Diet

Is Keto Diet Good for Diabetics?

Aditi Shenai

October 13, 2022

The keto diet, short for the ketogenic diet, is a widely known way to lose weight. It consists of eating foods that focus on getting more calories from fat rather than from carbohydrates.

It emphasises eating healthy fats, moderate amounts of protein, and very minimal amounts of carbohydrates. Recently, it has been getting noticed for its benefits for controlling Type 2 diabetes.

Diabetes is a severe public health problem with a growing prevalence and approximately 537 million diabetic adults worldwide. It is considered one of the significant contributors to morbidity and mortality due to a higher risk of developing heart disease and diabetic neuropathy. Therefore, it is the need of the hour to treat and manage diabetes.

One of the ways is by following a keto diet and an active lifestyle. There is growing evidence suggesting that it might help control diabetes because it allows the body to maintain glucose levels at a low level and prevents a rise in blood sugar levels. 

How Does the Keto Diet Work for Diabetes?

The primary energy source for the body is carbohydrates. When your carb intake is deficient and there is no glucose availability, the body goes through a metabolic state called ketosis and starts to break down fats for energy instead.

When fats are broken down in the absence of carbohydrates, a product known as ketone bodies are formed. In this state, the body uses ketone bodies for energy instead of glucose until you start eating carbohydrates again. 

The keto diet provides additional benefits such as:

  • Lowering blood pressure
  • Improving insulin sensitivity
  • Reducing dependency on medication
  • Improving levels of high-density lipoproteins (HDL) or “good” cholesterol, without adding to low-density lipoprotein (LDL) or “bad” cholesterol.

Indian diets are rich in carbohydrates, the primary energy source for many bodily processes. When you consume carbohydrates, it breaks down into sugars in the digestive system, entering your bloodstream.

The higher the sugar content in your bloodstream, the more insulin you need. Insulin plays a role in using the sugars for energy or energy storage. However, in a diabetic person, insulin is absent or does not function properly, which disrupts the body’s ability to use carbohydrates as energy effectively.

As a result, it leads to an increase in blood sugar levels which can be detrimental. So, if a person eats a high carbohydrate diet, it leads to a spike in blood glucose. Thus, a lower intake of carbohydrates in the diet can help eliminate large spikes in blood sugar, reducing the need for insulin.

Best Keto Diet Foods for Diabetes

The keto diet aims to consume a balance of nutrients, including vitamins, minerals, protein, fibre, and the proper amount of calories and healthy fats. Here’s what you can eat if you have Type 2 Diabetes and are on the keto diet:

Low Carb Vegetables

Having low-carb vegetables over starchy ones reduces your carbohydrate intake and puts you into a state of ketosis. A study concluded that eating non-starchy vegetables at every meal is best.

Examples of low carb veggies include cauliflower, zucchini, spinach, broccoli, cabbage, kale, and bell peppers. 

The nutritional values of some low-carb vegetables per 100 g of serving are:

Cauliflower

  • Energy: 25 kcal
  • Carbohydrate: 4.9 g
  • Protein: 1.9 g
  • Total fat: 0.2 g
  • Total dietary fibre: 2 g

Zucchini

  • Energy: 18 kcal
  • Carbohydrate: 3.1 g
  • Protein: 1.2 g
  • Total fat: 0.3 g
  • Total dietary fibre: 1 g

Low Carb Proteins

Limiting your carb intake is the first concern on a keto diet. However, you cannot neglect the importance of protein intake. Protein plays an essential role in the optimal functioning of organs, preventing unnecessary muscle loss and repairing and building body tissues. 

Consuming too much protein may lead to an increase in a process called gluconeogenesis and throw you out of ketosis. Gluconeogenesis is the metabolic process wherein your liver and kidneys make glucose from non-carb sources such as protein to meet the energy needs.

Studies confirm that you should keep your protein intake moderate and less than 1g per kg of body weight; that is, only 10-20% of your calories should come from protein. 

To fulfil your protein requirements, foods you can eat are:

Whole Eggs

Eggs are a staple in a keto diet. They are low in carbohydrates and are an excellent source of protein. Egg whites are low in calories, high in protein and good sources of minerals such as riboflavin, selenium and potassium. 

On the other hand, egg yolks contain healthy fats, good cholesterol, protein, iron, and other minerals. In addition, eggs are easy to cook with and can be used in a wide range of dishes. However, you should consume one tablespoon of healthy fats equal to each egg. 

The nutritional value of one whole egg is:

  • Energy: 63 kcal
  • Carbohydrate: 0.3 g
  • Protein: 5.5g
  • Total fat: 4.1g
  • Total dietary fibre: 0 g

Meats

Meat like chicken breasts and steaks are high in protein content that help in achieving ketosis. Even though keto is a low-carb, high-fat diet, it doesn’t mean you should be eating an excess of meat.

The nutritional values of some meats per 100 g of serving are:

Chicken Breast

  • Energy: 143 kcal
  • Carbohydrate: 2.6 g
  • Protein: 24 g
  • Total fat: 3.1 g
  • Total dietary fibre: 0 g

Fish

Fish is an ideal option to include in a keto diet since it is naturally high in protein and free of carbohydrates. Moreover, it contains healthy omega-3 They are also high in vitamin B, selenium and potassium. Examples include anchovies, salmon, tuna, halibut, herring, and sardines. 

The nutritional contents of some fish per 100 g of serving are:

Mackerel

  • Energy: 205 kcal
  • Carbohydrate: 0 g
  • Protein: 18.6 g
  • Total fat: 13.9 g
  • Total dietary fibre: 0 g

Sardine

  • Energy: 208 kcal
  • Carbohydrate: 0 g
  • Protein: 24.6 g
  • Total fat: 11.4 g
  • Total dietary fibre: 0 g

Tofu

Tofu is made from soybeans. While soybeans themselves are not suggested on a keto diet, tofu works well since it is relatively low in carbs and high in protein. Tofu does contain estrogen-like nutrients, which can affect hormone levels over time if consumed in very large amounts. Therefore, it can be keto-friendly if you’re careful about how much you consume.

The nutritional contents of tofu per 100 g of serving are:

  • Energy: 94 kcal
  • Carbohydrate: 2.3 g
  • Protein: 9.4 g
  • Total fat: 5.3 g
  • Total dietary fibre: 2.4 g

Dairy Products

You can have dairy in your keto diet as it has minimal carbohydrates and is without added sugar. However, synthesised dairy products like ice cream or flavoured yoghurts may disturb your ketosis since they contain a high amount of carbs or have an abundance of added sugar. 

Dairy contains fat that takes longer to digest and helps us stay full for a long time. Moreover, it offers nutrients like calcium, phosphorus, and vitamin D. 

Dairy products you can eat are butter, cheese, paneer, ghee. Ensure you are choosing healthier versions of these as often as possible, like paneer, low sodium cheese and home made ghee.

The nutritional values of some dairy products per 100 g of serving are:

Paneer

  • Energy: 321 kcal
  • Carbohydrate: 3.5 g
  • Protein: 21.4 g
  • Total fat: 25 g
  • Total dietary fibre: 0 g

Butter

  • Energy: 717 kcal
  • Carbohydrate: 0.0 g
  • Protein: 0.8 g
  • Total fat: 81 g
  • Total dietary fibre: 0 g

Healthy Fats

A high percentage of calories in a keto diet comes from fats which shift your body into ketosis. However, it is essential to include primarily healthy fats as some fat types bring health risks. Sources of healthy fats include fatty fish, nuts and seeds along with  nut butters and avocado.

In addition, you must avoid unhealthy fats such as bacon, sausage, red meat, and fried cheeses. Prioritise monounsaturated fats (like the examples mentioned above) and cook foods in coconut oil, homemade ghee or for quick saute olive oil that support a keto diet without excessive health risk. 

Let’s have a better look at the sources of healthy fats.

Avocados

Avocados are a rich source of heart-healthy monounsaturated fatty acids, making them a perfect addition to a keto diet. In addition, they offer fibre, which enhances digestive health. Moreover, they are a great source of potassium, folate and vitamins C, E, K, and B6. 

The nutritional contents of avocado per 100 g of serving are:

  • Energy: 160 kcal
  • Carbohydrate: 8.5 g
  • Protein: 2 g
  • Total fat: 14.7 g
  • Total dietary fibre: 6.8 g

Nuts and Nut Butters

Nuts are one of the richest sources of healthy fats, making them ideal for a keto diet. Furthermore, the fibre present in the nuts may provide anti-diabetic properties. You can consume them as a go-to snack or as nut butter. Stick to nuts like walnuts and almonds which are lower in carbs and avoid nuts like cashews, chestnuts and pistachios which are too high in carbohydrates for the keto diet. they can be consumed in a variety of ways, like just a fistful of mixed nuts at tea time or roughly chopped on your oats porridge in the morning, but do watch out for how much you consume, only 1 fistful is your daily quota! 

The nutritional contents of some nuts per 100 g of serving are:

Walnuts

  • Energy: 654 kcal
  • Carbohydrate: 13.7 g
  • Protein: 15.2 g
  • Total fat: 65.5 g
  • Total dietary fibre: 6.7 g

Almonds

  • Energy: 579 kcal
  • Carbohydrate: 20 g
  • Protein: 29.3 g
  • Total fat: 50 g
  • Total dietary fibre: 21.6 g

Seeds 

Seeds are another source of healthy fats that make an excellent addition to your keto diet. They provide low to moderate carbohydrates. In addition, they are high in fibre, which does not disrupt ketosis. Fibre isn’t digested and absorbed in your small intestine, thereby not increasing blood sugar. Seeds will also help you lose weight without having to starve yourself. 

The nutritional contents of some nuts per 100 g of serving are:

Sunflower Seeds

  • Energy: 283 kcal
  • Carbohydrate: 10 g
  • Protein: 11.6 g
  • Total fat: 25 g
  • Total dietary fibre: 5 g

Sesame Seeds

  • Energy: 573 kcal
  • Carbohydrate: 22 g
  • Protein: 17.7 g
  • Total fat: 49.7 g
  • Total dietary fibre: 11.8 g

Low Carb Fruits

Fruits generally need to be consumed sparingly in a keto diet. They that are low in carbs and have a low glycemic index can be consumed keeping in mind that they need to be eaten in the  right quantities.

Fruits such as avocados, strawberries, and watermelon are good sources of fibre, vitamins, minerals, and antioxidants that are okay to have in a keto diet if consumed in the correct quantity. 

The nutritional contents of some fruits per 100 g of serving are:

Watermelon

  • Energy: 30 kcal
  • Carbohydrate: 7.5 g
  • Protein: 0.6 g
  • Total fat: 0.1 g
  • Total dietary fibre: 0.4 g

Strawberries

  • Energy: 32 kcal
  • Carbohydrate: 7.6 g
  • Protein: 0.6 g
  • Total fat: 0.3 g
  • Total dietary fibre: 2 g

Foods to Avoid on Keto Diet for Diabetes

Now that we’ve seen all the foods okay to consume, let’s have a look at what needs to be avoided so as to keep your body in ketosis.

Starchy Vegetables and Fruits 

Starchy vegetables contain more digestible carbohydrates than fibre, increasing blood sugar levels. These include potatoes, sweet potatoes and beets.

In addition, high-sugar fruits like bananas, mangoes and chikoos can spike your blood sugar more quickly as they have a higher percentage of carbohydrates.

Baked Goods

Pastries, doughnuts, and cakes have high sugar content, leading to high blood sugar levels. Moreover, they include butter, which makes them high in saturated fat and cholesterol which then also leads to the increased risk for coronary heart diseases. 

Legumes

Although legumes are rich in nutrients such as iron, potassium, and zinc, they contain a lot of carbs which make them harmful to the ketogenic diet. 

Refined Grains

Refined grains are stripped of all nutrients and contain meagre fibre. They have a high glycemic index and hence digest quickly. It causes unhealthy spikes in blood sugar levels and a build-up of fats, especially around the waistline.

The keto diet completely avoids white bread, white pasta, pizza dough, white flour, white rice, and breakfast cereals. Hence, you can opt for alternatives such as spiralised vegetables, spaghetti squash and zoodles.

Keto Diet Meals for Diabetes

Non Vegetarian Options:

Breakfast:

  • Spinach scrambled eggs with raspberries
  • Omelettes made with coconut oil
  • Scrambled eggs with oil and cheese
  • Cheese omelette with smoked bacon
  • Boiled eggs with avocado 
  • Mushroom omelette
  • Breakfast salad with boiled eggs

Mid-Morning Snack:

  • Buttermilk
  • Pumpkin seeds
  • Boiled eggs 
  • Strawberry smoothie

Lunch:

  • Chicken malai tikka
  • Goan fish curry
  • Mashed cauliflower in mayonnaise with mutton seekh kebab
  • Basil chicken 
  • Egg stuffed avocado
  • Mutton meatballs
  • Baked chicken with cheese

Evening Snack:

  • Bullet coffee without sugar
  • Blueberries
  • Green Tea with almonds

Dinner:

  • Chicken salad
  • Mutton seekh kebab with mint chutney
  • Creamy fish soup
  • Avocado and egg salad
  • Vegetable egg bhurji
  • Zucchini “noodles” 
  • Tandoori chicken with pudina chutney 

Vegetarian Options:

Breakfast:

  • Cauliflower upma
  • Strawberry smoothie
  • Paneer bhurji
  • Vegetable cheese sandwich
  • Pumpkin French toast
  • Ginger smoothie
  • Keto pancakes with berries
  • Chia seed pudding

Mid-Morning Snack:

  • Lemon water with pumpkin seeds
  • Watermelon
  • Jeera water with walnuts

Lunch:

  • Paneer Tikka
  • Cauliflower “Mac” and cheese
  • Spicy grilled eggplant
  • Ginger paneer with almond flour roti
  • Spinach, mushrooms and capsicum stir-fried in olive oil
  • Eggplant and mushroom soup
  • Paneer stuffed capsicums 
  • Quinoa khichdi with a green salad

Evening Snack:

  • Black tea 
  • Pumpkin seeds
  • Bullet coffee without sugar
  • Carrots

Dinner:

  • Cauliflower zucchini fried rice
  • Grilled mushroom salad
  • Broccoli soup
  • Keto kabab roll with garlic sauce
  • Malai paneer tikka
  • Tomato soup with a green salad
  • Broccoli and mushroom stir fry with cheese

Vegan Meals:

Breakfast:

  • Tofu bhurji with olive oil
  • Green smoothie
  • Cauliflower poha
  • Lauki juice
  • Rava idli with coconut chutney
  • Keto porridge with full-fat coconut milk and ground flaxseeds
  • Tofu scramble with vegan cheese and avocado

Mid-Morning Snack:

  • Lemon barley water
  • Soaked almonds 
  • Carrot sticks 

Lunch:

  • Mixed veggies with tofu
  • Spinach and mushroom soup
  • Roasted eggplant vegan lasagna
  • Keto zucchini bread with scrambled tofu
  • Broccoli, carrots and green peas sabzi
  • Cauliflower rice stir-fry with tofu.
  • Grilled tofu with toasted sesame seeds

Evening Snack:

  • Cucumber slices
  • Strawberries
  • Methi seed water 

Dinner:

  • Spinach and bottle gourd soup
  • Stir-fried vegetables with tofu 
  • Coconut and cauliflower soup
  • Zucchini noodles with mushrooms
  • Vegan eggplant lasagna
  • Crispy tofu with a green salad
  • Vegetable and tofu salad 

Possible Health Risks on Keto Diet for Diabetes

While the keto diet has numerous health benefits, it is not magic or a miracle to cure diabetes. According to a recent study, one of the challenges of keto diets is that they support a lower vegetable, fruit and grain intake with an increased intake of fat which can be detrimental. 

Some short-term side effects of keto, such as the “keto flu,” occur when your body adjusts to the diet.

It involves fatigue, constipation, difficulty sleeping, dizziness, headaches and nausea. However, you can prevent these symptoms by adequate hydration and electrolyte intake. Other possible health risks include nutrient deficiencies, digestive issues, low blood pressure, kidney disease, and high cholesterol.

Who Should Avoid The Keto Diet?

  1. People with kidney diseases: The keto diet is relatively high in protein which may cause kidney stones. In addition, it may worsen kidney disease in those suffering from it. Because the kidneys’ function is to filter out toxins from the blood and consume too many proteins, it’s just harder on the kidney. This is why controlling protein intake is essential.  
  2. People with Type1 diabetes: Ketones, produced by the body during ketosis, are a risk factor for diabetic ketoacidosis, which is more common in people with type 1 diabetes than people with type 2 diabetes. 
  3. People With a history of heart disease: You should be cautious about the keto diet if you have a history of heart disease. It is because cholesterol levels spike during the initial stages of the diet, further increasing its risk. 
  4. Women trying to conceive: The keto diet is particularly harmful to pregnant women or trying to get pregnant. On a keto diet, you’re not eating vegetables, fruits, and whole grains, which have the nutrition required for a healthy baby. According to research, low-carb diets link to a higher risk of neural tube defects in babies. 

Conclusion

Eating a keto diet for diabetes can be highly beneficial because by following it, you swap your body’s preferred energy source from carbohydrates to fat. However, it can create some serious health problems in the long term. Therefore, it is also important to note that you should attempt it under medical supervision.

Although the keto diet offers many potential benefits for diabetes management, following it requires a pretty serious commitment. If you want it to be sustainable, then moderation is the key. So take a beat before you take the plunge and decide whether this is the proper diet for you. 

Frequently Asked Questions (FAQs)

Q. Is the keto diet OK for diabetics?

A. Yes, keto is effective for diabetics. A keto diet includes foods that focus on getting more fat and calories than carbohydrates. Lower intake of carbohydrates in the diet can help eliminate large spikes in blood sugar, reducing the need for insulin. It also allows the body to maintain glucose levels at a low level.

Q. What can you eat on a keto diet?

A. You can eat foods with balanced nutrients, including vitamins, minerals, fibre, and the proper calories and healthy fats. These foods include non-starchy vegetables such as carrots, broccoli, mint, cauliflower, and cabbage; healthy fats such as avocado and its oil, nuts, seeds, fatty fish, and olive oil; and non-sugary fruits including berries and watermelon. Moreover, you should not neglect the consumption of proteins. These foods include tofu, eggs, paneer and dairy products. 

Q. Who should not do keto?

A. People who have kidney disease should not do keto as it is high in protein which may cause kidney stones. People with type 1 diabetes should avoid the keto diet because it creates a risk factor for diabetic ketoacidosis. Moreover, people with a history of heart disease should be cautious about it because cholesterol levels spike during the initial stages of the diet, further increasing the risk of heart disease. In addition, pregnant women or women trying to get pregnant should avoid the keto diet.

Q. Can you drink alcohol on a keto diet?

A. Drinking while on a keto diet isnt the best option as it can slow down the rate of ketosis and can make the effects of alcohol more severe on the body. For a diabetic on a keto diet, its definitely best to abstain from alcohol. 

Q. What vegetables should I avoid on keto?

A. In keto, you should avoid vegetables with high starch content. Starchy vegetables contain more digestible carbohydrates than fibre, increasing blood sugar levels. These include potatoes, sweet potatoes and beets. Instead, you can opt for low carbohydrate vegetables such as cauliflower, cabbage, spinach, and broccoli. 

Q. Can you eat bananas while on keto?

A. No, bananas are high in sugars which can beat the purpose of ketosis. High sugar fruits can spike your blood sugar more quickly as they have more carbohydrates. One banana has 20 g of carbohydrates. So you should opt for low sugar fruits such as avocados, raspberries, and lemons instead of fruits like bananas. 

Q. Are mushrooms keto-friendly?

A. Mushrooms are low in carbohydrates, making them a perfect addition to a keto diet. They also offer micronutrients such as B vitamins, phosphorus, vitamin D, selenium, copper, and potassium. In addition, they can make a delicious meat substitute, and you can add them to a stir fry. Mushrooms are one of the healthiest low carb foods you can eat on a keto diet.

About the Author

M.Sc in: Dietetics and Applied Nutrition from Manipal University. Worked: All over India and have been involved in helping set up nutrition departments in start ups. Interested in lifestyle based nutrition. Mantra: A healthy lifestyle isn't a choice to be made or discarded, it's a way of life!


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