Diabetes and the ketogenic diet
A ketogenic (very low-carbohydrate) diet is effective in losing weight and preventing fat gain. It also has other uses in the treatment of various diseases.
One of the diseases that respond very well to the ketogenic diet in type 2 diabetes. Due to the growing epidemic of type 2 diabetes in our society, a ketogenic diet is a tool that can be used by almost everyone and independently.
- Adhering to a ketogenic diet is not complicated - it requires the reduction or complete elimination of carbohydrates.
- The main feature of type 2 diabetes, which is the leading cause of the disease, is insulin resistance.
- Insulin resistance also occurs in the general human population and interferes with the effects of insulin on cells to varying degrees.
- This causes the entire spectrum of signs and symptoms. The main feature of insulin resistance is the impaired ability of the muscle cells to take up glucose circulating in the blood.
- In a person with insulin resistance, a greater proportion of glucose is directed to the liver, where it is converted into fat in a process called (DNL) de novo lipogenesis. In healthy people, most of the glucose is burned in cells for energy.
- De novo lipogenesis contributes to about 20% of new triglycerides in the blood, mostly saturated fats- such increased conversion of carbohydrates to fat is not a normal process and contributes to an increased risk of diabetes and cardiovascular diseases.
- It can be said that insulin resistance manifests itself as carbohydrate intolerance.
- When dietary carbohydrate is reduced to a level below which conversion to fat is minimally achieved then the signs and symptoms of insulin resistance will diminish and even disappear altogether.
Various studies have shown that a well-formulated very low-carbohydrate diet that was meticulously followed by subjects with type 2 diabetes had surprising results for them:
- People with type 2 diabetes experienced a large weight loss within a few weeks and the fog drastically reduced the amount of insulin dosed.
- Obese subjects with CT2 were fed two diets with a caloric value of 650 kcal for three weeks. In both diets, the protein content was similar, but the number of carbohydrates in the diet differed - 24 grams in one group and 94 grams in the other group. A lower carbohydrate diet resulted in higher blood ketone levels (approx. 3 mmol / L). Higher levels of ketones were positively associated with lower liver glucose production. This suggests that higher levels of ketones may result in better glycemic control in diabetics.
- Obese people with type 2 diabetes are fed a low-carbohydrate diet of fewer than 20 grams of carbohydrates per day for 2 weeks. Fasting glucose dropped from 7.5 mmol / L to 6.3 mmol / L (from 135 mg / dL to 114 mg / dL), glycated hemoglobin (HbA1c) dropped from 7.3% to 6.8%, and improved dramatically become insulin sensitive. Triglycerides fell by 35% and cholesterol by 10%. All this in two weeks.
- Obese people with type 2 diabetes were prescribed a ketogenic diet for 56 weeks. Already after 12 weeks, there was a significant decrease in body weight and improvement in metabolic parameters. This improvement was sustained for a full 56 weeks. Fasting glucose decreased by 51%, total cholesterol decreased by 29%, HDL cholesterol increased by 63%, LDL cholesterol decreased by 33%, and triglycerides decreased by 41%.
Other studies also demonstrate effectiveness in alleviating the complications caused by type 2 diabetes.
Very often, limiting carbohydrates in the diet causes a significant decrease in weight.
However, a significant improvement in metabolic parameters such as glycosylated hemoglobin, cholesterol, improvement in glycemic control, and the reduction or even discontinuation of insulin and other drugs in many cases occurs even before significant weight loss.
In studies with different diets with the same caloric content, people with insulin resistance on a ketogenic diet show a dramatically better improvement in metabolic parameters than those on a lower-fat diet.
Huge epidemiological studies show that the risk of developing diabetes is positively correlated with sugar consumption, regardless of weight or sedentary lifestyle.
People with metabolic syndrome, insulin resistance, and type 2 diabetes a condition related to carbohydrate intolerance are likely to experience subjective improvement in symptoms and objective improvement in metabolic parameters by following a well-balanced, very low-carbohydrate diet.
Glycemic control will improve not only because of less carbohydrate intake but also because of an overall improvement in insulin sensitivity.
It should be added that in some patients the improvement may occur so quickly that it is advisable to monitor the dosage of drugs and insulin on an ongoing basis by a physician or to adjust the doses independently to the rapidly decreasing glucose level and greater insulin sensitivity.