Ketogenic Diet for Type 2 Diabetes: Benefits and Side Effects

Mehak Shah

November 18, 2022

High blood sugar levels are a critical problem in diabetes, no matter what type of diabetes you have. Usually, one sees Type 2 diabetes as the most common form of diabetes. It is a by-product of an unhealthy diet, obesity, and lack of exercise. This type of diabetes can also be inherited.

Type 2 diabetes diets focus on consuming low-carb foods. Recent studies show that low carbohydrate diets in people with type 2 diabetes are safe and effective over a short period while improving glycemic control. 

The ketogenic diet, commonly referred to as the keto diet, is a low carb eating plan that focuses on foods high in fat and moderate in protein. Because the keto diet is low in carbs, it may be appealing to diabetic people. First, however, it is essential to get a general outlook before starting a keto journey.

What is Type 2 Diabetes?

Type 2 diabetes is a metabolic disorder that occurs when the hormone insulin is not used effectively by the cells in your body. The ineffective insulin use results in insulin resistance, which causes blood sugar levels to rise. In advanced stages, type 2 diabetes causes damage to the pancreatic insulin-producing cells, leading to insufficient insulin production. Developing type 2 diabetes depends on diet, physical activity level, genetics and other environmental factors. If either parent has type 2 diabetes, the risk of inheritance of type 2 diabetes is 15%. However, if both parents have type 2 diabetes, you are 75% more likely to inherit the condition. Type 2 diabetes usually occurs in people over 35-40. However, in recent years, cases of type 2 diabetes have become more common in young adults, teens and children.

Generally, type 2 diabetes progresses more slowly than type 1 diabetes. As a result, diagnosis occurs years after you first develop the condition. You can detect it by checking for the following most common symptoms. However, some of these symptoms are the same for type 1 diabetes.

  • Sudden loss of muscle mass
  • Excessive thirst
  • Frequent urination
  • Increased hunger
  • Extreme tiredness
  • Headache
  • Delayed healing
  • Problems with sexual drive

What is a Ketogenic Diet?

The keto or ketogenic diet focuses on eating foods high in fat, moderate in protein and significantly low in carbs. The dietary requirements in a keto diet consist of 55% to 60% fat, 30% to 35% protein, and 5% to 10% carbohydrates. For example, in a 2000 calories per day diet, carbohydrates amount up to 20 to 50 g per day. As a result, the diet becomes fairly restrictive in your carb intake. Following a keto diet requires a significant shift in your eating habits. For people living with diabetes, the keto diet can help with weight loss and lower blood glucose levels.

The Keto diet works by changing how your body uses fat. First, the body experiences carbohydrate deprivation due to reduced intake. Therefore, the glucose availability drops and forces the body to enter a ketosis metabolic state. It is the metabolic state wherein your body burns fat rather than carbs for energy. With the keto diet, your body has better control over blood sugar levels or carbs intake. 

How Does the Ketogenic Diet Work for Type 2 Diabetes?

When you eat simple carbohydrates, your body breaks them down to sugars, which enter your bloodstream. The more carbs you eat, the more sugar in your bloodstream. As a result, blood sugar levels rise, and the need for insulin increases. Insulin is necessary to direct the cells to use sugar for energy or energy storage. However, the body of type 2 diabetic people fails to make enough insulin or can’t properly use the insulin it makes. Over time, this leads to an accumulation of sugar in the bloodstream. Adopting a low carb diet like keto prevents you from eating foods high in sugar (carbs). As a result, it can reduce the occurrence of blood sugar spikes throughout the day. Therefore, following a keto diet reduces the need for insulin, which is beneficial for type 2 diabetes. 

A study states that the ketogenic diet is superior for glycemic control or maintaining lower, more healthy glucose levels. Hence, it can work as an adjunctive treatment for type two diabetes. It also aids in easier diabetes management.

Keto diets help the weight come off faster than other diets. In addition, since type 2 diabetes shows a link to obesity, the keto diet can promote overall weight management during diabetes. A study shows that weight loss in type 2 diabetes cases leads to improved heart health, quality of life, and sexual function. However, there is no solid evidence to suggest that a keto diet can reverse diabetes.

Impact of Keto on Type 2 Diabetes Medication

Diabetic people try keto to manage their blood sugar better. It might also help cut down and eventually stop using insulin medications or injections. The keto diet helps lower blood sugar, and people don’t need to take insulin as often. Science backs this up. A study says that people with type 2 diabetes were able to reduce their average blood glucose (sugar) levels and fasting glucose. As a result, they were able to reduce or eliminate diabetes medications. However, you still need to monitor your blood glucose levels to ensure that you’re properly managing your diabetes.

Other Health Benefits of the Keto Diet

Manage Triglyceride Levels

Triglycerides are nothing but fat or lipid molecules that can cause a high risk of heart diseases. A low-carb diet like keto is an excellent method to reduce triglyceride levels. When people cut carbs, they experience a rapid drop in blood triglyceride levels. However, low-fat diets often cause triglycerides to increase. 

Increased Levels of ‘Good’ HDL Cholesterol

It is safe to say that a low-carb, high-fat ketogenic diet increases HDL levels. One of the best ways to increase good cholesterol is to eat healthy fat — and the keto diet includes a lot of it. The Keto diet also reduces bad cholesterol or LDL (Low-Density Lipoprotein) levels.

Effective Against Metabolic Syndrome

Metabolic syndrome is a set of risk factors which significantly puts you at the risk of cardiovascular disease and the associated complications. It consists of abdominal obesity, high blood pressure, high cholesterol, triglyceride rise, and high fasting blood sugar levels. A study shows that the keto diet, a restrictive low carb diet, helps treat these symptoms. Substantial weight loss and improved glycemic control due to the keto diet are essential to prevent metabolic syndrome. 

Potential Side Effects for Diabetics Going Keto

When you change from carbs to fats as an energy source, the number of ketones might increase in the blood. Ketones arise when your body achieves ketosis, as mentioned earlier. Unfortunately, too many ketones in your blood lead to diabetic ketoacidosis. It is a potentially fatal condition in type 2 diabetic people experimenting with the keto diet. Diabetic ketoacidosis arises from high blood sugar and acid buildup. Fluid loss from DKA can lead to kidney damage and brain swelling that can eventually cause a coma. It requires hospitalisation. 

The warning signs are:

  • Persistent need to urinate
  • Blurred vision
  • High blood sugar levels
  • Heavy breathing
  • Fruity-smelling breath
  • Confusion and irritability
  • Excessive thirst
  • Nausea and vomiting
  • Abdominal pain

Some of the other potential risks include:

Organ Problems

The low-carb, high-fat plan promises quick weight loss, but it can exert pressure on organs that process fats and proteins. For example, the pancreas can overwork during a keto diet, leading to problems.

Constipation and Diarrhoea

The lack of fibre found in simple carbohydrates can lead to constipation problems. The lack of fibre in the keto diet can also cause diarrhoea. When someone cuts way back on carbs and doesn’t supplement other fibre-rich foods, it can result in digestive issues. 

Nutrient Deficiencies

Many essential nutrient-rich foods are considered “off-limits” in a keto diet. For example, some keto diet plans call for a complete restriction of grains and legumes. As a result, it leads to a deprivation of essential vitamins and minerals. 

People on long-term keto diets often lose too much magnesium, calcium, iron, potassium, and selenium. So, make sure that you supplement these nutrients while following a keto diet. 


Since you limit your carb intake on the keto diet, you are more likely to have low blood sugar. However, hypoglycemia is just as dangerous as high blood sugar, especially when taking insulin. A study shows that the chances of hypoglycemia are more likely from a long term ketogenic diet paired with alcohol consumption. 

Things to Consider Before Going Keto

The most important thing to remember when starting a keto diet, whether short- or long-term, is that everyone’s bodies are different. So what works for your friend may not work for you. Depending on the approach, you must start by cutting off carb intake from unhealthy sources—for example, pizza, chips, fruit juices, sugary drinks, white bread, and cakes.

Make sure to be careful and understand your body. Research to understand what you’re getting into and consult with your doctor before beginning the diet. Adjust the number of carbs allotted to your specific ketogenic diet if your body doesn’t feel right after a week.

Do the maths and calculate your macronutrient needs depending on your age, height, weight, activity level, etc. Then, to keep up with the diet, keep track of the amount of fat, carbs, and protein you eat throughout the day. If you’re thinking about going keto, you have to drink a lot of water to stay hydrated.


Type 2 diabetics who follow the keto diet can experience improved blood sugar control and weight loss. However, these beneficial effects tend to last only for a short term. But dietary changes like low carb consumption can be a powerful tool to help manage diabetes. A more moderate reduction in carbohydrates through a keto diet can be a safe part of your diabetes treatment plan. In addition, ketogenic diets can improve insulin sensitivity and reduce dependency on diabetes medication. 

But everyone is different. Before trying a keto diet, always talk to your doctor, especially if you live with type 2 diabetes. Undergoing any change in your diet regimen comes with potential risks. Therefore, the keto diet does not mean that you can stop monitoring your diabetes. 

Frequently Asked Questions (FAQs)

Q. Does the ketogenic diet work for type 2 diabetes?

A. Yes, it does work for type 2 diabetes. Keto is one of the best dietary methods to decrease the high sugar levels in the blood. Keto is a low carb diet and helps reduce the intake of carbs, which eventually lowers sugar levels in your body. As a result, people with type 2 diabetes experience less dependence on insulin. 

Q. Is the ketogenic diet suitable for people with diabetes?

A. People with diabetes can lose weight and lower their blood sugar levels with the keto diet. The diet allows the body to maintain glucose levels at a low but healthy range. However, although the keto diet has many benefits for diabetes management, following it requires serious commitment. So, talk to your doctor and make sure it is right for you.

Q. Can type 2 diabetes be reversed?

A. Although there’s no cure for type 2 diabetes, diet changes and weight loss can help reverse the condition slightly. In addition, people can achieve glucose levels that return to the non-diabetes range through a low carb diet and regular exercise. The remission period might last as long as the person doesn’t regain the weight and keep the carb intake in check. 

Q. Can I reverse diabetes type 2 naturally?

A. You can reverse type 2 diabetes naturally with a balanced diet, regular exercise, and quitting smoking or alcohol consumption. However, reversing doesn’t mean a complete cure because type 2 diabetes is a lifestyle disorder.

Q. What is the best diet for diabetes?

A. The best diet for diabetes focuses on restricting sugary foods, high-carb food, and high-calorie soft drinks. You may need to eat every few hours to steady your blood sugar levels. In addition, a diabetes-friendly eating plan must include vegetables, whole grains, lean protein, low-fat dairy, berries, and healthy fats.

Q. Can you still live a long life with type 2 diabetes?

A. Type 2 diabetes is a severe condition without a cure. It can even lead to life-threatening complications. However, adopting effective management strategies can help you live as long as a person without the condition.

Q. Can walking cure diabetes?

A. Walking is the best form of exercise, and it is excellent for prediabetic people trying to lose weight, the elderly diabetic, or even those who have heart-related problems. Walking is considered the easiest way to increase physical activity and improve fitness. It lowers blood sugar. However, it is not a cure for diabetes. 

Q. Which leaf can cure diabetes?

A. Mango and guava leaves are natural remedies which can control diabetes and reduce blood sugar levels. As per Chinese traditional medicine, mango leaf extract helps treat diabetes and asthma. Further, drinking guava leaf tea prevents blood sugar spikes and improves type 2 diabetes symptoms. 

Q. Can the pancreas heal itself from diabetes?

A. It is possible for the pancreas to regenerate and self replicate. However, evidence is still lacking in this area. Nevertheless, people can opt for a pancreas transplant to cure diabetes and achieve long term benefits. 

Q. What is the best supplement for type 2 diabetes?

A. Vitamin deficiency is common among people with type 2 diabetes. They can take supplements for vitamin C, D, and B12. Other options are alpha-lipoic acid, omega-3, magnesium, and Gymnema Sylvestre supplements. 

About the Author

Mehak holds masters in foods and nutrition from Amity university, Noida. She has a keen interest in public health and nutrition and has been in charge of various projects with milestone NGO. She has worked with people over the globe to bring out the changes in their lives and has always been working towards lifestyle modifications via good dietary practices. According to her a healthy lifestyle is not about the destination but all about the journey.

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