We recently published an article documenting the grim long-term effects of low-carbohydrate diets, in which we explain the evidence-based research showing that low-carbohydrate diets high in fat and protein including meat, dairy products, eggs, fish, and oil actually worsen diabetes health, increase cancer risk, increase cholesterol, increase atherosclerosis, harden blood vessels, and increase all-cause mortality.

Type 2 diabetes is a metabolic disorder resulting from many things, with the greatest risk factors being weight, lifestyle and dietary habits contributing to its onset. Since the disease typically starts with a sedentary lifestyle paired with a poor diet, it makes sense to approach treatment with lifestyle changes. One effective strategy is adopting a ketogenic diet, a diet that’s proven to stabilize blood glucose and promote weight loss.
Thank you for this comment. It is truth! I keep telling people about this diet. It is literally the best diet I have ever been on. I can eat good food, I feel full, my weight is dropping, I feel better and I can actually feel the difference. While it is great for a professional to be skeptical of emerging diet trends (and lets face it, most diet trends are garbage peddled by snake oil salesmen), this one actually has science from some prestigious institutions behind it, not a marketing scheme.
A growing body of research is finding that behind many psychiatric and neurological issues — such as bipolar disorder, epilepsy, migraine — are malfunctions in the work of sodium, potassium and calcium ion channels in brain neurons, which pass the electric charge between nerve cells. As noted above, two thirds of the brain’s energy is used to help nerve cells “fire,” or send signals between cells. Another nerve cell signaling chemical (neurotransmitter), called GABA (Gamma-aminobutyric acid) has also been found to be disordered in bipolar, epilepsy and schizophrenia. A 2017 genetic study also found common genetic and biochemical pathways between bipolar disorder and epilepsy that create “excessive circuit sensitivity” in the neurons of both conditions.
At the core of the classic keto diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb intake, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).

The low-carb, high-fat approach to the keto diet limits the types of foods you can have, and entire food groups are eliminated entirely. Beans, legumes, and whole grains are out, as are many fruits and vegetables. Many of these foods carry vitamins, minerals, and other nutrients you can’t get from any other source, and without them, you may start to experience nutritional deficiencies.
Mastering Diabetes: Studies conducted in tens of thousands of people over 5+ years indicate that low-carbohydrate diets increase your risk for cardiovascular disease, hemorrhagic stroke, hypertension, atherosclerosis, diabetes mortality, obesity, cancer, and all-cause mortality (premature death). No matter how you slice it, low-carbohydrate diets trick patients and doctors into believing that ketosis is an excellent long-term dietary strategy, when in reality the consequences can be disastrous.
Yancy has seen similar results in his practice. “Carbohydrate intake is the main driver of blood sugar. So if you’re able to lower blood sugar by reducing carbohydrate intake, then you may be able to reduce diabetes medication,” he says. “We’ve seen people come off of hundreds of units of insulin just by changing the way they eat, and that can happen really quickly, in just a few weeks.”
This was very confusing and disappointing to read from Dr. D. Wheatbelly IS ketogenic. In fact, I got kidney stones while following it, along with some other weird symptoms like hair loss and very cold hands and feet. Granted I was probably dehydrated and lacking in some nutrients……but still. I never had those issues while following SAD. On SAD I never worried about drinking enough water or whether I was getting the right scientifically controlled combination of vitamins, minerals, pro/pre biotics. Never had to eat a raw potato or, dear God, a hard, chalky, green banana (who can do that for life? No one). I never got a kidney stone (or the other mentioned symptoms) on SAD. And they all went away when I stopped doing Wheatbelly. Very disappointing because I was losing weight on Wheatbelly and have gained it all back. Anyway, the diets are very similar. If you restrict carbs the way Dr. D says you should…. for life, you will be in ketosis long term.
The keto diet restricts carbs so much that anyone who is on blood sugar lower medication or who has type 1 or type 2 diabetes must consult his or her doctor before making such a severe dietary change. As the body adapts to low-carb dieting, medication dosages and treatment plans will have to be revised, and blood sugar levels must be carefully monitored.
If not treated or reversed, dehydration can lead to acute kidney injury, Dr. Rahnama says. That’s not the only way the keto diet can put your kidneys at risk, however. “Kidney stones or damage to the kidney may also be a side effect,” Grace Derocha, RD, a certified diabetes educator and certified health coach at Blue Cross Blue Shield of Michigan says. High levels of nitrogen created by excess protein can also increase pressure in your kidneys. This can lead to the formation of more stones and damage your kidney cells.

🙌🙌 thank you for some great info! USC just had an article about Keto, saying they don’t know the impact on bone health. So I’m not sure why all these articles are written without the documentation to prove the claims. We all know too much calcium supplementation can cause problems but every Dr wants you to supplement calcium. Most people could do a lot worse than doing Keto! The SAD will cause more problems for you than eating whole, unprocessed Keto food! Sugar seems to be the real issue along with aspartame and stressful living.

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.


That’s why many health experts are concerned about people on the keto diet, especially those who try it without the guidance of a doctor or nutritionist. Doctors say that high-fat diets like this one may raise cholesterol levels, and some studies suggest that they increase the risk of diabetes. Some have even called it a “cardiologist’s nightmare.”

That doesn’t mean keto causes diabetes; it’s amazing for most diabetics. However, if your cells are great at processing fat, but suck at processing glucose or carbohydrates, you won’t be able to run at full power, and parts of your body that prefer glucose over fat — like the glial cells in your brain that handle immune function and synaptic pruning — don’t work as well over time.
Atherosclerosis starts with the weakening of arterial wall, to the point that it tears (this tear usually happens due to scurvy caused by high sugar consumption and the subsequent vitamin C deficiency). Once the integrity of the arterial wall is compromised cholesterol is used by human body to heal and patch the tear. That starts the process of numerous circulatory diseases including hypertension, atherosclerosis and heart disease.
This rule eliminates your ability to eat many fruits and vegetables, as many of them contain natural carbs. A diet low in fruits and vegetables can put you at risk for certain vitamin and mineral deficiencies. It can also lead to your body not getting enough fiber, a type of carbohydrate often found in fruits, vegetables, and legumes. Without adequate fiber intake, you might experience constipation and be at risk for certain diseases.
Great article Doc! Question: One of the world top experts in high fat low carb diet, Dr Tim Noakes has stated that top level athletes actually perform better on keto, as himself an extreme marathoner , cured his type 2 diabetes by going keto. In the light of what we know today about keto, would you still assert that athletes shouldn’t adopt ketosis as their desired state?
So yes, the ketogenic diet is safe for diabetics. However, they still need to be closely monitored because diabetes medications including insulin, blood pressure, and beta blockers will have to be adjusted down when following a ketogenic diet. Therefore, the diabetic should do this with supervision from a doctor who is up to date with the nutritional literature.
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