“What many diabetics aren’t aware of, is that it is the fat that is the problem when it comes to type 2 diabetes. Nearly 100 years ago, healthy volunteers were split into two groups – half were fed a fat-rich diet, and the other half on a carb-rich diet. Within just two days, the fatty diet groups’ glucose intolerance skyrocketed to amounts twice as high as those fed a carbohydrate-rich diet (9).
Alison Moodie is a health reporter based in Los Angeles. She has written for numerous outlets including Newsweek, Agence France-Presse, The Daily Mail and HuffPost. For years she covered sustainable business for The Guardian. She holds a master’s degree from Columbia University’s Graduate School of Journalism, where she majored in TV news. When she's not working she's doting on her two kids and whipping up Bulletproof-inspired dishes in her kitchen.

To avoid the overload of stress, I find my relief by being the person at the origin of my son’s quality of life. I am not a doctor, a pharmacist, or a research person. I am just Max’s mother. For almost 15 years I have been using food to treat the adverse side effects of his syndrome. Angelman Syndrome (AS) is one of many neurological disorders that can be treated with therapeutic diets.
The key of these miraculous healing effects relies on the fact that fat metabolism and its generation of ketone bodies (beta-hydroxybutyrate and acetoacetate) by the liver can only occur within the mitochondrion, leaving chemicals within the cell but outside the mitochondria readily available to stimulate powerful anti-inflammatory antioxidants. The status of our mitochondria is the ultimate key for optimal health and while it is true that some of us might need extra support in the form of nutritional supplementation to heal these much needed energy factories, the diet still remains the ultimate key for a proper balance.”
I’m desperate to find some answers~I have no history of sensitivity to anything, no allergies. I understand allergies can happen at any time. I started the Keto diet and in a one month time I had four separate episodes of my tongue swelling~each episode worse than the one before. I LOVED this diet~felt great, handled it with ease. The last episode almost put me in the hospital~my tongue was so swollen it was coming out of my mouth making it difficult to swollen and breath. I had no choice but to narrow it down to Ketosis. All the foods were the same that I have eaten all my life. No new meds. The last episode I took 2 Benadryl and pulled myself out of Ketosis with consuming a Dr.Pepper, and 2 pieces of white toast. I was terrified. Everyone on Facebook in all these Keto sites tell me it has nothing to do with Ketosis….but I’ve tried literally everything I consumed when a was on that WOE and I’ve had no reaction in days. My body feels horrible, I have no energy, my entire body aches. I want back on the Keto diet because my body was responding really well to it~except for my tongue.
Recently, four studies have re-examined the effect of carbohydrate restriction on type 2 diabetes. One outpatient study enrolled 54 participants with type 2 diabetes (out of 132 total participants) and found that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet [5,6]. Another study enrolled 8 men with type 2 diabetes in a 5-week crossover outpatient feeding study that tested similar diets [7]. The participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. The third study was an inpatient feeding study in 10 participants with type 2 diabetes [8]. After only 14 days, hemoglobin A1c improved from 7.3% to 6.8%. In the fourth study, 16 participants with type 2 diabetes who followed a 20% carbohydrate diet had improvement of hemoglobin A1c from 8.0% to 6.6% over 24 weeks [9]. Only these latter three studies targeted glycemic control as a goal, and two of these were intensely-monitored efficacy studies in which all food was provided to participants for the duration of the study [7,8]. Three of the studies [6,8,9] mentioned that diabetic medications were adjusted but only one of them provided detailed information regarding these adjustments [9]. This information is critical for patients on medication for diabetes who initiate a low-carbohydrate diet because of the potential for adverse effects resulting from hypoglycemia.

This means that instead of generating tons of ketones from the very beginning, most people experience hypoglycemia for a period of time. With hypoglycemia comes a disruption in cortisol signaling which is what accounts for the HPA axis dysfunction. Finally, HPA axis dysfunction leads to an increase in secretion of minerals from the body in the urine.

Not only cells that use glucose as fuel become insulin resistant but also chronically inflamed fat cells. When they become insulin resistant, they take up fewer circulating lipids despite high insulin levels. Insulin resistance also increases the release of free fatty acids from fat storage. Free fatty acids in the blood reduce the glucose uptake into muscle cells and further contribute to insulin resistance.


Tammy, just because someone follows a keto diet doesn’t mean they can’t have their sweet treats. There are dozens of websites with hundreds of keto sweet treats and “fat bombs” made with stevia or other natural non-caloric sweeteners which will not raise blood sugars. One of my favorites is Keto Mocha Mousse https://www.ruled.me/keto-mocha-mousse/ which has 5 g net carbs per servings. We don’t have to be deprived on keto.

Several recent studies indicate that a low-carbohydrate diet is effective at improving glycemia. A few studies have shown that in non-diabetic individuals, low-carbohydrate diets were more effective than higher carbohydrate diets at improving fasting serum glucose [13,14] and insulin [6,14-16], and at improving insulin sensitivity as measured by the homeostasis model [6]. One of these studies also included diabetic patients and noted a comparative improvement in hemoglobin A1c after 6 months (low fat diet: 0.0 ± 1.0%; low carbohydrate diet: -0.6 ± 1.2%, p = 0.06) [6] and 12 months (low fat diet: -0.1 ± 1.6%; low carbohydrate diet: -0.7 ± 1.0%, p = 0.019) duration [5]. In a 5-week crossover feeding study, 8 men with type 2 diabetes had greater improvement in fasting glucose, 24-hour glucose area-under-the-curve (AUC), 24-hour insulin AUC, and glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet [7]. In a 14-day inpatient feeding study, 10 participants with type 2 diabetes experienced improvements in hemoglobin A1c and insulin sensitivity as measured by the euglycemic hyperinsulinemic clamp method [8]. Hemoglobin A1c also improved in an outpatient study of 16 participants who followed a 20% carbohydrate diet for 24 weeks [9].

It is now evident that high carbohydrate diets increase fasting plasma triglyceride concentrations (47–51) and decrease HDL cholesterol concentrations (52–55). These changes are associated with enhanced atherogenesis (55). However, it has been shown that short-term ketogenic diets improve the lipid disorders that are characteristic of atherogenic dyslipidemia (56). It has also been found that sugary drinks decreased blood levels of vitamin E, thus reducing the amount of antioxidants in the body. It has been proven, beyond a doubt, that disrupting the oxidant-antioxidant status of the cell will lead to various diseases of the body (57).
Nutritionists frequently advise clients to reach for more healthy fats and protein to stay full throughout the day. With this in mind, it makes perfect sense that a ketogenic diet would be about as good as it gets for staying satiated. One study from the American Journal of Clinical Nutrition found this type of low-carb approach was more effective for weight loss and managing hunger than a similar high-protein diet with a greater percentage of carbohydrates. One 2013 study even suggested the eating plan may suppress hunger hormones more effectively than other weight-loss programs.
Well… what are many people on a Keto diet trying to do? Lose weight right?  I would guess that prior to discovering the Keto diet many of these people were caught in the trap of low fat dieting.  This lead to months or years of low fat intake and consequentially low gallbladder activity.  The gallbladder wasn’t needed to digest fat and so it sat idle and stones were more likely to form.  Once they made the shift to a ketogenic lifestyle and their fat consumption increased upwards of 1000%, the gallbladder kicked into high gear.  If the previous period of low fat dieting had caused stone formation they are going to have to deal with flushing those stones out now while on a high fat Keto diet.
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.
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’
Ketosis Isn’t Forever.  It’s recommended that you follow this diet to arrive at a state in which your body adapts to burning fat and glucose stores for fuel. Then you’ll want to take an occasional ketosis holiday, adding a serving of unprocessed, whole grains to allow your body to chance to work less hard. Staying in ketosis long-term—without breaks— can cause muscle aches, nausea, and fatigue.

I am confused by this statement, as there are many wonderful “white” substitutions that taste great, and don’t make me feel like i am missing out. One of the things I thought I was just going to die if I couldn’t ever have it again, was waffles with peanut butter & maple syrup. Guess what….there is a sub for that! I am T2D, and my doctor, who specializes in diabetes, told me to stop eating sugar, carbs and she said that in a perfect world, I would stop eating fruit, as it contains sugar. That’s when I found Keto, on my own. I’ve been on it for a little over a month or so, and have lost 12lbs, but more importantly, BS levels that were averaging in the 200’s are now lower than the 90’s, consistently… The highest number I’ve tested was 97, after I ate dinner & had a satisfying bowl of Keto ice cream. I’ve been diagnosed Diabetic for approx 4yrs, but am certain I was diabetic for probably 3 yrs prior to that. I’m not over weight, and did not have the hope of “losing weight and getting off meds”. This has been my answer, and I truly think that if we did live in a perfect world, more things like this would be taught to those of us who need better choices than medications. There are so many other things in the world that are suppressed due to greed of Big Pharma & Government. Let’s start helping our fellow man be healthy & heal….

They focus on what to eat instead of what not to eat, according to Dr. J. Michael Gonzalez-Campoy, medical director and CEO of the Minnesota Center for Obesity, Metabolism, and Endocrinology, who worked on healthy eating guidelines with the American Association of Clinical Endocrinologists, the American College of Endocrinology, and The Obesity Society.
I suggest you or other readers who are not familiar with Dr Wahl's work and research into autoimmune disease and brain biology get a copy of 'The Wahl's Protocol'. Medicine and nutrition are ever-changing sciences and sadly we can't rely on our standard medical practioners (or registered dieticians) to share important research we should all be able to access.

Now, I know what you are going to say, “I can take a break from the diet anytime.” What do you think happens when you take that “break”? As soon as you start consuming a normal amount of carbohydrates again, you immediately go out of ketosis or the fat burning state, and your body starts storing fat again immediately. In other words, you immediately start gaining weight. So whatever weight you lost on the diet, you gain back right away. How healthy do you think it is for your body to be in a starvation mode, then in a feeding frenzy, making up for lost time?

Oh how I miss you, delicious high-fat smoothie 😫 🌿🌱🍃Day 15 on carnivore and I am feeling quite amazing though! 🥩 ~ UPDATE: I don’t have “recipes” I make food to taste but if I recall this was something like: -a handful of blueberries -half a carton of coconut milk -macadamia nuts -a couple glugs of @perfectketones MCT oil -some chunks of cacao butter -some chunks of coconut butter -half avocado -spinach, kale, cabbage -some ice and maybe a little water to get consistency right MUST use a badass blender (I use blendtec) -toppings: you can see them. Put what you like to eat on top.
The data presented in the present study showed that a ketogenic diet acted as a natural therapy for weight reduction in obese patients. This is a unique study monitoring the effect of a ketogenic diet for 24 weeks. There was a significant decrease in the level of triglycerides, total cholesterol, LDL cholesterol and glucose, and a significant increase in the level of HDL cholesterol in the patients. The side effects of drugs commonly used for the reduction of body weight in such patients were not observed in patients who were on the ketogenic diet. Therefore, these results indicate that the administration of a ketogenic diet for a relatively long period of time is safe. Further studies elucidating the molecular mechanisms of a ketogenic diet are in progress in our laboratory. These studies will open new avenues into the potential therapeutic uses of a ketogenic diet and ketone bodies.
Great article! Sustainability is key and Keto diet is extremely restrictive compared to others. Many of the comments I see don’t understand the importance of many years of research before stating something has a “significant difference” than the recommendations that are already in place. Also, understanding the pro/carb/fat balance in each meal instead of focusing on just carbohydrates. We have practiced the same modified Mediterranean diet at my practice where someone can enjoy life, eat complex carbohydrates and years later they are still successful and hundreds of pounds have been lost for good 🙂 Thank you for the reminder (and the comparison of Adkins supported research).

"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.


Is a keto diet good for type 2 diabetes? The keto diet can be very helpful for type 2 diabetes since the body is now using fat rather than carbohydrates as its main source of fuel. This way of eating decreases the body’s demand for insulin and helps to keep blood glucose levels at a low yet healthy level. If you’re a type 2 diabetic who takes insulin, then you may likely need less insulin as a result of following the ketogenic diet.

Researchers believe that the ketogenic diet can also help patients with schizophrenia to normalize the pathophysiological processes that are causing symptoms like delusions, hallucinations, lack of restraint and unpredictable behavior. One study found that the keto diet lead to elevated concentrations of kynurenic acid (KYNA) in the hippocampus and striatum, which promotes neuroactive activity. Some studies even point to the elimination of gluten as a possible reason for improved symptoms, as researchers observed that patients with schizophrenia tended to eat more carbohydrates immediately before a psychotic episode. (19) 

This upregulation is actually responsible for the anticonvulsant benefits in patients with epilepsy, and, likely, the benefits seen in other brain disorders with glucose uptake problems. By providing an alternate source of brain power, brains that don’t run so well on glucose can begin burning fat. There’s no indication that ketosis only induces mitochondrial biogenesis in “unhealthy” brains. It simply hasn’t been studied yet, but I don’t see why it wouldn’t also build mitochondria in healthy brains.
After seeing thousands of patients now for years and from personal experience, I still believe it comes down to staying away from processed foods and cooking at home whenever possible. Eating a variety of fresh fruits, vegetables, proteins, and fiber. Also, cutting out any sugary liquid calories; staying away from sodas, juices and the infamous sweet tea! Keeping stress levels under control and incorporating exercise into your routine will also be key to breaking through challenging times when you are having trouble with continued weight loss.
But more than that, people just don’t like giving up carbs. Dr. Kevin Fontaine, a Professor of Health Behavior at the University of Alabama at Birmingham School of Public Health and an expert on the ketogenic diet points to this as one of the main drawbacks of the diet. “Many people find it very difficult to give up carbs, and may be unwilling to do it. Plus, if you’re on the diet and eat a few carbs, you feel physically terrible. It’s hard to stick with this diet, especially while traveling.”
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.
Multiple sclerosis diet tips Multiple sclerosis (MS) is a chronic condition that can lead to weakness and memory loss, among other symptoms. Some studies suggest that making dietary changes may help boost a healthy gut flora, which could improve symptoms. Find out more about which foods to eat and which to avoid, and get some lifestyle tips, too. Read now
To understand what the keto diet is, you have to understand a little about how your body generates and uses energy for daily activity. All day, every day, your body undertakes a series of chemical processes (together referred to as metabolism) to break down and use a combination of carbohydrates and fats to produce energy. The energy produced is used for everything -- from breathing to brushing your teeth to running to catch a taxi. Your body is burning fuel constantly just to sustain basic life function. And while your body is always burning a combination of fats and carbohydrates, your brain’s primary fuel source is carbohydrates… and your brain requires a surprising amount of energy to get you through each day.
Additionally, you may find it difficult to eat adequate calories on a daily basis because fat is so filling. Some people even opt to fast for several hours each day. While this may help with weight loss, your body needs those calories for proper maintenance. Without them, it may turn to burning muscle for energy, and that can accelerate muscle loss.
Often these children who have trouble gaining *don’t feel good* when eating, so they aren’t interested in eating much.  In the case of underweight children who crave refined carbs, the dopamine hit they get from eating the simple sugars may override enough of the discomfort of eating, making these nutrient-void foods the only ones they accept.  In addition, if their gut flora is off balance, the gut flora may be sending signals to the brain to keep consuming simple starches and sugars.
Brain fog and a lack of focus can be caused by having too much glutamate and very little GABA. This will happen if your brain has to use glutamate and glutamic acid for fuel, which leaves little left over to be processed into GABA. By giving the brain another form of energy when you break down ketones, you’re able to balance out the neurotransmitter production.
Although many people find that their energy and stamina improve on a keto lifestyle, trying to do too much in the early stages can worsen keto flu symptoms. Well-known ketogenic researcher Dr. Steve Phinney has conducted studies in endurance athletes as well as obese individuals demonstrating that physical performance decreases during the first week of very-low-carb eating. Fortunately, his research also shows that by week 4, people typically perform better than before they started keto.
Traditionally, in the sports nutrition field, we talk about the importance of timing carbohydrate and fluid intake on improving sports performance. For some time now, research has been looking at the role of very low carbohydrate diets on sports performance. Trailblazers in keto and sports performance research like Dr. Stephen Phinney have been conducting studies in this area since the 80s. In one of his studies, the glycogen stores of cyclists on a keto diet were not completely depleted and lipid oxidation was increased. Researchers concluded that the body was able to adapt to the lack of carbohydrates and preserve what was needed to use the fat as fuel.  However, based on the VO2 max breath test, since the body was attempting to preserve the carbohydrate during the exercise, it appears that the intensity of the exercise was limited. In a more recent study, off-road cyclists following a keto diet experienced small improvements, but still not significant enough to make strong conclusions.
Unfortunately I think Dr. D has too much of a vested interest in distinguishing WB from Keto diet when they actually overlap quite a bit. Especially people practicing keto for overall health, not just weight loss. Having said that, more studies are needed to monitor side effects of keto diets in adults, and it is good to keep in mind that there could be unintended side effects from low carb diets. Fortunately most can be prevented by being aware of them, adjusting to have a well-rounded low carb diet, and taking supplements.
I am confused by this statement, as there are many wonderful “white” substitutions that taste great, and don’t make me feel like i am missing out. One of the things I thought I was just going to die if I couldn’t ever have it again, was waffles with peanut butter & maple syrup. Guess what….there is a sub for that! I am T2D, and my doctor, who specializes in diabetes, told me to stop eating sugar, carbs and she said that in a perfect world, I would stop eating fruit, as it contains sugar. That’s when I found Keto, on my own. I’ve been on it for a little over a month or so, and have lost 12lbs, but more importantly, BS levels that were averaging in the 200’s are now lower than the 90’s, consistently… The highest number I’ve tested was 97, after I ate dinner & had a satisfying bowl of Keto ice cream. I’ve been diagnosed Diabetic for approx 4yrs, but am certain I was diabetic for probably 3 yrs prior to that. I’m not over weight, and did not have the hope of “losing weight and getting off meds”. This has been my answer, and I truly think that if we did live in a perfect world, more things like this would be taught to those of us who need better choices than medications. There are so many other things in the world that are suppressed due to greed of Big Pharma & Government. Let’s start helping our fellow man be healthy & heal….
The keto diet involves a very high consumption of dietary fats, and very low carbohydrate consumption. Through these nutritional changes, the body reduces its use of glucose for fuel, and increasingly uses ketones (derived from fats). The diet was first used to control epileptic seizures, but there is growing body of research showing positive effects on Alzheimer’s disease, Parkinson’s disease, traumatic brain injury, inflammation1, and diabetes.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Type 1 diabetes causes the same blood sugar control issues as type 2 diabetes, but in an entirely different way. Type 1 diabetics cannot produce enough insulin or any insulin at all, which requires them to have insulin administered exogenously. On top of that, the perfect diet will not be able to reverse this disease as the ketogenic diet can for type 2 diabetes.
Type 2 diabetes is normally defined as a chronic and progressive condition resulting from the insufficient production of natural insulin, causing high blood sugar in many patients. Upon receiving an official diagnosis, most patients are told they will need to take medication for life and that there is no cure for diabetes. However, many scientists, clinicians and dieticians disagree with this prognosis, claiming that diets such as the ketogenic (keto) diet have the potential to support the reversal of Type 2 diabetes.
7. I should mention ALL my health markers have DRASTICALLY improved including cholesterol and inflammation markers? My fatty liver is resolving and my cardio markers are perfect! The study where you cited there were not significant changed in diabetes markers in two months, well it takes longer! Check it out at 6 and 8 months. Most people will show a VERY different story than what you are reporting!
To avoid the overload of stress, I find my relief by being the person at the origin of my son’s quality of life. I am not a doctor, a pharmacist, or a research person. I am just Max’s mother. For almost 15 years I have been using food to treat the adverse side effects of his syndrome. Angelman Syndrome (AS) is one of many neurological disorders that can be treated with therapeutic diets.
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.
Low carb, high fat diets have been used for centuries by doctors when working with obese patients. William Banting published the widely popular booklet titled ‘Letter on Corpulence Addressed to the Public’ in 1863. In this booklet he explained how he had slimmed down by eating a diet high in fat void of carbs. The Banting diet was used for decades by individuals looking to lose weight.

Since the state of ketosis forces cells to rely on ketones and to use the mitochondria for energy, ketosis feeds healthy cells while starving cancer cells. This especially seems to be true against some of the most deadly and incurable cancers. Researchers like Dr. Dom D’Agostino are also researching the role of ketosis and fasting in improving the outcomes and reducing the side effects of existing cancer treatments.
The keto diet is known for helping people lose a few pounds very quickly, says Becky Kerkenbush, RD, a clinical dietitian at Watertown Regional Medical Center. Carbs hold on to more water than protein or fat, so when you stop eating them, your body releases all that extra H2O by making you pee more. As a result, the scale might read a few pounds lower, and you may look a bit leaner.
In a recent study in the Journal of Sports Medicine and Physical Fitness, Weiss and his colleagues found that participants performed worse on high-intensity cycling and running tasks after four days on a ketogenic diet, compared to those who’d spent four days on a high-carb diet. Weiss says that the body is in a more acidic state when it’s in ketosis, which may limit its ability to perform at peak levels.
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.

Insulin allows sugar in our blood to enter our cells. When insulin attaches to the insulin receptor, it activates a series of enzymatic reactions, which ends with active glucose transport (a gateway for glucose to enter the cell). If our insulin receptors are covered in fat, we end up with high blood sugar, because insulin can’t enter our cells. This is called insulin resistance. This fat is called intramyocellular lipid, or fat inside our muscle cells (10).

In Europe and in North America the impact of mental illness on the individual and society is enormous. Each year, one in five people will be impacted by a mental health condition and over the course of a lifetime, almost one in three (29%). Since 2005 the rate of depression alone has increased 18%, now impacting 322 million people globally and the number one cause of disability in the world. 
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.
At some point, the pancreas is literally burned out and can’t produce enough insulin to keep even basic blood sugar under control, let alone after a high-carb meal. This state is end-stage of type 2 diabetes where insulin injections become necessary [7]. Type 2 diabetics do not produce less insulin than normal, but the insulin resistance increases the need for insulin. A diabetic pancreas is eventually unable to supply this increased demand.
You are so biased against Keto, this can be noticed very quickly because almost every positive thing you say about Keto, you immediately follow with a “but…” negative statement. And most of your negatives are simply saying it’s hard to maintain. You completely exaggerate the negatives “If you have one bad day and your body is kicked out of Ketosis, you immediately gain all of your weight back”. That is simply not true; if someone is on a Keto diet for 3 months, they will not gain that weight back in a day. Also, their body will be back into Ketosis the next morning. You say that the ADA doesn’t recommend 60-70 grams per meal, but it does (coincidentally I just left their website before coming here). I don’t claim to be a Diabetes expert; I admit that. But your bias is leaning heavily against Keto. “Moderation” is not your goal if you have diabetes. When you compare HbA1C levels, for example, you compare them with someone in Keto at less than 20 g of Carbs per day as compared to someone at a 70-90 gram of carbs per day diet. You should be fair and compare them with someone on a 200 g of Carbs diet. If you want to get rid of the effects of Diabetes, get on a Keto Diet, period. It MAY get rid of the effects completely, but in the very least it WILL reduce your Insulin needs to very low and you’ll have little-to-no side effects other than a relatively restrictive diet (most diets are WAY more restrictive than Keto). You back up everything with “science” and misleading numbers/arguments without providing any real evidence.
My point here is that the warnings about the ketogenic principles are well taken and well documented. My concern is implications that this is a fad. I don’t use the word diet with my patients and I’m concerned that the principles behind the label and the real results that these readers have commented on might get minimized. I have found it best to encourage patients to read authors like: Stephen Phinney, Jeff Volek, Patricia Daly, and Charles Gant and the be partners with their doctors and check blood work as they move along. I am not for or against the article. If ketogenic principles offer people enduring, satisfying, and cohesive change then why not read about its potential and flexilbity?
If you do try the diet outside of medical supervision, Kizer says it’s important to test your urine with urinalysis ketone test strips to ensure your ketone levels don’t become dangerously high. Ketone urine test strips are also used by people with diabetes to determine if they’re at risk for ketoacidosis (DKA), a life-threatening complication that occurs when an individual doesn’t have enough insulin in their body. (Healthy ketosis is considered 0.5 to 3.0 mM blood ketones.)
At any given intensity, a keto-adapted athlete burns more fat and less glycogen than a sugar-burning athlete. Long-term elite keto athletes can burn up to 2.3 times more fat at peak oxidation and 59% more fat overall than non-keto athletes, and they do it at higher intensities. They remain in the predominantly fat-burning zone at 70% of VO2max, whereas non-keto athletes switch over from predominantly fat burning to a spike in sugar-burning at 54.9% VO2max.

Keto breath, on the other hand, is less of a side-effect and more of a harmless inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone, Keatley previously told WomensHealthMag.com. (Yes, the same stuff that's in nail polish remover.)
The New York Times pieces also points out that studies are disproving this concern and making a case for both children and adults with type 1 diabetes to consider a ketogenic diet. Specifically, a 2018 study published in the journal, Pediatrics, which took a look at glycemic control among children and adults with type 1 diabetes who followed a very low-carbohydrate, high-protein diet. The researchers found that both the adults and children who consumed this diet along with smaller doses of insulin than typically required exhibited “exceptional” blood sugar control without high rates of complications. In addition, the study data did not show an adverse effect of a very low-carbohydrate diet on children’s growth, although more research may still be a good idea, according to researchers.
The trick to reaping the benefits of the keto diet is to stay in ketosis, which means keeping your carbs at 5% or less of your calories. The 5% can fall anywhere between 20-50 grams a day. However, if an insulin shot is missed while in deep ketosis, there’s a good chance you will find yourself quite sick, so it’s probably best to avoid the risk and keep carbs on the upper end of this spectrum.

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.


While a ketogenic diet helps normalize blood sugar (glucose) levels and can help you maintain or reach a healthy weight, an alkaline diet is beneficial for its anti-aging effects— especially lowering inflammation, boosting detoxification, and promoting hormonal balance, immunity and more. Traditional ketogenic diets usually miss the important factor of restoring alkalinity. For many patients the key is to reach an alkaline pH first before beginning keto in order to prevent feeling agitated, anxious, uncomfortable or overly hungry.
Protein: A typical recommended keto protein intake is between one and 1.5 grams per kilogram of your ideal body weight. To convert pounds to kilograms, divide your ideal weight by 2.2. It’s important to note that Kidney Disease: Improving Global Outcomes (KDIGO) recommends that adults with diabetes limit their protein intake to less than one gram per kilogram of body weight each day and that adults with chronic kidney disease avoid protein intake greater than 1.3 grams per kilogram per day.
High-protein ketogenic diet (HPKD): This version of the keto diet is often followed by folks who want to preserve their muscle mass like bodybuilders and older people. Rather than protein making up 20 percent of the diet, here it’s 30 percent. Meanwhile, fat goes down to 65 percent of the diet and carbs stay at 5 percent. (Caution: folks with kidney issues shouldn’t up their protein too much.)
Keto diets are high in healthy fats and protein also tend to be very filling, which can help reduce overeating of empty calories, sweets and junk foods. (4) For most people eating a healthy low-carb diet, it’s easy to consume an appropriate amount of calories, but not too many, since things like sugary drinks, cookies, bread, cereals, ice cream or other desserts and snack bars are off-limits.

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.


Thanks for reading Roxanne! You could try the following: eating more frequently, using MCT oils, consuming plenty of salts, and potentially using an HPA axis supporting formula such as adapt-strong: https://store.drjockers.com/products/adapt-strong we also have an awesome magnesium lotion with melatonin that could be helpful in this case: https://store.drjockers.com/products/magnesium-lotion-goodnight-with-melatonin
Low-calorie, low-carbohydrate diets are increasingly recognized to be more satiating than low-calorie mixed diets (meaning, overall calorie intake is reduced to promote weight loss).7 Many people on the keto diet commonly experience the feeling of being more satisfied after eating, and this could contribute to weight loss–but scientists have yet to find a clear advantage of keto for weight loss when compared to any other calorie-controlled diet.
To say that the keto diet has become one of the most popular diets of recent years is a complete understatement. Case in point: There are more than one million searches on Google every month for the keto diet. It’s unique because the fad diet has captured the interest of people who want to lose weight — and there’s no shortage of reported success stories to be found.
The author wrote this out of angst because she failed at the ketogenic diet. It’s not a “hard” diet and you don’t have to give up all forms of desserts. You just have to learn to cook using stevia, almond or coconut flour instead of the white refined flours the author is addicted to. The information presented is false as well. The ketogenic diet has great benefits for the type two diabetic or prediabetic specifically.

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.
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.
Those with mental health conditions have higher rates of physical illness and premature mortality, with life spans shortened by 13 to 30 years. People with mental health conditions also have higher rates and worse outcomes for chronic conditions such as diabetes, cardiovascular disease, and cancer. Years lived with disability for mental and substance use disorders increased 45% from 1990 to 2013 worldwide – during the same time that the incidence of obesity and the diabetes exploded.

My son started the Keto Diet (not perfectly) with the ok of his Dr and a Different Oral Chemo at the same time. Last Tuesday an MRI indicated no new growth or no new tumors. We don’t know if the new Chemo, Keto diet, lots of prays or what has stopped the tumors from growing.I found your site after looking for possible adverse reactions to Keto Diets, and appreciate your research. His platelets are low now and never have been low before. This is stopping the next Chemo treatment. I understand that being on Chemo for 12 months could have created the low platelets and now the possibility that the Keto Diet could also be causing low platelets is frustrating. They will do a new blood test Tuesday to see if the platelets have increased. Any suggestions about how if possible to increase the platelets on the Keto Diet would be helpful.


The kidneys play an important role in metabolizing protein, and it’s possible that eating too much of the nutrient can have a negative impact on kidney function. While ketogenic diets are supposed to be much higher in fat than they are in protein, many keto eaters make the mistake of loading up on lots of meat, Mancinelli says. The result? You could end up eating way more protein than you actually need.

I’ve been eating LCHF for almost a year. I’ve lost 40 lbs, feel hungry less often, reversed my insulin resistance, have lots more energy but my cholesterol keeps jumping up, not just creeping, but taking huge leaps! It’s in the mid 300’s now and my Dr wants me to go on statin drugs of which I’m very resistant, I don’t feel comfortable taking drugs. I read so often how this diet lowers cholesterol, not me! Any clue as to “why me?”
It’s very good info. Thanks. I have been doing Ketogenics for a few weeks and feel great. I really like the idea of adequate protein and not all you can eat. Now I have my husband on it and some relatives. I have been reading some good and bad articles cause now I feel responsible for all of them and what if I’m wrong and they have problems? But, I really liked your article and feel better. Thanks for busting some myths!
If you’re wondering about the difference between ketosis and diabetic ketoacidosis, you’re not alone. “The word ketone is scary for most people with type 1 diabetes because they relate ketones to diabetic ketoacidosis,” says Patti Urbanski, MEd, RD, CDE, a certified diabetes educator with St. Luke’s Hospital in Duluth, Minnesota. “But with the ketogenic diet, we’re talking about a much lower level of ketones.”

This concept was previously unthinkable as modern nutritional science was led to believe that the body’s metabolism relied on gluconeogenesis to create ATP as energy for the body’s metabolic processes. Glycogen derives from dietary carbohydrate intake, so by removing it from the diet, nutritionists expected devastating health results to emerge in practitioners of the diet.
Originally developed in 1924 to treat epilepsy, the ketogenic diet has most recently rose in popularity as the latest and greatest miracle weight-loss plan. Additionally, proponents of the ketogenic diet—or keto diet, as it’s commonly known—advertise health benefits ranging from glucose control to treatment of Alzheimer’s. But, what does the research really show?

A great long-term benefit of the ketogenic diet is reduced cravings for sugar and other unhealthy foods. However, you might initially have stronger cravings for carbs during the transition period. This can last anywhere from one to two days to around three weeks. But stick it out! At the end, you’ll be pleased with the reduced, and often eliminated, cravings.
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
Most dieticians I have met are over rated and under educated. This article somewhat proves me out. Congratulations on your accomplishments. I have been in Ketosis for a couple of months now. I have lost 28 pounds. I feel great. No sugar No Bread Nothing from a box lol. Only good fats and Meats and good veggies(dark greens mostly) and a few macadamia nuts now and again and a few berries now and then. I think even the dieticians being human are also addicted to sugar and unable to give it up so they play down ketosis unconsciously because they are just jealous! lol

It’s only dangerous to not get enough carbs at each meal if one is taking too much meds or insulin for the amount of carbs they are eating! Restricting carbohydrates doesn’t lead to hypoglycemia unawareness, but having lots of lows and lots of highs will (and decreasing insulin and carbs leads to way fewer highs and fewer lows, or at least it can). On the other hand, being in ketosis does make low blood sugars less negative as an experience. I still feel my lows just fine, but they are less of an emergency because my brain still works (feeding on ketones) and by body doesn’t freak out and release tons of adrenaline that then makes me want to eat a house. Mind you, I still wake up and know immediately if I’m low, I know from experience and how it feels in my head and body but without the crazy shakes. This is not unawareness but it is less reactive.
After reading that article I have to say that the “USC experts” are full of it. It’s the usual scare stuff that the mainstream docs and dietitians trot out to attempt to discredit LCHF and keto diets. There’s no reason why a keto diet should be any worse for bone health than any other diet provided it has adequate calcium, phosphate and Vit K2 and you have good Vit D levels. As for the recommendations of dietitians – eat lots of healthywholegrains and “vegetable” oils but no saturated fats – we know what the long-term results are of that: diabetes, heart disease and osteoporosis.
Carbohydrate facts: Simple = bad, complex = good? Carbohydrates provide energy for the body, but the health benefits they offer depend on the type of carbs we consume. Complex carbs, found in brown rice, for example, contain more nutrients than simple carbs, such as white rice. Refined carbs, such as sugary drinks, are best avoided, as their nutritional value is low. Read now
There are people who say that keto helps your athletic performance, and those who say it hurts it. "The literature is mixed on how an ultra low-carbohydrate diet like the keto diet affects athletic performance," says Grant Cox, C.S.C.S., head coach at Iron Tribe Fitness. But one thing is pretty clear: "A lot of it points to consistent decreases when athletes are looking for maximal power output (in weightlifting, vertical jumps, sprinting, etc.). Along the same lines, you'd be hard-pressed to put on weight and strength on such a low carbohydrate diet," he says.
Eating slightly more carbs may potentially slow down weight loss and mute rapid, dramatic health improvements, but it can still lead to better health, especially if you are cutting out sugar and processed foods. And keto flu will no longer be an issue. Once you’ve adapted to low-carb eating, feel free to try eating less than 20 grams of carbs again to see whether your body prefers this or slightly higher carb intake.
Ketogenic diets were first proposed as a way to control epileptic seizures in children. Before keto diets, epileptics often fasted to reduce seizures, so the keto diet offered a less restrictive alternative. Though effective, the diet was mostly supplanted by medications – except in a segment of the population suffering from epilepsy that cannot control it with medicine, and for them, the ketogenic diet has had great success. Along with the benefits it offers to epileptics, especially children, the keto diet is also being studied as a possible salve for many neurological conditions and diabetes, too.[1]
Many CDEs actually have diabetes…it’s what draws them to choose this career…to help others with diabetes, to share their knowledge. Most already wear an insulin pump and continuous glucose sensors (CGMs) also. When I first became certified on each new pump and CGM, I would wear them (and check my BG 4-6 times per day) for 2-3 weeks, not only to learn the technology really well, but to gain a sense of how my patients must feel having to wear them 24 hours per day. Since, I’ve started a 6 month old baby on a insulin pump and CGM all the way up to a 89 year old…there are no boundaries for people with diabetes!
Author’s note: I want to stress again the importance of consulting with your doctor before you try ketogenic dieting. The more I study this area of science, the more I realize that every individual is extremely unique when it comes to health issues and there are a ton of reasons why you should NOT go full-on keto (especially if you are prone to kidney, heart, or gallbladder issues). That being said, for many people this form of eating is life changing, and the amount of scientific research supporting a ketogenic lifestyle is significantly increasing. Subscribe to my newsletter to stay posted when I publish new articles, and I’d appreciate any and all feedback/corrections on the content I’ve written above. Thanks! (Image credit)
If you are pregnant or are nursing, you should not follow a Ketogenic diet. You will not receive enough of the recommended carbohydrates, vitamins and nutrients necessary for yourself and your growing baby on this diet. Your obstetrician will recommend how many carbohydrates you should consume per meal and for snacks during each phase of your pregnancy. They will likely refer you to a Certified Diabetes Educator for nutritional counseling as well. Please check out The Diabetes Council’s FAQ’ About Gestational Diabetes for all your gestational diabetes related questions.
It’s very good info. Thanks. I have been doing Ketogenics for a few weeks and feel great. I really like the idea of adequate protein and not all you can eat. Now I have my husband on it and some relatives. I have been reading some good and bad articles cause now I feel responsible for all of them and what if I’m wrong and they have problems? But, I really liked your article and feel better. Thanks for busting some myths!
Hello, I am hoping someone can reach out to me and explain something. My son who is T1D just started the keto diet 4 days ago. At first we were doing great numbers were good, then out of nowhere we are having highs! He is correcting and it’s not bringing him down into normal range. I am going into a panic, I don’t know what to do, or who to ask for help. His doctor would be no help, and thinks the Standard American Diet is fine. I don’t see eye to eye with him. I hope someone can tell me why this might be happening. Thanks in advance for your time!
Although many people find that their energy and stamina improve on a keto lifestyle, trying to do too much in the early stages can worsen keto flu symptoms. Well-known ketogenic researcher Dr. Steve Phinney has conducted studies in endurance athletes as well as obese individuals demonstrating that physical performance decreases during the first week of very-low-carb eating. Fortunately, his research also shows that by week 4, people typically perform better than before they started keto.

Brain fog and a lack of focus can be caused by having too much glutamate and very little GABA. This will happen if your brain has to use glutamate and glutamic acid for fuel, which leaves little left over to be processed into GABA. By giving the brain another form of energy when you break down ketones, you’re able to balance out the neurotransmitter production.
More and more studies show that low-carb diets are an effective way to lose weight: A 2018 report out of Framingham State University found that after five months on a low-carb, high-fat diet, overweight adults burned about 250 more calories daily than people who ate a high-carb, low-fat diet. The keto diet in particular has a number of famous adherents, including Halle Berry, Katie Couric and Gwyneth Paltrow. Kourtney Kardashian blogged about doing keto, calling it “a really positive experience.” And keto-friendly recipes, snacks and meal plans have proliferated in the past few years.
At the first visit, participants were instructed how to follow the LCKD as individuals or in small groups, with an initial goal of ≤20 g carbohydrate per day. Participants were taught the specific types and amounts of foods they could eat, as well as foods to avoid. Initially, participants were allowed unlimited amounts of meats, poultry, fish, shellfish, and eggs; 2 cups of salad vegetables per day; 1 cup of low-carbohydrate vegetables per day; 4 ounces of hard cheese; and limited amounts of cream, avocado, olives, and lemon juice. Fats and oils were not restricted except that intake of trans fats was to be minimized. Participants were provided a 3-page handout and a handbook [11] detailing these recommendations. Participants prepared or bought all of their own meals and snacks following these guidelines.
To see where you stand on the ketosis scale, you can test your ketone levels with a blood meter or with urine strips, the latter of which works similar to a pregnancy test and generally costs less than a dime a piece. Recent research shared in The American Journal of Clinical Nutrition, however, found that breath monitors (typically $200 to $300) provide the most accurate readings. Dozens of meters of all three formats are currently available on Amazon.
Eating in a restrictive way can be socially isolating, Brown says. "You may avoid parties and other gatherings because you may worry about what food will be available for you, or even what foods may tempt you. Having to plan and control what you are eating so closely may lead to increased anxiety and stress. And who doesn't want to enjoy a beer with a friend or a piece of cake on your birthday?" As you probably know, emotional well-being and physical health are closely linked, which is all the more reason to choose foods that make you feel good both mentally and physically. If keto does that for you, great! But if it doesn't, know you're not alone.
Something that makes the keto diet different from other low-carb diets is that it does not “protein-load.” Protein is not as big a part of the keto diet as fat is. Reason being: In small amounts, the body can change protein to glucose, which means if you eat too much of it, especially while in the beginning stages, it will slow down your body’s transition into ketosis.
You eat less than 50 grams of net carbs a day on keto. Cutting down on carbs increases your high-density lipoprotein (HDL) levels. HDL is known as the “good” cholesterol — it turns on anti-inflammatory pathways and protects your heart from disease. The keto diet also lowers blood triglycerides[12] — fat molecules in your bloodstream. High levels of blood triglycerides are linked to coronary heart disease.[13]
It’s no secret that carbs—especially refined ones like sugary cereals, white bread and pasta, or sweet drinks—cause your blood sugar to spike and dip. So it makes sense that eating less of them can help keep things nice and even. For healthy people, this can translate to more steady energy, less brain fog, and fewer sugary cravings, Mancinelli explains.

The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.


The kidneys play an important role in metabolizing protein, and it’s possible that eating too much of the nutrient can have a negative impact on kidney function. While ketogenic diets are supposed to be much higher in fat than they are in protein, many keto eaters make the mistake of loading up on lots of meat, Mancinelli says. The result? You could end up eating way more protein than you actually need. 
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