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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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February 07, 2018

Keto and Type 2 Diabetes

By Mark Sisson
90 Comments

Inline_Keto_and_DiabetesIf you think of Type 2 diabetes as carbohydrate intolerance, the natural dietary response should be to restrict the offending dietary component. And when this occurs—when diabetic patients restrict carbs—their symptoms improve, often to a greater degree than diabetic patients on other diets. Keto restricts more carbs than even other low-carb diets, so on the face of things, keto seems great for diabetes. 

Let’s take a closer look.

Common Features of Type 2 Diabetes

Insulin resistance: Your cells don’t respond as strongly to insulin, and you need more to produce the desired effect.

Hyperinsulinemia: Your insulin levels are always elevated. This inhibits you from releasing fatty acids from your body fat to be burned for energy.

Hyperglycemia: Because you’re not very good at using insulin to remove glucose from the blood, you often have high blood sugar—especially after eating. In fact, postprandial blood glucose is the most common way to diagnose type 2 diabetes.

Excess body fat: Gaining weight often leads to type 2 diabetes.

How Does Keto Affect Those Symptoms?

Insulin resistance: It depends. Keto can actually induce physiological insulin resistance, whereby the tissues become resistant to insulin so that the small amount of glucose you have in your blood is diverted to the areas of the brain that can’t use ketones. This is normal, not pathological, and doesn’t lead to hyperinsulinemia. If you’re losing weight on keto, your insulin sensitivity will improve.

Hyperinsulinemia: Keto lowers insulin levels. For ketosis to even occur, insulin must be low.

Hyperglycemia: It’s hard to spike blood sugar when you’re not eating carbs.

Excess body weight: Keto is an effective way to lose weight.

So far, so good. Theoretically, keto should work really well for people with type 2 diabetes. How does it work in real life folks with type 2 diabetes, though?

What Studies Tell Us

Study #1: Keto (No Control)

In 2005, researchers gathered 28 overweight patients with type 2 diabetes and placed them on a ketogenic diet with fewer than 20 g of carbs per day. Seven patients dropped out; 21 completed the 16 week study. Those who completed it had great results:

  • Body weight dropped by 6.6%, almost 20 pounds.
  • HbA1c dropped by 16%.
  • Triglycerides dropped by 42%.
  • Ten patients reduced their medications. Seven dropped them entirely. In only 16 weeks.

This was a pilot study without a control group, so it can’t be cited to directly compare keto to other diets. But it clearly worked.

Study #2: Low-Glycemic vs. Keto (Patients Who Were Obese and Had Type 2 Diabetes)

In another study, researchers directly compared keto to low-glycemic/carb. They took 84 obese patients with type 2 diabetes, randomly assigned them to either a ketogenic diet or a low-glycemic diet, and tracked their progress over 24 months. What happened?

Low-calorie group:

  • 16% reduction in fasting glucose
  • 6.9 kg bodyweight loss
  • 0.5 reduction in HbA1c

Keto group:

  • 20% reduction in fasting glucose
  • 11.1 kg bodyweight loss
  • 1.5 reduction in HbA1c

Both groups improved, but the keto group made bigger improvements, especially in HbA1c. Low-carb is good, keto might be better.

Study #3: Low-Calorie vs. Keto (Patients Who Were Obese)

Another study compared keto to low-calorie in obese patients, about a third of whom had diabetes. This time, the patients got to choose the diet that most appealed to them. So, it wasn’t random, but it was closer to how diets work in the real world.

Both groups improved markers of glucose control and metabolic health, but the keto group saw greater improvements on every single marker measured:

  • Blood lipids
  • Body weight
  • Waist circumference
  • HbA1c
  • Blood glucose
  • Uric acid
  • Urea
  • Creatinine

The drop in blood glucose in the keto dieters was intense enough that the researchers recommended anyone interested in trying it retain medical supervision.

In addition, only among the keto group were patients able to discontinue medications.

Study #4: Hypocaloric vs. Keto (Patients with Type 2 Diabetes)

In 2016, researchers ran a four month study comparing the effects of two diets in patients with type 2 diabetes. The first diet was your standard hypocaloric approach. The second was a very low carb ketogenic diet.

The keto group lost more body weight, more inches off their waist, and gained better control over their blood sugar. There were no adverse effects; kidney function remained stable throughout the study. Most importantly, the keto group had no trouble staying on the diet.

Standard Diabetic Education

Maybe you’re not convinced. Maybe you’re leaning toward meeting with the dietitian your doctor has recommended. That’s fine. Many medical professionals are waking up to the potential of the ketogenic diet, so you might actually hear similar advice. Just be aware of what else you might hear.

Let’s compare keto to how a Certified Diabetic Educator would feed the “average-sized” diabetic “trying to lose weight.”

  • 45-60 grams of carbs per meal.
  • 15-30 grams of carbs for snacks.

At three meals and two snacks a day, you’re looking at as many as 240 grams of carbohydrates for a person with diabetes who needs to lose some weight. If you follow the authority-sanctioned “expert.”

I read that and I’m completely blown away. It’s really that bad? That’s what your average type 2 diabetic who shows up at the doctor’s office with no clue about nutrition ends up eating? It’s probably even worse than that, because 60 grams of carbs easily turns into 70.

Perhaps that educator goes on to admit that keto is great for weight loss, has been shown to improve diabetic markers, and could even help prevent diabetes if you could “keep the weight off.” But it’s too hard, too restrictive for most people to follow, she’ll likely suggest.

She claims that the stress of watching how many carbs you eat will be “far more detrimental to your health” than going keto will be beneficial. I don’t actually disagree with that completely. If going keto is so stressful that your every waking moment is consumed by thoughts of carbs, and you can’t stick with the diet no matter how hard you try, maybe it’s not for you. That’s okay. I’ve never said everyone has to go keto, or even that everyone can go keto. Nor have I said that once you go keto, you can’t go back or rotate higher carb days into the routine.

So, good to go?

Mostly. Any medical patient should check with their doctor before changing their diet. You may have to adjust your medications (or remove them entirely). And keeping your doctor involved and apprised of your progress could legitimize the diet—if it works. Your doctor may even start recommending the diet to other patients.

Oh, and make sure you’re eating eggs, liver, or taking extra choline. Inadequate choline in the context of a high-fat diet can lead to hepatic fat accumulation, and a fatty liver increases insulin resistance and predicts the development of type 2 diabetes.

To sum up, going keto can be an effective dietary strategy for type 2 diabetes. All the available evidence suggests to me that, as a general guideline, it’s both safe and effective.

What about you? Anyone with type 2 diabetes try going keto? What were your results? And how has it influenced your work with your physician?

Thanks for reading, everyone. Take care!

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90 Comments on "Keto and Type 2 Diabetes"

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Harry Mossman
Harry Mossman
18 days 3 hours ago

I am type 2. I recently was in the hospital for over a week with a heart attack. I am not going to rant because I don’t need that stress on my heart. So I am going to treat this as humor.

Sixty grams of carbs/per meal. And offered more for snacks. Typical breakfast:
some scrambled eggs
Cheerios – 15 grams of carbs
cream of rice – 15 grams
fruit, usually grapes or a banana – 15 grams
low-fat milk – 15 grams
bad decaf
Oh, and because diabetic, Splenda not sugar. LOL
I ate half the carbs at each meal. Don’t lecture me.

wildgrok
wildgrok
18 days 2 hours ago

Harry very sorry to hear about your issue
Your post should be re-posted during Halloween for a terror story, good that you chose not to stress about it – hope you get well soon

Harry Mossman
Harry Mossman
18 days 1 hour ago

Thanks!

david
david
17 days 16 hours ago

just a heads up, if you leave a banana on the table it will turn to pure sugar if you eat it.. same

Nancy North-Gates
Nancy North-Gates
18 days 2 hours ago

Oh my. When I had my “non specific cardiac event” resulting in 3 stents in my heart I was given proper low carb meals. I was pleased.

Mary B
18 days 50 minutes ago

I am glad you took this setback with humor, looks balanced to me. So did the diet help your situation?

Susanna
Susanna
18 days 3 hours ago
Husband had very high blood sugar episode last spring. A week of intermittent fasting brought his fbs down to a reasonable level. He has eaten keto (loosely) since. We aren’t tightly tracking macros and I can barely get him to routinely track morning glucose levels for me. When I do get him to track them they are typically still over 100, but his blood sugar after eating barely rises so I’m fine with that. If the lows are high and the highs are low we’re good. He has lost 20+ pounds and his blood pressure has lowered. I need to… Read more »
Eve Fain
17 days 15 hours ago

sorry to hear about your insurance situation. You can get a A1c test kit from your pharmacy. Usually its kept cool/temperature controlled to avoid having the reagents break down. Another option for care is your local public health department which may have some adult care.

DaveNH
DaveNH
9 days 8 hours ago
Susanna, I don’t want to get too political, but the “insurance” problem in the US is the fault of government. That said, there ARE other options you can check out, specifically a Direct Primary Care practice. Obviously I don’t know your location, but here is just one site where you can search for a practice: http://www.mydpc.org/dpc-directory DPC often have monthly “subscriptions” in the $50-60 range per adult, and generally include all basic primary care and management of illnesses like diabetes. Some even include medications at nearly wholesale costs, as most states allow Doctors to dispense on site. Here is one… Read more »
DaveNH
DaveNH
9 days 7 hours ago
Susanna, Well my first reply appears to have been deleted, perhaps due to the links, so here’s Take 2. There are other affordable options instead of traditional “insurance.” Specifically, I would look at a Direct Primary Care practice. I don’t know where you live but there are sites where you can search for practices by location. DPC practices typically charge a monthly “subscription” in the neighborhood of $50-60/month for adults (usually somewhat lower/higher for children/elderly respectively). This subscription covers all basic primary care, and usually any procedures that can be done in house. It’s not unusual that they’ll cover testing,… Read more »
DaveNH
DaveNH
9 days 7 hours ago

Also, if you can afford a bit more, look into Health Sharing groups. These are ACA compliant alternatives to insurance. One with which I’m familiar covers couples for $300/month at their top level, and families for just $450.

The one thing to consider with Health Sharing, is that federal law limits them to religious/spiritual groups. Some require adherence to a particular set of beliefs, although some simply follow a more general moral/spiritual belief of an obligation to help others.

Susan
Susan
18 days 2 hours ago

Dr. Richard Bernstein has a great low-carb diabetes program that prevents the diabetes side effects (e.g. heart attack, kidney failure, blindness, etc) but he advocates high protein with whatever fat comes attached to protein. I can’t figure out why he doesn’t go with high fat because fat barely raises blood sugar levels at all, much less than either carbs or protein.

Mark
17 days 22 hours ago

High Protein? Too funny! Sounds like he needs to Dr. Ron Rosedale! 😉

Andrew Jensen
Andrew Jensen
17 days 19 hours ago

Actually, Dr. Bernstein doesn’t recommend “high” protein, he recommends a consistent amount of protein at every meal. And the fat that may be present is a freebie. He recommends the protein because that is what we need to maintain muscle mass. “High” as a percentage of the total calories, maybe, since the protein (meat, pork, fish, chicken) is usually higher in calories compared to the rest of the meal. It’s really simple.

Judith
Judith
17 days 17 hours ago
Dr Bernstein doesn’t recommend high protein but he does recommend a maximum of 30 carbs a day and does NOT recommend snacking at all. After I started Intermittent Fasting because I simply wasn’t hungry and finally got the sugar-coating off my tongue that I got from the ADA Dumb Diabetic plan of 225 plus snacking plan I had followed for years. his 30 grams carbs with NONE of the starchy carbs at all because they shoot the blood sugars way too high, I fell into a 23/1 Intermittent Fasting because his plan released my tongue from the sugar-fix it had… Read more »
499lake
499lake
18 days 2 hours ago

a keto diet is very hard to follow if you have eating issues. I am prediabetic and I tried a keto diet for a week. Too restrictive psychologically. So under a low carb diet with 40 grams /day is working for me with many fewer feelings of deprivation.

Jjc
Jjc
18 days 48 minutes ago

40 grams is actually ketogenic for lots of people, depending on individual factors (exercise, etc). Great that you found a balance that works for you and doesn’t have you feeling restricted. 40 grams is still like an eighth of what we’re “told” to eat!

Marissa
Marissa
18 days 25 minutes ago

You’re probably in ketosis much of the time. I definitely agree some do better psychologically with more carbs but 40 g a day is still very low carb.

Missy
Missy
18 days 7 minutes ago

I think you’ll find that puts you in a ketogenic state. Like it’s a keto diet.

Mark
17 days 22 hours ago

I hear you! I found full keto too unhealthy for me. I’m at 50 grams carbs now and doing much better! 🙂

Joanne
Joanne
18 days 2 hours ago
The Standard Diabetic Diet is nuts. If you go back and find my Primal Transformation story (the second one), it mostly revolves around my Gestational Diabetes I had during my second pregnancy (8 years ago already). I ate that diet the nutritionist told me to eat for a week after my diagnosis and recorded all my blood sugar readings (4 per day, which was massively annoying) and after every single meal (the 1hr mark) my blood sugar was way way way to high. 150-180, an hour after eating the diet they told me to. So, I decided to stop that… Read more »
EzAc
EzAc
18 days 46 minutes ago

That’s an awesome n=1 experience proving a great nutrition program fixes modern ills brought about by ridiculous food guidelines sanctioned by the “experts”. Good for you in taking control of your health and producing healthy babies.

Joanne
Joanne
18 days 46 minutes ago

Awww thanks!!

Stefano
Stefano
18 days 11 minutes ago

This was a great post to read, very motivating! Thanks for posting it 🙂
Just curious: did you go “all in” with the intermittent fasting (restricting the eating window to 6-8 hours) or you just reduced the eating window compared to what you were used to before?

Joanne
Joanne
18 days 8 minutes ago

I eat in a 6-7 hour window every day! I really like it. My husband does that on the days he doesn’t lift, on days he lifts he eats a regular three meal day and his fasting window is is roughly 10-11 hrs on lift days. I used to eat breakfast around 7am, snack around 10, lunch around 12, snack around 2 and dinner around 6, so IF changed that a lot for me. No snacks usually and just two big meals. Hope that helps.

Paul
Paul
17 days 18 hours ago

“The Standard Diabetic Diet is nuts”. Nuts is not the word. Historically low cab has been the standard treatment for managing and controlling diabetes until a few decades ago.

Nancy North-Gates
Nancy North-Gates
18 days 2 hours ago

I had a bad experience with Keto – I was disappointed. But because I am on insulin I had several low BG attacks and had to eat glucose tablets. However, just on my regular diet I stay below 100 grams of what I call hard carbs. I don’t count low carb and leafy vegetables.

Kiara
Kiara
16 days 8 hours ago

Hi Nancy,

I had a similar experience and lowered my insulin dose until I didn’t need it anymore. Taking insulin while cutting out carbs usually results in considerably lowered dosing.

Kathy Byram
Kathy Byram
18 days 2 hours ago

What recipe book do you recommend for Keto? Do you have one? Thanks.

Elizabeth Resnick
16 days 23 hours ago

Yeah, totally recommend The Keto Reset Diet for good recipes. Everything I have tried has been amazing…the slow cooker carnitas are the best I have ever had! And the thai soup is so good I made it twice in one week!

Lynn
Lynn
18 days 2 hours ago
A few comments: l was keto at 20 to 30 carbs a day for Two years. My blood morning sugars did come down to around 100 from 184 and usually dipped lower in the day. My A1c came down from 7ish to 6, triglycerides dropped to normal and my weight came down about 15 pounds……you say great, but hear the rest of the story. Not that it’s conversation for public viewing, but it would be good to know if others have had similar results…….while I was keto, I had to take laxitives daily, take large amounts of magnesium and electrolytes… Read more »
Rachel
Rachel
18 days 1 hour ago

Those symptoms almost sound like die-off symptoms from pathogenic microbes. I’m reading about SIBO now, and a ketogenic diet deprives those microbes of food, wreaking havic on the digestion.

Stefano
Stefano
18 days 7 minutes ago

Wondering if perhaps introducing a few days a week of keto, instead of going “every day” since the very beginning, could help reducing the intensity of this die-off symptoms…?

Matt
11 days 21 hours ago

two years of die-off? come on, guys. same diet doesn’t work for everyone. let’s not get cult-y with it.

Andrew Jensen
Andrew Jensen
17 days 19 hours ago

Are you a type 2 diabetic?

Lina
Lina
18 days 2 hours ago

The Ketogenic Forum is full of T2 folks who have dramatically improved their insulin sensitivity, gone off of their diabetes medications, and in some cases have had their doctors straight up change their records to reflect their new status: no longer diabetic. I know, I know… just anecdotal. But it’s anecdote after anecdote (there and elsewhere outside of the established standard-of-care practices).

Reversing T2 is totally possible – but not on 200 grams of carbs/day. Based on everything we know, those recommendations are starting to look criminal.

Sandy
Sandy
17 days 23 hours ago

I started my journey 6 years ago and reversed my T2, losing 4 needles a day, 5 pills, and 40+ lbs! This is my story and I share it with those that are interested, but have learned to only speak when spoken to, as there are a lot of cranky/closed minded people out there. 😉

Ann Kristapsons
18 days 2 hours ago

I’m type II, but I follow a diet based on Low Carb, Adequate Protein and Moderate fat, instead of the high fat version. (Jeff Voek, PHD and Stephen Phinney, MD, PHD). I eat 120 g Protein / 78 g Fat and 20 g Carbs a day. My starting fasting blood sugar was 181 and all this week it has been between 73 and 95. I go back to the doctor’s next month and will have my A1C and will talk about discontinuing Metformin. Started in July 2017, lost 50 lbs so far.

Mark
17 days 22 hours ago

Wow! That’s pretty high protein, but I guess it’s working for you. 🙂

Andrew Jensen
Andrew Jensen
17 days 19 hours ago

Those are good looking fasting blood sugars! Keep up the good work Ann.

Chrystyne
18 days 2 hours ago

I am a devout follower of the Primal Lifestyle and have been for >8 years. I am also a Nurse Practitioner with a doctorate degree and a certified diabetes educator. My diabetic and overweight (near diabetic) patients all do amazing using Primal principles and I NEVER tell people to eat any carbohydrates other than vegetables. I even warn again fruit as this can pull you right out of ketosis for many people. I just want you to know that CDEs deal with diabetics every day and unless they themselves are educated in low carb, high fat, the ignorance persists.

Jeff
Jeff
18 days 1 hour ago
Ive been doing low carb/keto for diabetes for almost 4 years. I lost 40 pounds and kept it off. My fasting insulin is now normal. My fasting glucose is 87. Before I changed my diet my Aic was 7.4 and now it varies between 5.4 and 6 (if I haven’t been careful about my diet) with no treatment. I think keto has put my diabetes into remission and returned me to a hugely healthier pre-diabetic state. I wish more people would realize what a serious disease this is, how very high the heart disease risk is, and how the standard… Read more »
Clank
Clank
18 days 1 hour ago
Mark nailed my experience with a nutritionist just after being diagnosed with type 2(ish… Could be some rare type). I said I was trying low carb Paleo and the nutritionist’s reaction was concern that it was “hard”. I couldn’t understand why eating very low carbs wasn’t the obvious recommendation for diabetics, but low carb made more sense to me than the ADA recommendation so I tried it (at the time, caring at all about nutrition was new to me). My A1C went from 7 to 5.4 in a couple weeks and has never been above 5.7 in the 5 years… Read more »
Roberta Jones
Roberta Jones
18 days 1 hour ago
When I went to meet with the “dietician” requested by my doctor, she was clueless as to what causes, and how to treat, diabetes. She read from a script from the ADA. I spent the rest of the time educating her. I’ve been watching my carbs for 3 years now. I’ve been off metformin since 2 weeks after reducing my carbs in 2013. My diabetes is completely controlled without medication and I have never been healthier. Still a bit overweight, but no longer obese and my labs are all very good. I’m 65 years old and was on metformin for… Read more »
NaturalGirl
NaturalGirl
18 days 1 hour ago

Type 2 Diabetes runs rampant in my family. Thankfully, I don’t have it. However, a sibling does. I get blood work done at least once a year. Great informative article. Thank you.

Teresa Toten
18 days 1 hour ago

I have gone from an A1C of 11.8, insulin 4 times a day and metformin to an A1C of 4.6, no more insulin and medication for HBP, cholesterol or thyroid. Keto work! I have maintained these great numbers, and I have regained much of what I had lost. I have reclaimed my health and my vitality with keto.

Valerie
18 days 1 hour ago

My husband eats low carb, moderate protein and fat, no grains, dairy or sugar. He has had no consistent success in getting his BG down. His doctor has just prescribed Met formin. What no one talks about is how chronic stress and poor sleep undermines any dietary changes. His job is very stressful and has erratic sleep habits, because of the stress. I really don’t see how anyone can reduce their insulin resistance, regardless of the diet, if they can’t get their cortisol regulated. Can anyone speak to this issue?

Marilee
Marilee
17 days 22 hours ago

I agree, stress and lack of sleep can undo or prevent positive changes that might otherwise occur. Based on years of thyroid issues, focusing on sleep and stress reduction had to be top priorities before I saw other improvements. Hard to come by though. You may also want to look into Berberine rather than Metformin. Very similar results but far fewer or no side effects.

Kennyb
Kennyb
18 days 46 minutes ago

So tell me why my FBG goes 120-140 while ketones measure 6.8 while eating keto. Even on extended fasts of 2-3 weeks. Just doing intermittent fasting and keto i can’t lose anything. In fact i steadily gain. 6’1” 170 endurance athlete frame

Julia Pace
Julia Pace
17 days 13 hours ago

insulin resistance?

Kennyb
Kennyb
17 days 7 hours ago

Evey time ive had my insulin tested its been ridiculously low that there doesnt seem to be a suspension of IR. Ive also had the serum c peptide tested and its also very low.

Julia Pace
Julia Pace
17 days 4 hours ago

Hypothyroid? ApoE4? -as in saturated fats will be bad for you. Check out ApoE4.info – Also Dr. Steven Gundry gave an interview where he said that his Keto diet for people with ApoE4 has limited animal fats and protein.

Julia Pace
Julia Pace
17 days 4 hours ago

Maybe you’re not making enough insulin to cover the calories – lacking beta cells.

Brian
Brian
18 days 42 minutes ago
There is something to be said about stress, blood sugar, and diabetes. The one thing that supersedes a good diet, or in this case a diet to reverse Type 2, and that is sleep. It won’t matter how good or perfect you follow a keto diet, if you don’t sleep enough, sleep properly, or restful enough, your cortisol rises dramatically and thus your blood sugar will go rocketing through the roof. Do this enough and you’re priming yourself for blood sugar issues and Type 2, even in the presence of a keto diet. In fact, talk to anyone with Type… Read more »
Marissa
Marissa
18 days 27 minutes ago

Thoughts on if it’s a functional cure meaning keto must be maintained or if insulin sensitivity can be restored enough to allow eating slightly higher carb?

Clank
Clank
17 days 19 hours ago
Great question. My experience has been functional only… Would be hard for me to say insulin sensitivity can be restored and for it to be permanent. There are so many factors, sleep, stress, genetics, exercise amount and type, etc. There are even more than 2 types of diabetes. For me, I don’t think my insulin resistance has gotten any worse in 5 years since diagnosis and a switch to Paleo (and most likely keto). So that is something. The switch also included trying to do all the things that improve insulin resistance, sleep, stress, etc. I’m also curious about others’… Read more »
Eva Fain
17 days 14 hours ago

Not sure if this link will appear correctly here but I posted it on my FB page a few days ago. It shows a mitochondria via electron microscopy of cell with & without diabetes….We just do not know about long term recovery from t2DM. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5737033/pdf/fendo-08-00347.pdf

Eve Fain
17 days 14 hours ago

Marissa: We do not know yet. Because of my background & having spent the last 2 years looking at what type 2 diabet(es) is….If you add more carbs into your diet, be prepared to do more exercise to burn the energy released off.

Eric
18 days 9 minutes ago
I am type 2 and have been for a long time. I have found it very difficult to get in to ketosis and lose weight, even back in the old Atkins days. I can improve my blood lipids by eating that way, but I can’t seem to mobilize the fat stores at all by diet alone. On occasion I’ll spill a lot of ketones in my urine after some HIIT. I can’t seem to make it consistent. I did pick up a Keto Mojo the other day. Currently my ketones are negligible, so I’ll have to see how that changes… Read more »
Shannon
Shannon
17 days 23 hours ago

Yep, I’m 52, typically considered average to underweight, exercise regularly, and was eating pretty strict Paleo to manage a few autoimmune diseases. Out of the blue I was diagnosed pre-diabetic (family history) and my doc told me I had to either get my blood sugar down or prepare to go on Metformin soon. I chose Keto, and within 3 months was back in the normal range.

I mostly stay Keto, with an occasional splurge back to Paleo (holidays, etc) and I feel great. My doc is now recommending Keto to other patients as a way to help manage blood sugar issues!

wildgrok
wildgrok
17 days 22 hours ago

wow you have a real doctor, nice 🙂

“My doc is now recommending Keto to other patients as a way to help manage blood sugar issues!”

Floyd Aldrich
Floyd Aldrich
17 days 22 hours ago

On Keto for 7 months so far A1c has come down from 7.1 to 5.9,waiting for results from a reading last week. Weight has gone down 50+lbs and Trigs have come down.that all will be retested in March.

aqf
17 days 21 hours ago
I was diagnosed with T2 about 20 years ago, and was given one of those 250g/carb low fat, low protein diet sheets (sponsored by a pharmaceutical company that sells insulin and other diabetes meds!). While, with one exception (the week I was on a steroid taper for poison ivy) I never followed a specifically ketogenic diet (or any formal diet plan). I quickly realized that if diabetes was a problem with carbohydrate metabolism, I shouldn’t eat more carbs than I can metabolize. And this is what I’ve done, for approximately 20 years, with no meds. It’s not difficult at all.… Read more »
Bill
Bill
17 days 20 hours ago

“Excess body fat: Gaining weight often leads to type 2 diabetes.” Since the weight gain and the diabetes are almost always caused by the same thing, insulin resistance, I think it might be better to say that weight gain often precedes type 2 diabetes.

I’m not diabetic but I was running fasting blood sugar numbers in the “prediabetes” range. I lost 30+ pounds and my fbs didn’t change at all.

Kim Falk
Kim Falk
17 days 20 hours ago

Hi, I’ve recently been diagnosed with Insulin resistance. I also had a very extensive food sensitivity test done. I’m sensitive to beef, pork, turkey, egg whites & dairy. ? what is your recommendation for weight loss?

Caroline Hind
5 days 11 hours ago

Hi Kim, some people find that some of their food sensitivities are due to abnormal intestinal permeability (leaky gut) and/or inadequate stomach acid and enzymes. The GAPs diet website focuses on a back-to-basics approach: http://www.gapsdiet.com/

Annette
Annette
17 days 19 hours ago
I was diagnosed with T2 diabetes last August with FBG at 132, A1c at 6.8. As of yesterday, after my 6 month check in with the doctor, my FBG was 90 and my A1c was 5.4! I was determined to change my ways and not take any medication. This has been done with low carb, moderate protein, whatever fat I felt like eating, intermittent fasting, moderate exercise, 99.9 percent dedication and 100 percent determination. I have also lost 45 lbs. Needless to say my doctor was very impressed with my results and so am I. It has been quite the… Read more »
Donna K
Donna K
17 days 19 hours ago

I was diagnosed last July, with an A1c of 6.9, fasting glucose of 112. I went keto, averaging 20-30 grams of carbs a day. My latest test results were an A1C of 5.2, fasting glucose of 73. I’ve lost 65 pounds and am almost halfway to my goal weight. When my insulin resistance decreases I may increase my carbs, but, I’ve found this way of eating to be very easy to maintain, and I have no desire to change anything.

Andrew Jensen
Andrew Jensen
17 days 19 hours ago
Great article Mark! The part about the Type 2 Diabetic and the recommended diet is spot on. But it may even be mild in it’s description. Over the past few years, the diabetic medical community has been catching on to the benefits of low carb, and keto diets. But the standard recommendations are still far from optimal. What’s worse is what most diabetic educators and doctors say about children and eating. As a whole, but not across the board, it’s still recommended for type 1 children to “eat what you want and cover it with insulin.” So what we now… Read more »
Janet L Moore, MS RD CDE
Janet L Moore, MS RD CDE
17 days 18 hours ago

Hi all, I just wanted to say that not all Registered Dietitians or Certified Diabetes Educators follow the “rules.” They can be great resources if they choose to educate themselves on the research. It may be more likely that you find a dietitian or CDE that understands the benefits of a keto diet before you meet a practitioner who does. Always ask. 🙂

Joanne
Joanne
17 days 17 hours ago
Hey Janet Moore, Sounds like you know your stuff. I would like to ask you a question, or anyone else out there. Would Contrave help me with all my cravings for sweets and bread while trying to get into ketosis? I find the cravings crazy no matter if I do get a little into ketosis. I would gladly eat tons of fat if it stopped cravings but it has not for me. What is a person to do, just run from bacon to eggs, to dishes of butter, and just pray that the need for bread will die suddenly? I… Read more »
Shary
Shary
17 days 3 hours ago
Jojo, you might want to check the list of side effects before you consider taking Contrave. Chances are it wouldn’t work anyway since most cravings are more emotional/mental than physical. The best way to get rid of cravings, IMO (having been there), is to totally eliminate all sweets and grain products cold turkey. That means ALL of them, including gluten-free bread products and artificial or alternative sweeteners. You are addicted to those things, and merely reducing consumption or trying to taper off won’t work. All that does is fan the flames of your addiction. Get them out of your house… Read more »
Patty Lee
Patty Lee
8 days 5 hours ago

Jojo, it could be that you are having cravings due to using artificial sweeteners. I find if I eat/drink things with the various “replacements” I crave more food, particularly carbs, all day long. They also seem to throw me out of ketosis. It’s just my experience, but I thought I would throw it out there for you – no two cents payment required 🙂

Shary
Shary
17 days 18 hours ago

I’m in favor of any diet/lifestyle that reduces or eliminates the need for prescription pharmaceuticals, which are usually nothing but a Band-Aid anyway. Chris Kresser’s book, “Your Personal Paleo Code” teaches people how to get to the underlying cause of many health issues through dietary changes. The first step is a month-long, fairly restrictive reset, similar to the Whole 30 and various other Paleo/Primal approaches. It’s a good read for anyone struggling with intractable health issues.

Tom White
17 days 17 hours ago
I resolved my T2 diabetic condition in Oct 2011 by going primal. Keto wasn’t even on the radar back then. Keto IS NOT REQUIRED to resolve T2/pre diabetes. It took 3 days for my daily blood sugar range to go from 6.5 – 13.7 down to 4.2 – 5.4. Yep, 3 days. My A1c went from 8.6 to 5.0 in the first 3 months. A few years ago I became a certified Primal Health Coach so that I can educate others on the ‘power of food’. No need to go keto to resolve diabetes and it is certainly difficult to… Read more »
Nocona
Nocona
17 days 1 hour ago

Great stuff Tom. I feel a close connection with you. I also went primal in October 2011 and had metabolic syndrome. All perfect health returned within weeks without going Keto. Being fat adapted I can now slip in and out of keto whenever I want, fast for 2 days, eat 100 grams of carbs the next, etc. Very flexible. Keep up the good work!

Tom White
15 days 2 hours ago
Nocona, it certainly is amazing to BE THE ONE IN CHARGE, isn’t it! I used to be at the mercy of my doctor, diabetes educators, pharmacist etc. They are only trained to ‘manage’ diabetes (and my many other health issues) – not to address the root cause. Food, and food alone resolved my health issues – you can read my Marks Daily Apple success story at: https://www.marksdailyapple.com/100-pounds-lost-type-ii-diabetes-gone-and-high-blood-pressure-normalized-after-going-primal/. After I became certified as a Primal Health Coach I founded EndDiabetesManitoba.ca and educate others on the ‘power of food’. Most people do not want to change their diet and they are blindly… Read more »
Eden
Eden
17 days 16 hours ago

I was 5’4″ 120lbs very healthy eater. Gluten free due to colitis. I was very surprised to be diagnosed with type 2 diabetes. My endocrinologist recommended daily insulin injections when my A1C reached 7.6. I received a dexcom glucose monitor and was able to see what foods spiked my glucose. I changed my diet accordingly and ended up on a keto diet since May 2017. My physical in December showed that my A1C dropped to 5.2… I personally would much rather live in ketosis than on daily injections!!!

Rob Jobe
17 days 12 hours ago
I started eating Ketogenic Aug 4th 2017. In 2007 I found out I was diabetic. I had an infection in my leg after clearing it at the hospital, insuring it was not a dvt, they told me I was not managing my diabetes well and my blood sugar was 22. That’s how I found out I had diabetes. I was 375 pounds. Lost 30 pounds by removing sugared drinks and performing. Thought I had it solved but my AC1s averaged 10-14. Insulin in my future for sure. Since starting Keto (Aug 4 2017) I have lost 50lbs, and stand at… Read more »
stummee
stummee
17 days 6 hours ago
I’m a male and 50 yo. I was able to get my A1C from 5.7 down to 5.3 (Dec 2017). I tried keeping my carbs low (below 30 g) and protein moderate (80g – 120g). I did intermittent fasting for an average of 20 hours seeing I read your body benefits more if you fast at least 18 hours. Plus, I noticed I am able to stay within my calorie limit by limiting myself to eat within a 4 hour window. I believe the intermittent fasting improved my blood sugar and also noticed this winter my psoriasis on my calf… Read more »
Lee Siemon
17 days 2 hours ago
I just cure T2D (doctors words, not mine). one year on Keto I lost 60 pounds, have an A!C of 5.2, blood pressure from 138 to a steady 118, complete control of my cholesterol. Off 7 medication as per my doctor. That is proof to me that Keto works after trying many other diets. There is possibly a down side. In that year my PSA jumped from 3.1 to 6.1. I am 70 years young, so it could be a coincidence, but I am reading some studies that some compounds in certain veggies feed specific cancers. I would appreciate any… Read more »
marc
marc
17 days 1 hour ago
I am a type 2 diabetic, who also has high cholesterol. I have tried several medications (for both my diabetes and my high cholesterol) but just hated the side effects. I found this https://tinyurl.com/y9ycnp98 for alternative treatments. After changing my lifestyle quite a bit and doing everything in the book for nearly 3 months, I had my annual checkup. I did not say a word to my doctor about what I had been taking. When the lab results came back, he personally called me and I could tell that was obviously very excited. He asked me What the heck I… Read more »
Robin Inabinett
Robin Inabinett
16 days 23 hours ago

How about adults with type 1 diabetes who control their insulin intake? Are there any studies on Keto eating with this autoimmune disease?

Caroline Hind
5 days 11 hours ago

Dr Ian Lake in the U.K., who has type 1 diabetes himself, talks about his own experience with this, referring too to Dr Bernstein’s work: https://youtu.be/vWmxxbs_mns

Melanie Hopkins
Melanie Hopkins
16 days 15 hours ago
Just diagnosed with Type II diabetes in January. I have been walking 40 miles per week on my treadmill for two years but am still overweight. Even though I have limited calories and eaten a balanced diet. I believe my carbohydrates have undermined weight loss and caused my sugar levels to spike. My carbs will come from only vegetables that grow above ground ; ) and no grains. Fruit is limited to a few occasional berries. I’ve ordered keto strips and downloaded added a keto app to help me track the carbs and ensure I take in the right amounts… Read more »
Polyphemus
Polyphemus
16 days 57 minutes ago

Type 2. Diagnosed in 2010 at A1c 9.2, down to 5.8 in 5 months, currently 5.3. Not terribly strict, keeping carb intake under 50 gr per day with a low glycemic slant.

30 lbs lighter than I was at diagnosis.

I haven’t actually tested for ketone levels, but it seems that I’m probably there.

Kerry
Kerry
15 days 8 hours ago

Mark, would Alpha GPC be a good form of choline too and would taking inositol with it be a good idea?

My liver is already fatty and before I start this I want to protect it from further damage.

Thank you for discussing choline’s importance!!

Dwayne Robinson
14 days 14 hours ago
Type 2 Disney’s about nine years Keto for 4 almost five Within two months of starting, I was taken off every medication I was on. Blood pressure , acid reflux, statin. I had previously had an adverse reaction to metformin and had to stop taking it. (Think the normal greater issues times fifty bazillion!! Could not leave the house for a week. Stopped the medicine, better in the days Started again, symptoms returned immediately Did thought it was the stomach flu But I refused to start it again, been medication free ever since) Diagnosis was 566 mg/do A1c was 14.8%… Read more »
David
David
13 days 7 hours ago

keto is of course just one type of diet that may be helpful for diabetics and therapeutic for a handful of other conditions too. But its far from the only diet that has been found to be effective for diabetics. The cherry picking of studies above is misleading in terms of low carb, high carb low fat seems to work well too

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