8 Reasons Why the Keto Diet is Ideal for Managing Type 2 Diabetes

Keto Diet Managing Type 2 Diabetes

There is currently no actual “cure” for Type 2 Diabetes (T2D), but with the current statistics shining light on diabetes as one of the most common and costly chronic diseases in the US, there is significant research and interest into the best ways to manage it. Here’s where the Keto Diet comes in! The Keto Diet is steadily gaining recognition for its proven ability to manage blood sugar (glucose) and blood pressure levels and may prove to be one of the best ways to manage Type 2 diabetes.

The twin hallmarks of Type 2 diabetes are insulin resistance, in combination with high levels of insulin (hyperinsulinemia)1. Insulin resistance occurs when our cells “resist” the action of the hormone insulin (which regulates our blood sugar levels) and are unable to use it effectively, leading to high blood sugar. In response, the pancreas releases even more insulin, leading to higher insulin levels, or hyperinsulinemia. This subsequent rise in insulin also appears to be one of the underlying factors leading to weight gain and obesity, and is often both a result—and a driver—of insulin resistance.

There are several ways the Keto Diet can counter this insulin resistance and help correct high levels of insulin, improving both your blood sugar and your weight. Together, these outcomes exemplify the gold standard for managing Type 2 diabetes for both the short- and long-term.

Here are 8 reasons why the Keto Diet is ideal for managing Type 2 diabetes. A Keto Diet has been shown to:

1. Lower Blood Sugar Levels

As most everyone who follows Keto knows, one of its distinguishing features is its very low-carb content. The simple truth is that, of all the macronutrients, carbohydrate is the greatest contributor to blood sugar, making Keto’s low-carb nature its claim to fame for blood sugar control2. Even non-diabetics show an improvement in their fasting blood sugar and insulin levels when they make the switch to a low carb diet. Compared to a low glycemic index diet, the ketogenic diet contributed to an even greater improvement in blood sugar control, as well as a more drastic reduction (and even elimination) of diabetes medications3.

2. Lower Insulin Levels

The reduced impact on blood sugar following a low-carbohydrate meal results in a blunted insulin response, virtually eliminating the insulin spikes which are strongly linked to weight gain and obesity. This drop in circulating insulin gives your body the “green light” to begin burning your fat stores for fuel once the stored glucose (glycogen) in your muscles and liver has been depleted (usually within the first few days of beginning the ketogenic diet)4.

3. Increase Insulin Sensitivity

Insulin sensitivity is on the opposite side of the spectrum from insulin resistance and determines how effectively your body utilizes carbohydrates and how much insulin needs to be released in order to process blood sugar in a healthy and balanced way. The more sensitive your cells are to your insulin, the less glucose your body will tend to store as fat5. For a Type 2 diabetic, the weight loss and the ketosis (the ‘switch’ in fuel from glucose to fat) associated with the Keto Diet can lower the level of insulin resistance and can rapidly and dramatically improve the body’s insulin sensitivity6.

4. Increase Metabolism

Low carbohydrate diets such as the Keto Diet also appear to have a metabolic advantage over high carbohydrate diets. It might sound counterintuitive, but studies have demonstrated significantly greater weight loss with a higher calorie, very low carbohydrate diet, compared to a lower calorie, high carbohydrate diet (60% calories from carbohydrates)7.

5. Decrease Dangerous Abdominal Fat

Low carbohydrate diets have been shown to help people lose potentially dangerous abdominal, or “belly” fat. This effect appears to be more pronounced in those with insulin resistance, a major risk factor for Type 2 diabetes.

6. Improve Function of Fat Cells

A very low-carbohydrate diet has been shown to improve the function of fat cells (adipocytes) that specialize in fat production and storage8. The weight loss associated with low-carb diets appears to be linked to the increased insulin sensitivity of these fat cells.

7. Improve Blood Pressure

Just as there exists a strong association between insulin resistance and metabolic disorders such as Type 2 diabetes, a strong link has also been demonstrated between insulin resistance and high blood pressure, or hypertension. (13) Both of these health conditions are not mutually exclusive, given that over 70% of Type 2 diabetics are also being treated for hypertension and 50% of individuals with hypertension also have insulin resistance or hyperinsulinemia, two of the underlying features of Type 2 diabetes.

One of the most effective ways to manage high blood pressure in Type 2 diabetes is to get blood glucose in good control9. So, in essence, the ketogenic diet has the unique potential to effectively control both blood sugar and blood pressure levels in diabetics. In addition, it appears that a very low-carbohydrate diet such as the ketogenic diet has an additional blood pressure-lowering effect caused by metabolic, chemical, and hormonal shifts10.

8. Reduce Risk of Heart Disease

Just as heart disease (cardiovascular disease) is the major cause of death in adults in the US, it is also the major cause of death for Type 2 diabetics11. Major risk factors for heart disease in Type 2 diabetes are elevated levels of triglycerides and “artery-clogging” LDL-cholesterol, and low levels of “good” cholesterol known as HDL. Low carbohydrate diets have been shown to improve the low-HDL cholesterol levels characteristic of Type 2 diabetes. The combination of decreased triglyceride levels and increased HDL-cholesterol levels associated with very low carbohydrate diets can have a very beneficial impact on heart disease risk specific to diabetics12. In addition, very low carbohydrate diets such as the Keto Diet not only can lower LDL-cholesterol, but can also change the small, dense form of LDL-cholesterol (more prone to plaque formation) to a less dangerous form13.

Key Takeaways

Through its mechanisms of overcoming insulin resistance and high insulin levels, and optimizing insulin sensitivity, the ketogenic diet can play an important role in managing blood sugar and its associated risk factors in Type 2 diabetics. For many Type 2 diabetics, the ketogenic diet may be the key to achieving recommended blood sugar levels and other targets, such as healthy blood pressure, triglyceride, and cholesterol levels. The ideal approach to using the Keto Diet as a first-line therapy for improved diabetes management would be to form a partnership with your healthcare provider, working together to adjust your diabetes and other medications (i.e. for blood pressure, cholesterol) and helping you make the best decisions on your journey to better health.

  1. Hyperinsulinemia and Insulin Resistance: Scope of the Problem: https://insulinresistance.org/index.php/jir/article/view/18/25
  2. A low-carbohydrate, ketogenic diet to treat type 2 diabetes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325029/
  3. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633336/
  4. Hyperinsulinemia: a Cause of Obesity? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5487935
  5. Understanding Insulin Sensitivity and Diabetes: https://www.nih.gov/news-events/nih-research-matters/understanding-insulin-sensitivity-diabetes
  6. The case for low carbohydrate diets in diabetes management: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1188071/
  7. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes:  https://www.ncbi.nlm.nih.gov/pubmed/15767618
  8. The Effects of a Low-Carbohydrate Diet vs. a Low-Fat Diet on Novel Cardiovascular Risk Factors: A Randomized Controlled Trial: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586572/
  9. Link between insulin resistance and hypertension: What is the evidence from evolutionary biology? https://dmsjournal.biomedcentral.com/articles/10.1186/1758-5996-6-12
  10. A Pilot Trial of a Low-Carbohydrate, Ketogenic Diet in Patients with Type 2 Diabetes. Metabolic Syndrome and Related Disorders:  https://www.ncbi.nlm.nih.gov/pubmed/18370668
  11. Diabetes, Heart Disease, and You https://www.cdc.gov/features/diabetes-heart-disease/index.html
  12. Effect of 6-Month Adherence to a Very Low Carbohydrate Diet Program:  https://www.ncbi.nlm.nih.gov/pubmed/12106620
  13. Modification of Lipoproteins by Very Low-Carbohydrate Diets: https://academic.oup.com/jn/article/135/6/1339/4663837
Mary Paley

Fearless Dietitian; 30+ years as a professional dietitian; Master’s Degree in Nutrition and Dietetics at the MGH Institute of Health Professions; Lead research dietitian for several major pharmaceutical companies; Currently focused on health and wellness and the benefits of ketogenic diets for both obesity and diabetes management. MS, RDN, CDE, LD/N

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