Is the Keto Diet Linked to an Increased Risk of Diabetes?
The Keto Diet: What Is It?
The keto diet is characterized by a low carbohydrate intake and a high fat intake. Consuming a low carbohydrate diet with a moderate amount of protein results in the synthesis of tiny molecules called "ketones." When the body does not manufacture enough glucose, these ketones are used for energy (blood sugar).
On a ketogenic diet, the body runs on fat and hence constantly burns fat. Ketosis is the metabolic state in which the body burns fat for fuel and creates ketones. When people follow a ketogenic diet, their ketones production increases as their insulin levels decrease.
What is the cause of diabetes?
Normally, the body converts carbs and starches to glucose. Insulin aids in the uptake of glucose into cells for use as an energy source. Additionally, insulin inhibits the liver's sugar synthesis. However, if blood glucose levels are very high, diabetes can develop.
Insulin resistance is a key feature of type 2 diabetes. This is in contrast to type 1 diabetes, which is an autoimmune disorder in which the body's ability to produce insulin is impaired. Type 2 diabetes is frequently caused by excessive sugar consumption, which leads the pancreas to release excessive insulin in order to maintain normal blood glucose levels. Insulin resistance develops when blood insulin levels remain continuously high. Ketones, which are created during a ketogenic diet, have been demonstrated to help individuals with type 2 diabetes lessen their need on medication.
A diabetic monitors his blood glucose level with a glucometer.
Credit for this image: urbans / Shutterstock
Is there a connection between the ketogenic diet and diabetes development?
The keto diet is comparable to starvation in that it results in low blood glucose and insulin levels. According to some research, one to three days of fasting or carbohydrate restriction may be sufficient to reduce the requirement for type 2 diabetic medication.
Numerous studies on keto diets have revealed an early-onset risk of type 2 diabetes. Mice were given one of two distinct diets - the ketogenic diet or a high fat diet - in a study conducted by ETH Zurich and University Children's Hospital Zurich. Metabolic testing revealed that mice fed a ketogenic diet developed aberrant glucose levels and insulin resistance more rapidly than mice fed a high fat diet. Due to the liver's inability to handle regular insulin levels for glucose regulation, the chance of developing type 2 diabetes increased as well.
A another study introduced mice to the ketogenic diet for several days. The researchers discovered that the mice's livers had developed resistance to insulin and were unable to maintain normal blood sugar levels. Insulin resistance is a critical prognostic factor in type 2 diabetes. This suggests that the ketogenic diet may be associated with an increased risk of type 2 diabetes. The study, however, did not examine whether a ketogenic diet would result in long-term obesity. Furthermore, the origin and final causes of type 2 diabetes are unknown. It is critical to investigate the relationship between ketogenic diets and type 2 diabetes. Additionally, the mechanism by which low-carbohydrate, high-fat diets induce physiological changes associated with insulin resistance is unknown.
In contrast to these findings, a 2018 study by Westman et al. demonstrated that keto diets may actually help to lessen the consequences of type 2 diabetes rather than increasing the risks. It has been suggested that a low carbohydrate, ketogenic diet may be beneficial for improving glycemia and decreasing medication requirements in patients with type 2 diabetes. The diet was found to enhance glycemic control when it was introduced to people with type 2 diabetes. This led in a decrease in and, in some cases, a cessation of type 2 diabetes medication. Additionally, the diet has been demonstrated to promote weight loss and improved glycemic management. It has been advised, however, that diets be tailored to the individual patient.
Previously, a 2017 study by Saslow et al. demonstrated that a keto diet resulted in lower HbA1c levels than a control diet. Patients with type 2 diabetes experienced improved glucose control and weight loss. The researchers hypothesized that a ketogenic diet might be useful for self-management of type 2 diabetes.
Due to the variability of study findings, additional well-controlled human trials are necessary to evaluate whether a ketogenic diet is safe for patients with type 2 diabetes or at risk of developing type 2 diabetes.
Sources
Westman et al. 2018. Implementing a low-carbohydrate, ketogenic diet to manage type 2 diabetes mellitus. https://www.ncbi.nlm.nih.gov/pubmed/30289048
Garneata L., MD, PhD et al. 2013. Effect of Low-Protein Diet Supplemented with Keto Acids on Progression of Chronic Kidney Disease. https://doi.org/10.1053/j.jrn.2013.01.030.
Grandl G. et al. 2018. The physiological society. Short‐term feeding of a ketogenic diet induces more severe hepatic insulin resistance than an obesogenic high‐fat diet. https://physoc.onlinelibrary.wiley.com/doi/full/10.1113/JP275173
American council on science and health. 2018. Ketogenic Diet Linked to Increased Risk Of Type 2 Diabetes. www.acsh.org/.../ketogenic-diet-linked-increased-risk-type-2-diabetes-13288
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