Content Library Articles The Keto Diet and Type 1 Diabetes

The Keto Diet and Type 1 Diabetes

January 28, 2020

The conventional approach to type 1 diabetes has been to monitor carbohydrate intake and use insulin to offset it accordingly.

While taking insulin is an essential piece of managing this disease, diet can greatly impact how much reliance a patient needs to have on it. Insulin injections can lead to side effects like weight gain, hypoglycemic reactions (low blood sugar), soreness around the injection site, swelling, and other uncomfortable symptoms, so why not try to minimize them? Fewer carbs can lead to fewer insulin injections and less severe blood sugar swings resulting in overall better health.

Some people have found the ketogenic diet, or keto, is helpful for managing both type 1 and type 2 diabetes due to the very low-carb nature of it combined with high amounts of healthy anti-inflammatory fats. That last part isn’t always something people focus on (instead, reaching for poor-quality fats that can increase inflammation) but it’s a foundational piece of doing keto the right way.

On the keto diet, the body creates ketone bodies from fat to use as fuel, instead of glucose. Some studies have shown great improvements in HbA1c, a test that shows the average blood sugar levels over the past three months, as well as little glycemic variability in the test subjects. Other studies show average daily insulin usage goes down with a low-carbohydrate diet.

Of course, there is always the caveat that everyone is different. Some people on a high-fat diet experience negative imbalances in cholesterol. That’s why it’s important to work with your doctor and monitor changes closely if you’re trying out the keto diet with diabetes.

What we do know for sure is that plenty of wholesome, real plant foods benefit both types of diabetes—and every other state of health for that matter. Foods like colorful vegetables, nuts and seeds, and low-glycemic fruits increase our nutrient intake with vitamins, minerals, and antioxidants and reduce inflammation. They provide fiber to fill us up and feed good gut bacteria and help balance blood sugar.

No matter what diet works best for you, make sure it includes tons of nourishing plant foods.

If you missed last week’s episode of The Doctor’s Farmacy, I interviewed Drs. Carrie Diulus and Ethan Weiss to discuss different forms of the keto diet and the benefits it can have for some people. Dr. Diulus eats a vegan-keto diet (yes, it’s possible!) and has found it extremely helpful for lowering her insulin usage for type 1 diabetes and managing her weight. Dr. Weiss eats more of a pescatarian version of keto and explains why the right kind of fats and fiber are so essential to benefit from keto.

Wishing you health and happiness,

Mark Hyman, MD