The ketogenic diet, often called “keto,” has gained significant attention as a potential strategy for managing , type 2 diabetes. The diet’s popularity stems from its promise to help individuals control blood sugar and promote weight loss. However, medical professionals caution that the risks and limited long-term evidence necessitate a personalized evaluation before adopting this dietary approach.
The keto diet is characterized by a drastic reduction in carbohydrate intake and a substantial increase in fat consumption. By limiting carbohydrates, the body enters a metabolic state called ketosis, where it begins to utilize fats as its primary energy source. While this metabolic shift may seem beneficial for those with type 2 diabetes—given the direct impact carbohydrates have on blood glucose levels—it’s not a universally suitable solution.
According to experts at the Cleveland Clinic, the potential benefits of the keto diet for individuals with type 2 diabetes include improved glycemic control, possible reduction in medication needs, and weight loss. However, these advantages are often observed primarily during the initial months, and there’s currently a lack of conclusive studies regarding its safety and efficacy over the long term.
“The advantages have been observed mainly during the first months, and to date, there are no conclusive studies on its safety and efficacy in the long term,” explained Melissa Matteo, a registered dietitian at the Cleveland Clinic.
The diet works by fundamentally altering the body’s energy metabolism, leading to increased fat burning and a tendency toward weight reduction. However, the restrictive nature of the keto diet presents potential risks, particularly for individuals taking insulin or oral diabetes medications.
One of the most frequent dangers associated with the keto diet is hypoglycemia, a rapid decrease in blood glucose levels that can cause tremors, sweating, palpitations, dizziness, confusion, and sleep disturbances. The Cleveland Clinic emphasizes that symptoms can appear suddenly and require immediate attention.
Another significant risk is ketoacidosis, a serious complication caused by the buildup of ketones in the blood when there isn’t enough insulin. While more common in type 1 diabetes, the Cleveland Clinic warns that it can also occur in individuals with type 2 diabetes if metabolic control is insufficient. Symptoms to watch for include nausea, vomiting, abdominal pain, and rapid breathing.
Long-term adherence to the keto diet also poses challenges. The Cleveland Clinic notes that many individuals find it difficult to maintain this restrictive eating pattern over time, potentially leading to deficiencies in vitamins and minerals, as well as digestive problems like constipation.
Recent research, published in , by researchers at University of Utah Health, adds another layer of caution. A study conducted on mice revealed potentially dangerous impacts of a very high-fat, very low-carbohydrate ketogenic diet on metabolic health, including how the body processes fats, and carbohydrates. The study, published in Science Advances, found that keto was associated with fatty liver disease and harmed blood sugar regulation, with some changes occurring within days. While these findings are from animal research, they raise concerns about the long-term health risks of ketogenic diets in humans.
A study published in , reviewed the effects of the ketogenic diet on glycemic control, body weight, cardiovascular risk factors, and liver and kidney function in patients with type 2 diabetes. The review, published in Diabetes Ther, found that ketogenic diets have favorable metabolic and weight reduction effects in the short term.
Given the growing interest in the keto diet, experts consistently emphasize the importance of consulting with a healthcare professional before adopting any restrictive dietary plan. Matteo stressed that “diabetes type 2 is a chronic disease, so the sustainability of eating habits is fundamental.”
The Cleveland Clinic recommends implementing dietary changes under professional supervision, with an individualized approach that prioritizes patient safety and quality of life. Regular blood glucose monitoring, vigilance for symptoms of hypoglycemia, and control of essential nutrient intake are key recommendations for those considering the ketogenic diet as a therapeutic option.
Selecting a diet for managing type 2 diabetes should consider not only the potential for achieving glycemic balance but also the feasibility of maintaining that pattern long-term and adapting it to each individual’s lifestyle. The keto diet may be a viable option for some, but it is not a one-size-fits-all solution and requires careful consideration and medical guidance.
