Is the Ketogenic Diet Safe for People With Diabetes?

The Short Answer from a registered dietitian

Q: Is the ketogenic diet safe for people with diabetes?

A: The ketogenic diet is one treatment option for people with type 2 diabetes who are overweight. A 2013 review found the diet significantly improved blood sugar control, A1c and weight loss — and reduced insulin requirements — in overweight individuals with type 2 diabetes.

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Originally created in the 1920s as a treatment for epilepsy, the ketogenic diet is low in carbohydrate (less than 20 grams a day), high in protein, and moderate to high in fat.

Because of the extremely low carbohydrate intake, your body is forced to convert fat into energy instead of sugar. This process, called ketosis, allows for rapid weight loss when followed properly, but should be medically monitored by your doctor.

The ketogenic diet restricts all forms of carbohydrate, including starches, starchy vegetables, grains, fruit, milk, yogurt and sugars. It allows meats, heart-healthy fats and limited amounts of non-starchy vegetables.

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Because certain food groups are eliminated completely, vitamin and mineral supplementation may be needed. (The ketogenic diet is not recommended for anyone who is pregnant, has chronic kidney disease or is prone to gout.)

It’s important to keep in mind that weight loss requires an individualized approach, and that multiple meal-planning options are safe and effective for people with diabetes. 

—Dietitian Melissa Matteo, MS, RD, LD, CDE, Diabetes Center 

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