Type 2 Are there any research/evidence shows it is OK to have keto diet for type 2 diabetes?

[GIAMARIE]

I've just seen some posts about it on dietdoctor.com. I'm not too sure if keto diet is good for my current state, but I'm trying to stick with 100g of carbs per day. Any suggestions about this? Many thanks!

 

[Antje77]

I've just seen some posts about it on dietdoctor.com. I'm not too sure if keto diet is good for my current state, but I'm trying to stick with 100g of carbs per day. Any suggestions about this? Many thanks!

Hi @GIAMARIE , welcome to the forum.

Keto can be very helpful in managing T2, but suddenly lowering your carbs if you are on insulin can be very dangerous, please don't!

From your other post I take it you've been diagnosed with T2 and on insulin for less than a week, and you're on fixed doses of insulin, not yet adjusting to what you eat.

Are you being treated by your GP or do you see an endocrinologist at the hospital?
Are you sure you have a T2 diagnosis and not T1? They're very different conditions, and the treatment you got right after diagnosis is much more common in T1 than in T2.

Either way, being new on insulin, please learn the basics of using insulin before contemplating a radical diet change.

Good luck!

 

[ianf0ster]

Even for those with T2D but not on insulin or other medication with danger of Hypos, it's still not a good idea to reduce Blood Glucose levels too quickly because large sudden BG changes (in either direction) can cause vison problems since the eyes are very sensitive to Blood Glucose levels.

 

[KennyA]

I've just seen some posts about it on dietdoctor.com. I'm not too sure if keto diet is good for my current state, but I'm trying to stick with 100g of carbs per day. Any suggestions about this? Many thanks!

I'd suggest one thing at a time, and don't try to rush. 100g carb/day is almost certainly not low enough to trigger nutritional ketosis. It's still low-carb though, and would/should lower your BG - it did mine.

However - while you're learning to adapt to and use insulin it might be advisable to hold back on lowering carbs n for a few weeks or months? One thing at a time.

 

[GIAMARIE]

Hi @GIAMARIE , welcome to the forum.

Keto can be very helpful in managing T2, but suddenly lowering your carbs if you are on insulin can be very dangerous, please don't!

From your other post I take it you've been diagnosed with T2 and on insulin for less than a week, and you're on fixed doses of insulin, not yet adjusting to what you eat.

Are you being treated by your GP or do you see an endocrinologist at the hospital?
Are you sure you have a T2 diagnosis and not T1? They're very different conditions, and the treatment you got right after diagnosis is much more common in T1 than in T2.

Either way, being new on insulin, please learn the basics of using insulin before contemplating a radical diet change.

Good luck!

Thank you for your reply! I am not 100% sure on which type I am really is, I can find out with the appointment on Friday with a diabetes nurse. I was diagnosed with T2 after a DKA diagnosis at the a&e so I haven't seen the GP just yet. I was thinking to check with the GP, and diabetes consultant first before making any decisions on this diet. Especially got to check with the dieticians too!

 

[GIAMARIE]

Even for those with T2D but not on insulin or other medication with danger of Hypos, it's still not a good idea to reduce Blood Glucose levels too quickly because large sudden BG changes (in either direction) can cause vison problems since the eyes are very sensitive to Blood Glucose levels.

Thank you for your reply! I see, I'll keep that in mind and take baby steps for now. Maybe it will be worth to ask the consultant and a dietician about this too!

 

[GIAMARIE]

I'd suggest one thing at a time, and don't try to rush. 100g carb/day is almost certainly not low enough to trigger nutritional ketosis. It's still low-carb though, and would/should lower your BG - it did mine.

However - while you're learning to adapt to and use insulin it might be advisable to hold back on lowering carbs n for a few weeks or months? One thing at a time.

Thank you for your reply! I don't know much about keto diet and I'm not 100% sure if that works for me either. I'm taking baby steps for now and will ask the GP and the diabetes consultant about this before making any changes myself. I just thought it could be something I could consider, maybe not the keto diet but the low carb option. I don't eat a lot during the day and thought if the carb is just a little amount, I could just stick with it and it won't be too hard for me. But again, you're right. I should wait and see and possibly see a doctor about it first.

 

[HSSS]

Thank you for your reply! I am not 100% sure on which type I am really is, I can find out with the appointment on Friday with a diabetes nurse. I was diagnosed with T2 after a DKA diagnosis at the a&e so I haven't seen the GP just yet. I was thinking to check with the GP, and diabetes consultant first before making any decisions on this diet. Especially got to check with the dieticians too!

Whilst not impossible DKA is significantly less common in type 2 than type 1. Please make sure they have checked for type 1 and have not based it purely on assumptions surrounding age, weight or even a single negative antibody test. Also ask if they checked cpeptide or insulin levels (High would tend to indicate T2, low T1 and mid range a need to look at the entire picture more closely).

It’s important they get this right at the outset. If you are indeed type 2 you have different options for treatment, some that may even result in remission based on dietary choices, than if you are type 1 with the absolute necessity for insulin. Also in the uk options for diabetes tech is different for type 1 and 2, as is the care team responsible for you in most cases.

As for your original question keto (less than 50g of carbs a day) is suitable and even ideal for a lot of type 2 but for as long as they are on insulin or medications that actively lower blood glucose it takes a large amount of knowledge, monitoring and care to avoid hypos and constant medication adjustment. Not the situation for someone unsure of type and new to insulin and definitely unwise on fixed doses. Diet doctor has pages discussing keto and medications.

I suspect there are few nhs dieticians that understand keto in type 2 well enough to risk stepping outside of official guidance of the eatwell carb based diet. Doesn’t make them right though, just that their education doesn’t cover it and the policies they work under would at best make them wary to recommend it.

 

[KennyA]

Thank you for your reply! I don't know much about keto diet and I'm not 100% sure if that works for me either. I'm taking baby steps for now and will ask the GP and the diabetes consultant about this before making any changes myself. I just thought it could be something I could consider, maybe not the keto diet but the low carb option. I don't eat a lot during the day and thought if the carb is just a little amount, I could just stick with it and it won't be too hard for me. But again, you're right. I should wait and see and possibly see a doctor about it first.

I don't want to put you off a low carb/keto approach completely - it works really well for me. It's just being new to insulin, and adapting to that is probably a lot more complicated than reducing carbs. Get your insulin sorted (and confirmation of your diabetes type, as well) and then think about other things.

Depending on the individuals, you may well get a very negative reaction from the medics in relation to reducing carbs. The official line is still to base all meals around starchy carbs and they may simply tell you to do that.

 

[oldnevada]

Great question! My MD told me to go as low carb as I could tolerate. I think I'm consuming about 125g carbs/day on average. My BG was 6.1 mmol/L two hours after supper this evening, but I'm feeling a little peckish this evening,but I just had lean stew with onions and gravy. No potatoes.

 

[MrsA2]

Great question! My MD told me to go as low carb as I could tolerate. I think I'm consuming about 125g carbs/day on average. My BG was 6.1 mmol/L two hours after supper this evening, but I'm feeling a little peckish this evening,but I just had lean stew with onions and gravy. No potatoes.

I'm not surprised you are hungry after just lean meat, onions and gravy. I'd add cabbage for filling fibre and perhaps finish with a little cheese to up the satiating fats.
Are you testing your bg before and 2 hours after eating.? You might also find an app like carbmanager good for carb counting.
125g carbs a day is a lot for most of us who aim for 50 or 20 or even less

 

[ianf0ster]

@oldnevada Most of us eating Low Carb are not restricting calories, protein, or fat. Some fat can be quite satiating as well as being a essential macro nutrient (unlike carbohydrates). Also fattier cuts of meat and fattier minced meat (ground beef in the USA) are often cheaper than the leaner ones as well as being more suited to a low carb way of eating.

 

[oldnevada]

@oldnevada Most of us eating Low Carb are not restricting calories, protein, or fat. Some fat can be quite satiating as well as being a essential macro nutrient (unlike carbohydrates). Also fattier cuts of meat and fattier minced meat (ground beef in the USA) are often cheaper than the leaner ones as well as being more suited to a low carb way of eating.

Thanks. I usually buy medium ground chuck or pork. I also eat grain fed pork bacon, but drip off and pat dry. I buy my food from pesticide/herbicide free farm. The veggies are hydroponic.

 

[KennyA]

Thank you for your reply! I don't know much about keto diet and I'm not 100% sure if that works for me either. I'm taking baby steps for now and will ask the GP and the diabetes consultant about this before making any changes myself. I just thought it could be something I could consider, maybe not the keto diet but the low carb option. I don't eat a lot during the day and thought if the carb is just a little amount, I could just stick with it and it won't be too hard for me. But again, you're right. I should wait and see and possibly see a doctor about it first.

I'm sorry, I meant to post these published papers on my last reply, and forgot. It's by a UK doctor called Dr David Unwin and they report on low carb/keto and its impact on T2 diabetic patients at his practice. There are so many more, but these are a good place to start.

I still think your priority should be learning your insulin, though.

2014 paper

https://wchh.onlinelibrary.wiley.com/doi/10.1002/pdi.1835

2019 paper

Substantial and Sustained Improvements in Blood Pressure, Weight and Lipid Profiles from a Carbohydrate Restricted Diet: An Observational Study of Insulin Resistant Patients in Primary Care

Hypertension is the second biggest known global risk factor for disease after poor diet; perhaps lifestyle interventions are underutilized? In a previous small pilot study, it was found that a low carbohydrate diet was associated with significant improvements ...

www.ncbi.nlm.nih.gov