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Diets, Health, Weight Loss

Can the Ketogenic Diet Cure Diabetes? The Ultimate Guide

Looking for the lowdown on the ketogenic diet diabetes story? We’ve got everything right here, from results, science and cautions to the nuts and bolts of how to do it.

Can the ketogenic diet cause diabetes? Will it cause deadly ketoacidosis? Will eating that much fat clog your arteries and give you a heart attack? Can it reverse diabetes completely?

The answers to those and other questions come from looking at hundreds of diabetics who’ve tried the ketogenic diet, both in controlled studies and on social sites like Reddit.

Get the full story on keto and diabetes here, including how it interacts with medications, how it can lower blood sugar, meal plans, recipes and other resources.

What’s the Ketogenic Diet?

Here’s the idea: Your body can get energy in two ways. The first is the glycemic route. You eat something starchy (cake, cookies, pasta, potatoes, oatmeal, crackers, breads, or root vegetables) and your body turns it into sugar in the form of glycogen.

The second way you can get energy is by eating fat. Ever see a grease fire? It’s the same idea. You eat something fatty (fatty meats, fish, cheese, yogurt, whole milk) and your body turns the fat to energy. That’s the ketogenic route.

Here’s the trick: your body can burn either sugar or fat to create energy. The sugar-to-energy process requires insulin. The fat-to-energy process doesn’t.

See the picture?

Graph of cases of diabetes in the U.S. starting at 2 million in 1958 and growing to 22 million by 2014.

Via: U.S. Centers for Disease Control

What Makes the Ketogenic Diet Healthy?

The human race evolved in part to use the ketogenic diet. We did it in a kind of feast-or-famine way. For a while we’d eat a lot of fat. (Think: you and your buddies killed a buffalo and now you’ve got to eat it). Then we’d eat a lot of roots and fruits and nuts. (Think: we ran out of buffalo so we’re eating anything we find).

According to Dr. Terry Wahls, author of The Wahls Protocol, we were meant to live in this kind of feast-or-famine, fat-or-forage way. For a while we’d eat a lot of starchy foods and get our energy from sugar. Then we’d eat a lot of fat and get our energy from that.

Did you see the graph above that shows the number of diabetes cases in the U.S. over time? It looks like something you’d launch off in a Supercross race, doesn’t it?

According to proponents of the ketogenic diet, the reason for our recent diabetes explosion is, we’ve abandoned keto as a way to get our energy. We’ve got the throttle wide-open on the sugar/starch energy path, and it’s killing us.

Can the Ketogenic Diet Help with Diabetes?

The ketogenic diet says, let’s stop getting all our energy from sugar. Let’s stop eating foods with a high “glycemic index.” That includes big, sugary fruits, all grains, sugary foods and big roots like potatoes.

The mind blower here is that, without those foods, we don’t need insulin for energy. At least, not in the quantities we need right now.

A diabetic who adopts the ketogenic diet gets energy from healthy fats. So, can the ketogenic diet help with diabetes? According to keto advocates, you bet your glucose meter it can.

The ketogenic diet is a ticket off the sugar/insulin roller coaster. With most of our energy coming from the “ketone bodies” produced by eating healthy fats, energy without insulin becomes a reality.

How the Ketogenic Diet Can Fight Diabetes

Take a look at the chart above. It’s from a study on how the ketogenic diet helps with diabetes. In the study, 28 overweight type 2 diabetics tried the keto diet for four months.

By week 16, most of the participants were able to stop taking their diabetes medications.

Blood glucose dropped by 17%. Triglycerides fell by almost half. Body weight fell by 6.6%.

Is this magic? According to the study’s authors, no. The participants just stopped eating starch and sugar. Without it, they didn’t need insulin. They got their energy from fat instead.

Can the Ketogenic Diet Prevent Diabetes?

It makes sense that a diet that gives energy without insulin can help with diabetes. But there’s evidence the ketogenic diet can even help with pre-diabetes.

In a study of 49 type 2 diabetes patients, half tried the standard glycemic diet for six weeks. The other half did the ketogenic diet.

By week six, the keto group saw a 20% improvement in blood-glucose levels and 11% less body weight. They also nailed a 4% improvement in the Body Mass Index.

The takeaway? Getting control of diabetes markers is great for type 2 diabetics. But it’s even better to nip the problem in the bud. By the evidence, a ketogenic diet stands a strong chance of warding off type 2 diabetes before it starts..

Does the Ketogenic Diet Reduce Diabetes Symptoms?

Let’s compare the ketogenic diet to a couple other diets. In a study of 84 people, the group that tried the ketogenic diet cut their insulin levels 36%.

The group that tried a high fat diet dropped insulin too, but a lot less. Meanwhile, the group that tried a low fat diet actually got worse.

The main point here? According to the study’s authors, the ketogenic diet diabetes plan doesn’t just help with diabetes symptoms. It helps a lot more than other diets.

Enough Science. Let’s Look at a Real Life Success Story

By now you’ve had enough of ketogenic diet diabetes science. Let’s see a real life story of a doctor who found himself rapping on death’s door.

Dr. Peter Attia suffered from “metabolic syndrome.” That’s a cluster of disease. It includes high risk for diabetes, heart disease, Alzheimer’s and stroke. I happens when our bodies “run rich” for too long. Too much sweet fuel starts to clog us up and shut us down.

When Dr. Attia tried the ketogenic diet, his fasting blood sugar dropped by 25%, his body fat cut in half, his waist shrunk and his blood pressure plummeted. His “good fats” doubled and his “bad fats” dropped by 22%.

Is this a miracle? According to Dr. Attia, it’s what naturally happens when we stop eating sugar and switch to healthy fat. It’s the unavoidable result of switching to a ketogenic diet. It’s what happens when we stop burning insulin-grabbing sugar for energy and start running on ketones. If you’ve got time, watch the full story in the video above.

Can the Ketogenic Diet Reverse Diabetes?

Can the ketogenic diet actually reverse diabetes?

As we said above, the diet dusts off our ability to turn fat into energy.  In doing so, it eases diabetes symptoms.

It’s proven to drop blood glucose levels. It can even taper down the need for insulin.

According to Dr. David Ludwig at the Harvard School of Public health, the diet can even reverse the illness altogether.

Ludwig says in some cases a very low carb diet like the ketogenic diet can reverse diabetes rapidly.” Not only that, but keto pulls off this miracle without calorie deprivation. In other words, it doesn’t starve you while you’re watching what you eat.

Will the Ketogenic Diet Cause Heart Disease?

Man clutching his chest as he has a heart attack.


What about heart disease? Of course the fear with a high-fat diet is that we will clog our arteries. We’ve been taught since we were kids that fat = death.

That’s a real fear. Can you start eating cans of crisco and hope to ward off the inevitable stroke? Must we trade diabetes for heart failure? Does the ketogenic diet put us at risk for coronary artery disease?

The evidence says, “no.” In study after study, keto actually drops bad cholesterol in the blood stream. Participants saw lower LDL (“bad” fat) and lower triglycerides.

There’s even  evidence that high carb diets contribute more to heart disease than high fat diets.

So, no. According to the research, diabetics who try the ketogenic diet won’t place themselves at elevated risk of heart disease. That’s provided we eat healthy fats and not a lot of fat from junk foods.

The Dangers of the Ketogenic Diet for Diabetes

If you’re a diabetic, you may have heard of a few ketogenic diet diabetes risks. One is ketoacidosis. Another is letting blood cholesterol get dangerously high.

What’s ketoacidosis? That’s when a diabetic’s ketones spike. It can make a person critically ill.

Now some good news. Ketoacidosis only happens in a state of high blood sugar with no insulin. According to Dr. Attia, the ketogenic diet actually fights that problem. With less sugar in the diet, the risk of ketoacidosis actually goes down.

Next, cholesterol. Here again, the research shows that keto boosts our body’s “good fats” while it drops our “bad fat” levels. (See the charts shown higher in this article).

Still wary? In the next section we’ll discuss some monitoring tools to keep an eye on ketone levels.

How to do the Ketogenic Diet for Diabetes Safely

Image of a blood ketone test kit for diabetes.

Use a blood glucose meter that also measures ketones.

First off, as we said above, there really aren’t many dangers for the ketogenic diet when it comes to diabetes.

One big exception is pregnant women. Pregnant women need lots of carbs and plenty of energy. They should never try a ketogenic diet.

Keto during pregnancy causes changes in organ development, and eventual behavioral problems. Avoid it like the plague.

Those among us without a bun in the oven can enjoy a ketogenic diet safely. Still a little worried? Take the steps below to soothe those fears:

  • Talk to your doctor. Tell your doc you’re thinking about going keto. Hammer out a plan to do it safely.
  • Measure those ketones. Many blood/glucose meters measure ketones to ensure you stay in the safe zone. If your meter doesn’t, consider getting one that does.
  • Track your blood fats. Simple, inexpensive home kits can give a fairly accurate read of your HDL, LDL and triglyceride levels. If you see them spiking high, you’re doing something wrong. Either way, monitoring will ease the worry.

An even better way for diabetics to ensure a safe ketogenic switch is following a few guidelines. We’ll get into those below.

Will the Ketogenic Diet Interact with Diabetes Medications?

Is the ketogenic diet safe for diabetics who take certain medications?

The watchword here is: ask your doctor. That said, in most cases keto won’t conflict with diabetes medications. There are a few serious exceptions to watch out for.

  • High blood pressure medications can butt up against the ketogenic diet. Since keto lowers blood pressure, the mix of meds and keto can create a double whammy. You might find yourself fainting from low blood pressure.
  • Insulin can conflict with keto. The ketogenic diet lowers blood sugar, which means we need less insulin.
  • Lithium can cause trouble with the ketogenic diet too. Keto can cause dangerously high concentrations of this common mood med in the blood.
  • Some other diabetes meds that help with insulin resistance may conflict with keto. So far, metformin seems to work safely with the ketogenic diet.

There are certain people who should never try a ketogenic diet. Those with gallbladder problems (because we need a healthy gallbladder to digest the fat) and pregnant women are examples.

Again, consult your doctor before starting up the ketogenic diet meal plan.

The Ketogenic Diet and Type 1 Diabetes

Will the ketogenic diet help with type 1 diabetes? Type 1 diabetes usually shows up in childhood. With type 1 diabetes, the body doesn’t make insulin.

Keto helps with type 1 diabetes for the same reasons it clobbers type 2 diabetes. Namely: less sugar in the blood stream means less need for insulin. Type 1 diabetics sick of playing the carbs-and-insulin seesaw game can smooth things out with keto.

Just like with type 2 diabetes, type 1 diabetics can benefit from getting their energy from fats. Cutting out the starchy foods, the breads, the pastas, grains, big fruits and root veggies means less sugar in the blood stream. Adding lots of healthy fat means a nice, full feeling in the belly, plus lots of energy from ketones.

The key word there is healthy fats. We’ll talk more about those further down.

Here’s How the Ketogenic Diet Works for Real People

Blood sugar graph of Redditor with diabetes before the ketogenic diet (high) and after (low)


We were curious to see how the ketogenic diet worked for diabetics in the real world. What better place to look than Reddit?

We looked at a single Reddit thread with ten comments from Redditors with diabetes who’d tried the diet. We’ve summarized the results from all ten people here:

Redditor 1 50% drop in blood glucose levels.
Redditor 2 50% drop in blood glucose levels.
Redditor 3 Cut insulin dose in half and lost 25 lbs.
Redditor 4 Lost 50 lbs, off diabetes meds.
Redditor 5 Totally reversed diabetes.
Redditor 6 Pre-diabetes reversed.
Redditor 7 Cut insulin dose in half.
Redditor 8 Cut fasting blood/glucose level by 40%.
Redditor 9 Cut blood/glucose level in half.
Redditor 10 Lost 40 lbs, doesn’t feel hungry anymore.

Want more? Below are links to several Reddit threads, each with dozens of ketogenic diet diabetes success stories:

  • Reddit link with several different stories from diabetics who went on keto.
  • Link to a story from one woman about how she reversed her diabetes with a ketogenic diet. Lots of comments with other success stories.
  • Reddit thread with a short term weight loss story and lots of success stories.
  • Link to a Reddit post with tons of success stories. One says the diet is very satisfying in the tummy.
  • The success story of one Redditor who tried the ketogenic diet, plus comments.
  • The story of a woman who reversed her diabetes symptoms with keto.
  • Dozens of success stories about diabetes and the ketogenic diet.

One major point here is, we didn’t run across any Redditors who said the ketogenic diet didn’t work for them.

What to Eat on the Ketogenic Diet for Diabetics

Salmon, nuts, avocados and olive oil on a rough wood table.

Via: WholeFoodsMagazine

By this point, most readers have clued in that the ketogenic diet for diabetes means low carbs. But how does that work and what exactly can we eat?

Let’s start by looking at what we don’t eat. In a nutshell, that’s any food with a lot of sugar. Obviously that means no pies, cakes, cookies or sugared soda. But it also means:

  • No sugar.
  • No grains.
  • No large, sugary fruits.
  • No tubers.

Sound easy? Well, it’s simple, but that doesn’t mean it’s easy. Once we realize that means no bread, no oatmeal, rice, breakfast cereal, pizza, pasta, potatoes and about a million other things, it gets downright ascetic.

Or its seems that way. The flip side is, we get to eat a lot of healthy fats. The key word here is healthy. We’re not talking cheeseburgers with mayo.

Ketogenic diet food pyramid chart.

Ketogenic Diet Food List for Diabetes

Does that 70% fat rule sound crazy? Remember that it’s 70% of calories from fat. Since many veggies have very few calories, we’ll be eating lots of those.

The can-do list of approved foods for keto includes some fruits with high fiber and low sugar content. Meats are fine (especially the ones with healthy fats like oily fish or grass-fed beef).

The main source of energy though is “healthy” fats. That means foods like avocados, coconut butter, high fat dairy and so on. Yum, right? Here’s a more complete ketogenic diet food list:

  • Fats
    • Coconut butter
    • Coconut milk
    • Avocado
    • Walnuts
    • Peanut butter
    • Macadamia nuts
    • Other nuts and seeds
    • Butter
    • Duck fat
    • Whole oily fish like salmon, mackerel, herring
    • Olive oil
    • Beef tallow
    • Chicken fat
    • High fat milk, cheese and other dairy
  • Meats
    • Fish
    • Shellfish
    • Eggs
    • Red meat
    • Poultry
    • Pork
    • Bacon/sausage
  • Vegetables
    • Broccoli
    • Carrots
    • Asparagus
    • Garlic
    • Cauliflower
    • Green beans
    • Bell Peppers
    • Onions
    • Summer Squash
    • Spinach
    • Snow peas
    • Zucchini
    • Tomatoes
    • Cucumber
    • Celery
    • Spaghetti squash
    • Pickles
    • Romaine lettuce
    • Mushrooms
    • Acorn squash

Ketogenic Diet Meal Plans and Recipes

Looking for ketogenic diet meal plans for the diabetic? We’ve rounded up the best of the web below.

  • Ketogenic Diet Resource. This site offers a simple diabetic keto meal plan for one day. It’s a good way for you to get the general idea. It follows the typical keto rule of 70% of all calories from fat by relying on foods like quiche, salmon and meatloaf. Side dishes include broccoli, cauliflower and cole slaw.
  • Dieting Well. This ketogenic diet/diabetes meal plan offers seven days of dishes. Enjoy bacon and eggs for breakfast, cheeseburgers (without the bun) tuna salad and cole slaw. It’s a little on the simple side, but functional.
  • Diet Doctor. Here’s a 14-day ketogenic diet meal plan with pesto chicken, meat pie, baked salmon, breakfast frittata and “low-carbonara.” These are truly yummy recipes.
  • Ruled.Me. Download this 30-day ketogenic diet meal plan for a donation as low as $0, then enjoy a month of mouth-watering low-carb meals. This one has some great ketogenic diet recipes.
  • NutritionMagic. Dare we pat ourselves on the back? Why not. We’ve got a fun and easy 3-day ketogenic diet meal plan that uses lots of avocados, eggs, stir fries, nuts, smoothies and tasty, healthy fats.

A Complete Guide to the Ketogenic Diet

Looking for a more complete “how to” guide for the ketogenic diet for diabetes?

We’ve put together a comprehensive keto guide, complete with menus, meal plans, printable food lists, snacks, supplements and more.

Check out our complete ketogenic diet guide right here.

Key Takeaways

The ketogenic diet works for both type 1 and type 2 diabetes. It lowers blood sugar and body weight by getting us to burn ketones for energy instead of sugar. Ketones come from eating healthy fats and cutting carbs.

The ketogenic diet’s diabetes powers have been proven in several studies and by hundreds of Redditors who’ve tried the diet. The main worry of most people interested in switching to the diet is ketoacidosis. The ketogenic diet actually helps prevent this deadly problem.

When you make the switch to the ketogenic diet for diabetes, it’s important to consult your doctor. Discuss how the diet may affect your need for certain medications.

Finally, the ketogenic diet cuts out carbs and adds healthy fats. Most people find it an extremely satisfying, yummy way to eat.

Have you tried the ketogenic diet? Are you thinking about making the switch? We’d love to hear your story in the comments section. Also, if we goofed anywhere above, give us a shout. Bon appetit!

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