New evidence for the effectiveness of the ketogenic diet against type 2 diabetes

Our expert: Dr. Evelyne Bourdua-Roy, author of Reversing Overweight and Diabetes

Type-2 diabetes

Type 2 diabetes (T2D) is a lifestyle disease that affects more and more people: scientists estimate that in 2021, 537 million adults were affected worldwide and that the prevalence of diabetes is expected to increase to reach 643 million by 2030 and 783 million by 2045. Compared to the general population, people with type 2 diabetes have a lower life expectancy, a risk higher risk of developing heart disease, diabetic neuropathy, retinopathy and kidney disease. In 2021, around 6.7 million people died from diabetes, or one person every five seconds.

The main risk factors associated with T2D are overweight and obesity, present in approximately 80% of patients. The main strategy against T2D is weight loss, which can be achieved through dietary changes, preferably combined with exercise training. “Studiessays Dr Bourdua-Roy, report that the benefits of weight loss in the management of T2DM are not limited to glycemic control, but also extend to other cardiovascular risk factors such as blood pressure, high-density lipoprotein (HDL), total cholesterol (TC), and triglycerides (TG).”

Type 2 diabetes is therefore not inevitable and dietary interventions can reverse the disease, without medication. For example, the Newcastle protocol, a very low-calorie diet, in certain cases allows weight loss and a return to normal blood sugar levels, and the Reversa protocol which recommends intermittent fasting and a ketogenic diet also allows type 2 diabetes to be reversed.

Low-carb and ketogenic diets

“Today we have many dietary therapies, including low-carb and ketogenic diets, to effectively manage T2D.“, explains Dr. Bourdua-Roy. The ketogenic (keto) diet is attracting interest as a rapid and effective weight loss strategy.

The ketogenic or keto diet

Keto is a diet very low in carbohydrates (<50 g/day) and high in fat (>75% of total energy). The first applications of keto in medicine date back to the 1920s when this diet was proposed as a treatment for drug-resistant epilepsy in young patients.

Keto induces nutritional ketosis in patients, that is, the appearance of fat-derived ketone bodies, which serve as fuel for cells, says Dr. Bourdua-Roy. This ketosis has an appetite suppressant effect; therefore, many patients are advised to use this diet to help lose weight. “What’s moresays Dr Bourdua-Roy, in diabetic patients, keto reduces blood sugar and weight, as we have shown in our Quebec clinic.”

In diabetic patients, keto reduces blood sugar and weight

The benefits of the ketogenic diet against diabetes

Several studies show that patients who followed a keto diet lose weight, have better blood sugar control and can reduce medication doses. A systematic review of nine randomized controlled trials reported that very low-carbohydrate diets significantly reduce weight in the short term and reduce glycated hemoglobin (which reveals blood sugar levels over the previous 3 months) compared to high-carbohydrate or normal diets. The study also reports that overweight patients with T2D were able to reduce doses of anti-diabetes medications or stop them.

In a study published in the journal Cureusresearchers carried out a meta-analysis of clinical trials conducted on the effect of low-carbohydrate diets, including the ketogenic diet in patients with type 2 diabetes. The researchers selected 15 studies for the meta-analysis. All participants suffered from obesity and type 2 diabetes. The number of participants was at least ten in the clinical trials: some participants followed a ketogenic or low-carbohydrate diet and the others (control group) a hypocaloric diet with control over the quantity and quality of carbohydrates consumed and/or a low-fat diet.

The results show that low-carbohydrate diets reduce glycated hemoglobin (HbA1c) more than other diets. Likewise, a significant decrease in the percentage of HbA1c was recorded in patients who followed a keto diet compared to those who consumed the control diets. Generally speaking, although low-carb diets are effective, keto is superior to them in terms of lowering weight, blood sugar and glycated hemoglobin. According to the authors, following a ketogenic diet improves blood sugar control: it reduces glycated hemoglobin levels and fasting blood sugar levels.

In 2022, two other studies confirmed the beneficial effects of the ketogenic diet for blood sugar control :

• A systematic review examined the results of 12 clinical trials that explored the effects of a ketogenic diet on insulin sensitivity in prediabetics and type 2 diabetics, with and without exercise. Results: The ketogenic diet provides a marked improvement in blood sugar control in participants. One of the studies, however, noted that while a ketogenic diet significantly improved blood sugar control, it created disorders of lipid metabolism in the liver. By combining a ketogenic diet with exercise, liver problems were avoided;
• A meta-analysis of 21 studies showed that the ketogenic diet improves cardiovascular risk factors (glycemia, weight, waist circumference and lipids) in obese/overweight patients, particularly those with T2DM.

Read also: Normand Mousseau: “The fear of diabetes complications motivated me to heal”

In practice

“Type 2 diabetes can be reversed through diet and this new study provides a little more evidence of the effectiveness of the ketogenic diet, which is also part of the Reversa dietary protocol for losing weight, returning blood sugar to normal and reducing the risks associated with diabetes.“, says Dr. Bourdua-Roy. The ketogenic diet promotes weight loss by reducing appetite, increasing energy expenditure and increasing the use of body fat. Furthermore, the ketogenic diet is recommended by many doctors in the treatment of childhood epilepsy.

To help you start a ketogenic diet, you can consult our ketogenic diet starter kit but if you are diabetic, it is advisable to seek help from a healthcare professional. The Atkins diet can also be a solution to improve blood sugar levels in type 2 diabetics.