis which is when ketones are produced from all the dietary fat you’re relying on and can thus keep your blood sugar levels under control at low and stable levels.
Others consider the keto diet a short-term solution for weight loss. Tyler Drew, a 34-year-old real estate broker from Los Angeles, first read about the diet on Reddit and used it to lose 45 pounds in six months before returning to a traditional diet. While on the keto diet, Drew’s cholesterol levels improved, even though a typical day of eating involved bacon at both breakfast and dinner.

One reason it's hard to determine the exact health effects of diets is that it's often unclear whether any observed effects come from the diet or from a combination of other factors, like stress, environment or genetics. Still, that doesn't mean all the bold claims about the keto diet are wrong, but rather that you should approach them with a healthy degree of skepticism.
Hello everyone. I was diagnosed as a diabetic in 2010. I followed the ADA diet while taking metformin and lnsulin and could never get by glucose readings below 135. Most mornings it was at 175 or higher. In mid 2017 I had to find a new doctor. I ran out of meds in Semtember of that year but could not find a doctor due to not accepting new patients and or my health insurance. I broke my foot at work on the last workday in December. Was instructed to stay off foot for 6 to 9 months . In the mean time I finally got to see my new family practitioner on March 28 2018. Represcribed meds and ordered blood work. A1c was ar 14.1. With my new glucose meter my readings were 375. Due to basically being bedridden while my foot heals I was concerned about diabetic complications an weight gain as I was already overweight. After doing research online I learned about the keto diet. I began the diet on 3/29 /2018 along with intermittent fasting. I weighed 265#. As of 4/26/2008 I am at 245#. My glucose readings have been on average 73 to 98 and a couple of times 111. I stopped all my medication about a week ago just to see if they would increase. They have not so far and I check 4 times daily. I sleep better and do not crave sweets. I feel full . The first two weeks were tough but now I can go 2-3 days without being hungry. I am looking forward to the results of my next blood test in June. This diet fits my circumstances and I do plan on to exercise when I am able to. I want to reach my weight to height ratio also. When I achieve this goal I may tweak my diet at that time but for right now that is what is working for me. I may never be able to eat some of the things I used to but considering the complications of diabetes it is one hell of incentive for willpower to stay on the diet.I will repost again after my next blood test or if there are any significant changes.
By switching to a ketogenic low-carb diet, you are essentially transitioning yourself from a water-retaining diet, to a water-flushing diet. There are a variety of reasons for this, including reduction of inflammation (water tends to be bound up in inflammation) and the depletion of glycogen stores (glycogen retains water) in your liver and muscles.
The most important thing that diabetics have to learn is that there is no reason to avoid fat, not even saturated fat. It is not saturated fat that causes arteriosclerosis and heart disease, but an excess of refined carbohydrates like sugar and flour. Seed oils are implicated in the disease although by other mechanisms that involve damaged lipids and mitochondrial toxins.

Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.
Balance your fat. Saturated fat has received a terrible rap in the literature, but that doesn’t mean it’s the only fat you should consume. Look to the fatty acid ratios of ruminants like beef and lamb—or your own adipose tissue—for guidance. They have about equal amounts of saturated and monounsaturated fat with a small amount of PUFA. Mix up the butter and cream with olive oil and avocado oil.

He also told me that I was in horrible shape, that I would need a lot of medication, and that because I was T2, insulin would do nothing for me. I still remember walking out of the building after. I felt like shooting myself. My brother had just gone blind from retinopathy 2 months earlier. There was no hope for me. High numbers were inevitable. Complications were inevitable.
Hi Eric, nice to see you. Some do well on whey instead of protein powders. They do have carbs so be careful. I have learned every little change helps and no beating up allowed. Every improvement helps. It takes 2 weeks to get sugars out of the body. Then cravings will be gone. Good foods also lessen the craving. Apples are great, lol. Good health to you.
The diet calls for consuming high amounts of fat, a moderate amount of protein, and a very limited amount of carbs. It’s usually broken down to 75, 20, and 5 percent of your daily calories, respectively, says Pamela Nisevich Bede, RD, a dietitian with Abbott’s EAS Sports Nutrition in Columbus, Ohio. Compare that with the typical American diet — which is usually 50 to 65 percent carbs — and it’s safe to say this is a completely different way of eating, Nisevich Bede says.
The average American eats entirely too much sodium, but on the keto diet, you may struggle to eat enough. “One main concern from a dietary standpoint is an increased risk of dehydration and hyponatremia (low blood sodium), especially when exercising intensely in hot environment,” Fisher says. Low levels of sodium in your body can lead to leg cramps, decreased energy, confusion, and even vomiting. “Add a pinch of salt to every meal,” Dr. Petre says. Sea salt is recommended, as it also provides some traces of minerals. Add a pinch to any one of these 10 keto recipes that are so good they’ll make you forget you’re on a diet.

Ketones are more beneficial to the brain than glucose is.  This is great news for patients with Type 1 Diabetes, because it will not affect the brain function when you are running low in glucose. Ketosis prevent raising blood glucose levels, since you are not introducing large amounts of carbs into your system. They help in stimulating the growth of healthy brain cells.


Other causes of diarrhea on the keto diet include consuming a diet low in fiber (fiber helps ward off diarrhea by bulking up stool) and eating processed low-carb foods like shakes and bars that may contain sugar alcohols. These sugar alcohols can ferment in the gut and cause gastrointestinal discomfort. Yawitz suggests limiting foods labeled “sugar free” if you’re prone to gas or diarrhea when you eat them. And you may want to gradually adjust your carbs downward and your fats upward. “Also build your diet around [naturally] high-fiber, low-carb foods like avocado and nonstarchy vegetables such as broccoli, cauliflower, and asparagus,” she says. Other keto-friendly ways to get more fiber include chia seeds, almonds, and coconut.


According to Dr. Cabeca, “Fasting is a key aspect of a healthy diet and has many anti-aging effects.” In particular Dr. Cabeca recommends fasting to women during or after menopause due to it’s anti-aging effects. For example, a 2016 study published in the Journal of the American Medical Association found that when women went 12.5 hours between dinner and breakfast (a common form of fasting), the overnight fast seemed to help improve immune system functioning to the point that it reduced their risk for breast cancer. (03) 
Work towards cycling fasting days so you’re fasting on 2–3 nonconsecutive days per week (e.g. Tuesday, Thursday and Saturday). Stick to only light exercise or yoga on fasting days to reduce feeling exhausted or hungry, keeping higher intensity activities for your non-fasting days. This approach allows for more dietary and lifestyle “moderation” because the goal isn’t to eat 100 percent “perfectly” all the time. 

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I am a 7 year stroke survivor that is partially paralyzed from the stroke. I work part time and while working I walk at least 2 miles at work three to five times per week, but I can only walk 1 mph if even that speed. Which I know average speed is 3 mph when walking. I am 40 pounds overweight due to not being to do cardio workouts. I take aspirin daily as a blood thinner. I have considered getting on the keto diet. I drink sweet tea and one dr pepper per day along with coffee and water. I talked to my dr about this diet all he could tell me was he hasn’t researched it enough but knew of someone that lost weight on it. For my health I need to maintain a healthy weight and not be overweight. I have a b12 deficiency along with folic acid. I have not been taking any supplements for either.
The backbone of a keto plan is its extraordinarily high fat content, making up 65 to 80 percent of calories daily. Protein—which can raise blood glucose, though not as much as carbohydrate does—makes up 15 to 25 percent of calories on the keto diet. And carbs are even more heavily restricted to just 5 to 15 percent of calories. That’s only about 20 to 50 grams a day (compared with the average 245 grams daily), or the amount in a small apple or a cup of cooked brown rice, respectively.
The keto diet can be an effective way to reduce excess body fat but there are several cons that should be noted by anyone wanting to follow this eating plan, says Ms. Zarabi says. In fact, the keto diet has serious risks. For one thing, it’s high in saturated fat, which has been linked to heart disease. Additionally, a nutrient deficiency and constipation could occur since the keto diet is very low in fibrous foods such as fruits, vegetables, and whole grains.
In the present study, a control population on a low fat diet was not included due to the difficulties in recruiting subjects for a control group. However, several studies (63,64) with appropriate control groups that compared the effect of a low fat diet with a low carbohydrate ketogenic diet have recently been published. In this regard, these two recent studies are comparable with the present study. Brehm et al (23) showed that obese women on a low carbohydrate ketogenic diet lost 8.5 kg over six months compared with 4.2 kg lost by those in the low fat diet group (P<0.001). Twenty-two subjects from the low carbohydrate ketogenic diet and 20 subjects from the low fat diet completed the study, with both groups reducing their energy intake by approximately 450 kcal from the baseline level. In another study performed in 132 severely obese subjects for six months (24), there was greater weight loss in the low carbohydrate ketogenic diet group than in the low fat diet group (5.8 kg versus 1.9 kg, P=0.002). Both of these studies support the findings presented in the present paper.
Many people on a ketogenic diet report sleeping much deeper, says Pamela Ellgen, a personal trainer and author of Sheet Pan Ketogenic. However, during the adjustment period (the first three to five days after you start keto), you may experience insomnia or difficulty staying asleep. This will end once your body adjusts to ketosis and burning stored fat. Then, you may find you’re able to sleep longer, sleep deeper, and feel more relaxed and rested when you wake up. Here are 15 things you need to know before starting the keto diet.
I’m in ketogenesis now – 3 weeks in. Lost over 10kg. Protein shakes. Great. But what I wanted to add was that i’m Diabetic (2) and quite badly so. I was Injecting insulin twice a day – Novomix (part immediate, part slow acting). But since I went into keto, my blood sugar has been steady between 5-9, normal range. No injections needed. And no hypo attacks either – that occurs below a reading of 4, for me. This is NOT a cure of course – it’s directly related to low carb intake. But I do wonder if discontinuing insulin is partly responsible for my improvement in alertness, activity level and so on. Magnesium tabs, 1000 units twice a day, have also been helpful – I suffer leg and foot cramps due to spinal arthritis – but they had worsened until I upped the dose.
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In nature, historically, there were very few ways to store carbs – which were available only for a short time seasonally. The solution to this is that when eating the available fruit in the autumn the sugars switch off the fat burning system and then use insulin to store the sugars as body fat. Carbs signal our body to go into fat storage mode. When the carbs run out then slowly the fat burning more resumes – first of all feeding ketones to the brain and other vital organs and then eventually to the muscles.
In the study, the researchers fed mice a ketogenic diet for several days and expected to find a favorable outcome — perhaps weight loss or another indication of improved health. Instead, they found that the liver began resisting insulin almost immediately and the mice were unable to regulate their blood sugar levels after only three days on the diet. (Insulin resistance, meaning that cells in the body don't respond to insulin, is a key characteristic of type 2 diabetes.)
Familial Hypercholesterolemia. Familial hypercholesterolemia is a condition where one or more of the genes for the LDL receptor are defective, making it more difficult for them to clear cholesterol from the blood. If a person with familial hypercholesterolemia is then put on a high-fat diet, they will become even more vulnerable to heart disease as the increased saturated fat and cholesterol content of the diet provokes higher cholesterol levels. To counteract these genetic vulnerabilities, it is may be best to follow a low to moderate fat diet with plenty of whole foods, fiber, monounsaturated fats, polyunsaturated fats (especially omega 3s), and limited saturated fats. This, as well as a lifestyle that prioritizes physical activity, stress relief practices, and plenty of sleep, should keep their cholesterol levels under control.

These findings were backed up in a 2012 study which had obese diabetics follow a ketogenic diet for 12 months. The researchers found lower fasting glucose levels, improved cholesterol markers and improved HA1c readings. Remember, carbs and glucose are not required when on a ketogenic diet, as stable, clean burning energy is sourced from fat. This makes controlling blood sugar levels near foolproof.
No Pete, this is not true. What you have mentioned is based on the seven country epidemiological study done by Ancel Keys in the 1970s. This entire study was based on flawed science. Ancel Keys cherry picked the data that supported his argument for the foundation for his hypothesis. Although this hypothesis was never backed by scientific evidence the mainstream medical system took it as gospel in creating standards for the health professionals.
The good news here is no! All the evidence points to the fact that a low carbohydrate diet actually does lower blood glucose and A1c levels and does contribute to weight loss. The problem is we do not yet have enough large studies, over enough sustained years to support evidence that people with diabetes can remain on a highly restrictive Ketogenic Diet for the rest of their life and also not have other consequences to their health.

I am sorry you had this experience. I feel that this educator was not giving you good advice. All my women who want to lose weight are recommended to consume 30 grams of good carbohydrates at each meal, and 15 at each snack. If you were not trying to lose weight, I would have recommended 45. I find this is all it usually takes to begin to lose some weight as you start to get active. Patients set their own goals with motivational help from their Certified Diabetes Educator. Our intent is never to insult, and you should not have gone through that. It sounds that you have now found the right path. There are many CDEs who could help you, so see what tools and motivation others may offer. I wouldn’t let one bad apple spoil the whole bunch. Many CDEs are also diabetic.


Keto flu symptoms and side effects can include feeling tired, having difficulty sleeping, digestive issues like constipation, weakness during workouts, being moody, losing libido and having bad breath. Fortunately, these side effects don’t affect everyone and often only last for 1–2 weeks. (And yes, you CAN build muscle on keto.) Overall, symptoms go away as your body adjusts to being in ketosis.
Ketosis and fasting also activates an anti-aging cellular cleanup process called autophagy (auto = self, phagy = eat). Autophagy is when a cell eats its own defective parts in order to recycle nutrients and keep the different parts functioning like new. In addition, autophagy can protect against neurodegenerative diseases, viral and bacteria infections, and cancers.

I’ve been there and have tried the Ketogenic Diet. It’s very difficult even though I am a very determined and goal oriented person. When I set my mind up to do something, I will normally achieve it because I am just so stubborn about personal goals that I don’t give up until I do! Yes, you will lose a lot of weight quickly, but I am not interested in giving up bread, pasta and birthday cake for the rest of my life.

I think what bothered me most about the article was the way in which the writer has put her own fears about living without cake onto the shoulders of any diabetic she might treat. In the same way an epileptic might choose a life without cake in order to remain seizure free I choose a life without cake to remain “undiabetic”. I must admit that when I was researching this diet I did worry that I would not have the stamina, but the thought of going blind is a useful motivator.
With the high intake of fat, are we concerned about the high intake of cholesterol? YEP. A study using the keto diet as a form of treatment for epileptic seizures in children found that after 6 months of administering the diet, triglyceride levels increased, total cholesterol levels increased, and HDL and LDL increased. These results suggest that over time, a keto diet may lead to an increased risk of hypercholesterolemia and hypertriglyceridemia. In the same ten-year study, 40% of patients developed hypertriglyceridemia and 29% of patients experienced hypercholesterolemia. So, if heart disease runs in your family, you may want to bow out now.
Since carbohydrates do increase insulin and insulin is a storage hormone many people have made large leaps of logic to point the finger at carbohydrates as the primary cause of fat gain and obesity as opposed to overall caloric intake. They also point out that in a keto diet, carbohydrates are not being used as fuel hardly at all whereas fats become the primary fuel.
Try to be patient. Although some people get into ketosis relatively quickly, it can take others a while. Unfortunately, people who are insulin resistant often have a longer journey. Put in a solid month of consistent keto eating, and try to ramp up your physical activity, if possible. Within four weeks, you should definitely be in ketosis and experiencing its benefits.

We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.
The keto diet is an extremely effective way to lose weight over a short period of time—even better, according to some research, than low-calorie and low-fat diets. There a few reasons for this: When you’re in ketosis, your body stores less fat. Dieters feel fuller for longer, partly because of the rich food they’re eating, and partly because ketosis changes your hunger hormone levels.
Every day, you will notice how simple my methods are and how the secret fat burning meal plans will speed up the fat burning process even while you rest at night. Not everyone is the same, but after the first week with the 3-Week Ketogenic Diet, most people experience one or more of the following… more energy, 5lbs lighter, joint relief, self-motivation, happiness, and a positive change in their physiological states. After 3-weeks many people have anywhere from 3-9 pounds weight loss and 7-17 inches off their waist, hips, chest, and triceps.

Once the medical community acknowledged the keto diet’s effectiveness in reducing seizure episodes, they decided to look further and study its impact on neurological diseases in general. Neurological diseases share a common problem – a deficiency in energy production. Ketones provide that energy for normal brain cell metabolism, and may even be a more efficient   when the body is in starvation mode. When patients were put on the keto diet, the number of mitochondria (energy powerhouse) in brain cells increased. Ketones may also act as an antioxidant by inhibiting the formation of reactive oxidant species, which is why they may have promising effects in the treatment of certain cancers in conjunction with chemotherapy.
But beyond that, experts aren't convinced that the keto diet has any other scientifically-proven health benefits. In fact, it may have some distinct downsides. If you follow the keto diet incorrectly, for example (like by eating lots of saturated fats, versus healthy unsaturated fats), you're at risk of raising your cholesterol levels. “The best strategy to keep your heart healthy is to get as much fat as possible from unsaturated sources such as olive, avocado and canola oils, nuts, seeds, avocados, and olives," says Ansel.

“constant keto supposedly caused selenium deficiency and stunted growth in epileptic kids on keto diets. As I previously commented large areas of North America & Western Europe have Se-deficient soils with the notable exception of the NA grain-growing regions. Consequently the major source of Se in the SAD is grains and deficiency is a result of eliminating the grains on a Keto or WB diet. Opponents could just as easily use Se-deficiency as an argument against WB. The solution is not eating grains it’s taking a supplement.

What are the side effects of the ketogenic diet?  It’s not uncommon for people beginning the keto diet to experience “keto flu” symptoms, which can include: irritability, cravings, menstruation issues in women, constipation, fatigue, headaches and poor exercise performance. These side effects are due to the body going through major metabolic shifts and essentially withdrawing from carbs and sugar.
In the present study, 83 obese patients (39 men and 44 women) with a body mass index greater than 35 kg/m2, and high glucose and cholesterol levels were selected. The body weight, body mass index, total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, fasting blood sugar, urea and creatinine levels were determined before and after the administration of the ketogenic diet. Changes in these parameters were monitored after eight, 16 and 24 weeks of treatment.
And what benefit you will have with “moderate” diets that let you eat bread and others carbohydrates but high insulin ? remember that it is critical to not only look after glucose levels on blood, it is very very important to reduce your intake of insulin to avoid a lot of diseases including metabolic syndrome for high insulin and insulin resistance.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
According to Dr. Cabeca, “Fasting is a key aspect of a healthy diet and has many anti-aging effects.” In particular Dr. Cabeca recommends fasting to women during or after menopause due to it’s anti-aging effects. For example, a 2016 study published in the Journal of the American Medical Association found that when women went 12.5 hours between dinner and breakfast (a common form of fasting), the overnight fast seemed to help improve immune system functioning to the point that it reduced their risk for breast cancer. (03) 

I would just like to share with you that my patients are HORRIFIED if their physicians ask them to cut out “everything white” in their diet. This is what some doctors ask for…essentially asking for the Ketogenic diet and most of my patients are in shock! Not only would I never want to skip a year of my birthday cake, but I wouldn’t ask my patients to either! One slice of cake is certainly not going to harm anyone with diabetes and hopefully you know enough about carbohydrates and their short term effect on BG levels to know this too! I am not a Registered Dietitian, so I couldn’t speak to this diet in regard to children with epilepsy. Are you a Neuro RN? TheDiabetesCouncil did just post another article where 25 Registered Dieticians weighed in regarding the Ketogenic Diet, so I would encourage you all to check that out!
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