How Low Can You Go? Expert Advice On The Keto And Other Low-carb Diets And Diabetes
How Low Can You Go? Expert Advice On the Keto and Other Low-Carb Diets and Diabetes Can blood sugar be better managed by following a ketogenic diet? An expert explains the benefits and the risks. Written by Marina Chaparro, RD, CDE, MPH Is it possible to slim down on a diet of butter and steak? Yes, but many experts aren't fans of high fat, carb-restricted diets. Drawbacks explained below. Low-carb diets seem to have made a comebackAtkins, Paleo and more recently the ketogenic dietall follow a low carbohydrate regimen and claim greater weight loss and even improved glycemia in people with diabetes. While there is no doubt that carbohydrate restriction has the most significant improvement in blood glucose (since foods that contain carbohydrates can spike blood sugar after meals or snacks), the question remains:What is the ideal grams of carbohydrate for people with diabetes to consume? According to the American Diabetes Association 2017 Standards of Care, there is no single ideal dietary distribution of calories among carbohydrates, fats, and proteins for people with diabetes." The previous recommendation of 45-60% of calories from carbs is no longer supported by evidence. Instead, the distribution of carbs, protein,and fat should be individualized "while keeping total calorie and metabolic goals in mind. What works for one person with diabetes, might not work for another. Still, ketogenic diets have gained popularity thanks to celebrities like Lebron James and Kim Kardashian claiming superior athletic performance, mental well-being, and faster weight loss. The medical community is even testing the effects of the ketogenic diet on cancer, Alzheimer's and Parkinson's disease. The ketogenic diet seems to be trending now, but is this diet really safe for people with diabet Continue reading >>
Ketogenic Diets For Prediabetes
Low-Carbohydrate and Ketogenic Diets for Prediabetes Low-carbohydrate diets have gotten a lot of attention recently as strategies for reversing prediabetes . The carbohydrates in your diet that provide calories include sugars and starches. Starches are in grains and flour, beans, and starchy vegetables. Added sugars include sugars in sweets, sweetened foods such as flavored oatmeal and ketchup, and sugar-sweetened beverages such as soda. There are also natural sugars, which are found in nutritious foods such as dairy products and fruit. Proponents of low-carbohydrate weight loss diets, such as Atkins, claim that the diet can help you lose weight because instead of burning dietary carbohydrates for fuel, you burn body fat because you are eating so few dietary carbohydrates. The diet can help you cut calories by: Eliminating or severely restricting high-calorie foods such as sweets and refined carbohydrates. Promoting satiety by increasing protein and fat, which are filling nutrients. Reducing appetite by reducing the food choices available to you. Sugars and starches that you get from your diet enter your bloodstream as a type of sugar called glucose. In prediabetes , your body has trouble managing the glucose in your blood due to resistance to a hormone called insulin. Normally, insulin is able to help your body keep blood glucose levels in check, but the effect is weaker if you have prediabetes, so blood glucose rises. There is research supporting reduced-carbohydrate diets in the treatment of prediabetes. Reducing your sugar and starch intake may lower blood sugar levels by preventing as much sugar from going into your blood. It can also help reverse insulin resistance. Reduced-carbohydrate diets range from moderate to very low-carb. The rest of your calories come fr Continue reading >>
Ketosis And The Ketogenic Diet: Debunking 7 Misleading Statements
Ketosis and the Ketogenic Diet: Debunking 7 Misleading Statements The ketogenic diet is the most popular dietary trend in our world today. Especially for those living with diabetes, its likely that youve been tempted to follow a ketogenic diet to lose weight, drop your A1c, and flatline your blood glucose. Even though it may seem tempting to enter the metabolic state of ketosis, its important to understand the caveats of ketosis, so that you fully understand your risks for developing long-term complications. So what exactly is a ketogenic diet? And why is ketosis a popular recommendation for those living with diabetes? A ketogenic diet a very low-carbohydrate diet by design, containing a maximum of 30 grams of dietary carbohydrate per day. When eating a ketogenic diet, you are told to avoid carbohydrate-rich foods like fruits, starchy vegetables, legumes, and whole grains, and instead eat larger quantities of meat, dairy, leafy greens, non-starchy vegetables, nuts, seeds, and vegetable oils. At the base of the ketogenic food pyramid are eggs, dairy, meat, oil, and fish, which make up the bulk of calories eaten. Non-starchy vegetables contain too much carbohydrate energy and are avoided, while non-starchy vegetables or green vegetables are included, along with nuts, seeds, and very limited amounts of fruit (mainly berries). In order to achieve the state of ketosis, you are only allowed to eat a small amount of carbohydrate energy from fruits and starchy vegetables. The ketogenic diet explicitly prohibits the consumption of grain products (even whole grains), pasta, refined sugar, milk, corn, legumes (including lentils, beans, and peas), as well as rice. When you eat a ketogenic diet, your muscle and liver switch from oxidizing glucose as their primary fuel to fatty acid Continue reading >>
Higher Fasting Glucose On Ketogenic Diets: Reason To Worry?
Higher Fasting Glucose on Ketogenic Diets: Reason to Worry? The vast majority of people who adopt a low carb or ketogenic diet experience stunning improvements in blood glucose control and insulin levels. Carbohydrate restriction is so effective for type 2 diabetes and metabolic syndrome, in fact, that researchers have said it should be the default treatment for these issues , and those who follow it are typically able to reduce or eliminate many medications, including insulin . However, individual variability being what it is, a small percentage of patients see a rise in fasting blood glucose after some length of time on a very low carb diet. Considering that elevated fasting glucose is part of the diagnostic criteria for both type 2 diabetes (T2D) and metabolic syndrome, is this seemingly paradoxical rise a reason for concern? As is true for so much of functional medicine, its all about context. A fasting blood glucose (FBG) thats higher than one would typically expect in someone adhering long-term to a very low carb diet doesnt automatically indicate anything nefarious. There are many reasons why FBG might be elevated, and many ways to assess metabolic health and glucoregulation beyond just this one measurement. The dawn phenomenon will be well known to any physician who treats patients with diabetes or insulin resistance (IR). Blood glucose naturally rises in response to surges of cortisol and other energy-mobilizing hormones in the early hours of the morning. This happens in everyone, not just those with diabetes or IR , but for healthy people with good insulin sensitivity, by the time they wake up, glucose has come back to a normal level. In those with diabetes or IR, on the other hand, the glucose remains elevated for a bit longer , so when they test it first th Continue reading >>
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Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?
In this article we will cover what a Ketogenic diet is and if you can manage your diabetes while on this diet. Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject. As a CDE, I have been taught to follow the American Diabetes Association Dietary Guidelines for Americans which is low in carbohydrates, high in fiber, with fresh vegetables, fruits and whole grains. The Ketogenic Diet this article will be discussing is much lower in carbohydrates, in order to promote the state of nutritional ketosis, or the fat burning state for weight loss. What is a Ketogenic Diet? The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up? Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy. The Ketogenic Diet with Diabetes Some precautions must be made clear; this diet is not appropriate for people with any Continue reading >>
Ketogenic Diet For Type 2 Diabetes: Does It Work?
Type 2 diabetes is a condition affecting blood sugar levels that can be managed by following a healthful diet and maintaining a healthy weight. People who are obese can reduce their risk of developing diabetes by eating a balanced, nutritious diet. Following a diet that is full of vitamins and minerals and low in added sugars and unhealthful fats can help people to lose some of the extra weight. People who lose 5-10 percent of their body weight can lower their risk of developing diabetes by 58 percent. For people with diabetes or people with pre-diabetes, losing the same amount of body weight can help provide a noticeable improvement in blood sugar. For some people, the ketogenic diet is an effective way to control their diabetes. It has been shown to lower blood glucose levels as well as reduce weight. Contents of this article: What is the ketogenic diet? Foods containing carbohydrates, such as bread, pasta, and fruit, are the body's main fuel source. The body breaks the food down and uses the resulting sugar (glucose) for energy. A ketogenic diet is a high-fat, very low carbohydrate diet. It was initially developed and recommended for children with epilepsy. The diet recommends that people eat 30 grams (g) of carbohydrates or below per day. The goal is to eat 3 to 4 g of fat for every 1 g of carbohydrate and protein. Impact on blood sugar levels Because the ketogenic diet restricts carbohydrates, there is not enough sugar available for the body to use as fuel, so it resorts to using fat. The process of breaking down fat is called "ketosis," and it produces a fuel source called ketones. A ketogenic diet helps some people with type 2 diabetes because it allows the body to maintain glucose levels at a low but healthy level. The reduced amount of carbohydrates in the diet Continue reading >>
I Tried The Keto Diet To Manage My Diabetes This Is What Happened
I Tried the Keto Diet to Manage My Diabetes This Is What Happened Medically reviewed by Natalie Olsen, RD, LD, ACSM EP-C on February 23, 2018 Written by Kareem Yasin Health and wellness touch everyones life differently. This is one persons story. When Lele Jaro received a diagnosis of type 2 diabetes in 2006, she didnt leave the doctors office with a complete understanding of how the condition would influence the rest of her life, or fully equipped with the tools shed need to manage it. When I found out I had type 2, I didnt really know how to feel about it. I was so young and, to put it bluntly, nave about the whole diagnosis, she recalls. They gave me medication, some information [on] what to eat if you have diabetes, and that was it. Her doctor told her that shed probably been living with the condition since she was in her teens. The symptoms of type 2 diabetes creep up slowly without you really knowing the damage that its already doing to your body, she says. I thought it was something I could eventually overcome. It wasnt until I got pregnant at 29 when I realized that type 2 diabetes is a serious, chronic disease, she says. Following her doctors recommendations, she started to follow the Standard American Diet (SAD). Combined with working out, she managed to lose about 60 pounds by 2008. But when it came to actually managing her diabetes, relying on weight loss simply wasnt cutting it. Though she followed her doctors advice, it became increasingly clear to Lele that shed need to take matters into her own hands and develop a means by which to manage her diabetes that didnt leave her reliant on medication. The most common misconception about type 2 [diabetes] is that its easy to manage it by just losing weight, she says. While I understand that losing weight can de Continue reading >>
Dr Advising Against Keto Diet
Long time Type 2 diabetic (almost 20 years), new to the forum, first post. My doctor threatened to put me on insulin in March because my A1c was 8.4% Ive brought my average BG down from 194 to 136 with exercise and diet (6.36 on A1c calculator). I started out my diet by limiting carbs. In the past week I shifted to a Keto Diet. I sent my BG numbers to my doctor and he was impressed then he urged me not to do a Keto diet. He said that fat promotes insulin production and increases insulin resistance. This completely contradicts all the Keto literature that claims that high fat diets reduce insulin secretion and insulin resistance. He went on to recommend a DASH diet which includes high fiber foods like whole grains, whole wheat, and oats. Frankly, Im flabbergasted. This is the same advice I got when I was first diagnosed with diabetes 20 years ago. I ate whole wheat bread, brown rice, whole wheat pasta, and oatmeal for over a decade and it wrecked my BG. I continued to increase my medication to adjust over the years. Now Im maxed out on oral meds. Does anyone else have experience with a doctor who is against a diet that is working to bring your BG levels down? Any thoughts about Keto vs DASH? Has DASH actually worked for anyone out there? I had a similar experience with a doctor, who strongly opposed eating keto (or even low-carb). He also strongly opposed strenuous exercise, weightlifting, and other such activities (on the premise that risk of injuries outweighed potential benefits). After doing some research, I realized that I wanted to use diet and exercise to help manage my BG, and that what I really needed was a new doctor. So I got one, and its been great to have a supportive physician who isnt close-minded to such ideas (her take is generally show me it works, and Continue reading >>
Approach Keto (very Low Carb) Diet With Caution
In a second study,2 a Harvard-led research team evaluated the benefit of a ketogenic diet in both children and adults with type 1 diabetes despite concerns about a possible negative effect on growth and development in children following such a restricted diet.These researchers report "exceptional" glucose controlwith little adverse effects. However, the participants were recruited from a closed Facebook group, TypeOneGrit, for people who follow a diet and diabetes program based on the recommendations in the Diabetes Solution,3a book by Richard K Bernstein, MD, who devised this program tomanage his own type 1 diabetes. The ketogenic diet focuses on lean meat and lots of vegetables to promote weight loss. Too good to be true? Many experts are pushing back and raising questions about whether the keto diet itself is responsible for the improvement in weight and blood sugar or maybe the dieters' successes are due to other components of the research methods, such as lifestyle differences or physiological changes. "First, the studies are too small to make sense of the differences between the groups," says Michael J Gonzalez-Campoy, MD, PhD, medical director and CEO of the Minnesota Center for Obesity, Metabolism, and Endocrinology, in Eagan, Minnesota. And, it's important to recognize that both study teams acknowledge that as exciting as their findings seem,a large,randomized controlled trial is still needed to more closely assess a variety of components that may be contributing to the successes found in both studies before the findings can be recommended to anyone outside the study groups1,2he says. "We recommend against 'dieting',which is invariably a short-termsolution," Dr. Gonzalez-Campoy, tells EndocrineWeb, "and since weight loss may be accomplished by a reduction in c Continue reading >>
How To Lower A1c - Maria Mind Body Health
I work with a lovely woman with Type 1 diabetes who said something so striking to me, Maria, I wish I would gain weight when I cheated. We are a vain society. I know that I have internal inflammation but since I dont see it on the outside I have a hard time staying on your keto meal plans. She was right. She had terrible internal inflammation. Her A1C was 11.5 and she had a stroke. Jennifer was only 28 and just had a baby girl that she needed to stay healthy for but the addiction for carbs and sugar was getting the best of her. She also was right; we are a vain society. It isnt until we look unhealthy on the outside that we finally change bad eating habits. When clients tell me that their doctor told them, Dont worry, eat whatever you want, just make sure you cover your glucose with insulin, its like saying to a firefighter, Dont worry, pour as much gasoline as you like on that fire, as long as you cover it with enough water. It is absolutely dangerous and irrational. In this case, I suggest finding a new doctor who will encourage you to eat a keto-adapted diet while watching your need for insulin. There is also a Facebook group called typeonegrit that has a whole group of people managing their type 1 diabetes with diet and is a great source for how to adjust your insulin and adapt to this lifestyle. We have helped many type 1 diabetics achieve A1c levels below 5.0! Following this lifestyle and adjusting your insulin as needed can result in very good blood sugar control. Cutting carbohydrates lowers inflammation and WILL lower A1c! A1c is a test that estimates the average blood glucose levels of the last 3 months. This is a great indicator of how well you have managed your blood glucose and also is a great indicator of health. Figure 1 shows that the higher your A1c, t Continue reading >>
The Ketogenic Diet And Diabetes: The Definitive Guide
The Ketogenic Diet and Diabetes: The Definitive Guide The ketogenic diet has been around for a LONG time. Its popular. Its controversial. Some love it. Some hate it. Some even say it can help your blood sugars stay in better control. After thoroughly reviewing the scientific literature and trying the ketogenic diet myself for over 6 months, I am ready to unfold everything youve been hearing and let you decide for yourself what you think about the diet that has taken the world and diabetes community by storm. In this guide to the ketogenic diet and diabetes, I will cover the following: 7. Conclusion: Is a keto diet good for people with diabetes? This guide is relevant for people with any type of diabetes. I will mainly talk about insulin when I discuss how a keto diet affects blood sugar, but some studies also show a possible reduction in certain type 2 medications. Disclaimer: Please always consult with your medical team before you start a new diet, adjust your medication or change your diabetes management routine. Once upon a time, keto was the original diabetes diet prescribed to type 1 diabetes patients before the advent of insulin, as this would prolong their lives as it has less of an impact on blood sugar levels. More recently, Doctor Bernstein has popularized the keto diet for people living with diabetes in his book: Dr. Bernsteins Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars The ketogenic diet is a low-carb diet where you get only ~5% of your daily caloric intake from carbohydrates. By restricting your carbohydrate intake so severely, you force your body to get most of its energy from fat. A byproduct of this fat burning is the production of natural ketones in the body, hence the name of the diet. Burning ketones supplies the body with Continue reading >>
The Effect Of A Low-carbohydrate, Ketogenic Diet Versus A Low-glycemic Index Diet On Glycemic Control In Type 2 Diabetes Mellitus
Go to: Abstract Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus. Eighty-four community volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate, ketogenic diet (<20 g of carbohydrate daily; LCKD) or a low-glycemic, reduced-calorie diet (500 kcal/day deficit from weight maintenance diet; LGID). Both groups received group meetings, nutritional supplementation, and an exercise recommendation. The main outcome was glycemic control, measured by hemoglobin A1c. Forty-nine (58.3%) participants completed the study. Both interventions led to improvements in hemoglobin A1c, fasting glucose, fasting insulin, and weight loss. The LCKD group had greater improvements in hemoglobin A1c (-1.5% vs. -0.5%, p = 0.03), body weight (-11.1 kg vs. -6.9 kg, p = 0.008), and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p < 0.001) compared to the LGID group. Diabetes medications were reduced or eliminated in 95.2% of LCKD vs. 62% of LGID participants (p < 0.01). Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes. Effect of diet programs on indices of glycemic Continue reading >>
Is Your Fasting Blood Glucose Higher On Low Carb Or Keto? Five Things To Know
This past spring, after 18 months of great success on the keto diet, I tested my fasting blood sugar on my home glucose monitor for the first time in many months. The result shocked me. I had purchased the device, which also tests ketones, when I was diagnosed with pre-diabetes in the fall of 2015. As I embarked on low-carb keto eating, I tested my blood regularly. Soon my fasting blood sugar was once again in the healthy range. I was in optimal ketosis day after day. Not only that, I lost 10 lbs (5 kg) and felt fantastic — full of energy with no hunger or cravings. Before long I could predict the meter’s results based on what I was eating or doing. I put the meter away and got on with my happy, healthy keto life. When my doctor ordered some lab tests this spring, I brought the meter out again. While I had no health complaints, excellent blood pressure and stable weight, she wanted to see how my cholesterol, lipids, HbA1c, and fasting glucose were doing on my keto diet — and I was curious, too. To check the accuracy of my meter against the lab results, on the morning of the test I sat in my car outside the clinic at 7:30 am, and pricked my finger. I was expecting to see a lovely fasting blood glucose (FBG) of 4.7 or 4.8 mmol/l (85 mg/dl). It was 5.8! (103 mg/dl). What? I bailed on the tests and drove home — I didn’t want my doctor warning me I was pre-diabetic again when I had no explanation for that higher result. The next morning I tested again: 5.9! (104). Huh??? For the next two weeks I tested every morning. No matter what I did, my FBG would be in 5.7 to 6.0 (102 to 106 mg/dl), the pre-diabetic range again. One morning after a restless sleep it was even 6.2 mmol/l (113 mg/dl). But my ketones were still reading an optimal 1.5-2.5 mmol/l. I was still burnin Continue reading >>
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Should Keto Be Used To Manage Type 2 Diabetes? One Womans Story | Everyday Health
Although the keto diet isn't recommended for people with diabetes, Stephanie Lofton says that for her, the eating approach has helped jump-start a path to a healthier future. Nothing seemed to work for Stephanie Lofton when she began to try to lose weight and manage her blood sugar after being diagnosed with type 2 diabetes in 2015. She tried the South Beach Diet , calorie counting , eating low-fat at one point, she even considered bariatric surgery to lose weight and control type 2 diabetes . Thats when she came across the ketogenic diet, a popular high-fat, low-carb eating plan sometimes referred to as the keto diet. Lofton, 40, says that while she hasnt lost much weight, her blood sugar is in the mid-100s milligrams per deciliter (mg/dL) the healthiest level shes reached in years. She had previously recorded her highest blood sugar levels between 600 and 800 after being rushed to the emergency room in 2016. This looks like something that for me is sustainable, says Lofton, a medical biller who weighs 300 pounds. I haven't lost much weight, but for me my biggest priority has been to get my sugar numbers down. She says shes proud that her A1C the two- to three-month average of blood sugar levels is 8.7, down from 10.4 about a year ago. Although the improved level still signals diabetes (anything above 6.5 is defined as diabetes), Lofton is hopeful that the keto diet can continue to help her improve her health. RELATED: How to Stabilize Your Blood Sugar The Pros and Cons of the Keto Diet for People With Diabetes The basis of the keto diet is achieving ketosis , a natural state in which the body turns to burning fat instead of carbs (or sugar) for energy. During ketosis, ketones, or fat metabolites, are released in the blood. People on the keto diet are tasked with gett Continue reading >>
Is “keto” The Key To Reversing Diabetes?
SEATTLE -- A wave of recent studies show that in many cases, type 2 diabetes is partly or wholly reversible with high fat, very low carb ketogenic diets. Speakers at the Personalized Lifestyle Medicine Institute 5th annual Thought Leaders Consortium urged the clinical community to radically re-think the received wisdom about this common disorder, and start applying diet and lifestyle programs that actually address the root causes of the condition. Fresh data from an ongoing study of 232 overweight or obese women and men with type 2 diabetes (average age 54 years, average BMI of 41), provide evidence that after 10 weeks on a carefully-formulated low-carb ketogenic diet, 36% were able to stop insulin therapy completely, while an additional 51% were able to significantly lower their doses. Mean hemoglobin A1c (HbA1c) measures dropped from 7.5% to 6.5%, with 56% of the participants reaching A1c levels below the diagnostic threshold for diabetes. This was accompanied by clinically significant weight loss in 71% of cases (McKenzie A, et al. JMIR Diabetes. 2017 2 (1): e5). Though many clinicians and researchers have long predicted the possibility, this is the first large-scale study to show that major biomarkers of type 2 diabetes can be consistently shifted in the right direction via dietary interventions. “We are very pleased with what we are seeing,” said Stephen Phinney, MD, PhD, Chief Medical Officer and co-founder of Virta Health, a San Francisco based clinic specializing in lifestyle-based treatment of diabetes and related metabolic diseases. “And all of this is based on eating to satiety. There are no additional medications, no calorie counting, no anxiety.” Dr. Phinney told PLMI attendees that while he hesitates to say ketogenic diets can “cure” diabetes, Continue reading >>
