Patient Blogs | Type 2 Diabetes
Is a Keto Diet Good for People With Type 2 Diabetes?
photo of woman eating a slice of avocado toast

If you google “keto diet,” you get over 320 million results consisting of guides, food lists, and menus for beginners and veterans alike. With this kind of popularity, there's no reason why keto diets wouldn’t make headlines. But is it suitable for everyone -- specifically, someone living with type 2 diabetes? Let's take a closer look.

What Is a Keto Diet?

A ketogenic diet, commonly referred to as a “keto diet,” is a low-carb, moderate protein, high-fat eating pattern designed to induce ketosis. Ketosis is a metabolic state that occurs when the body burns fat instead of glucose for energy. Initially, the diet was prescribed for people with seizures and consisted of a 4:1 ratio of fat-to-carbohydrates plus protein. Nowadays, there are a few variations to eating keto, but all restrict the overall intake of carbohydrates. 

Are Keto-Friendly Foods OK to Eat With Diabetes?

Keto diets allow fat and protein-rich food groups while limiting foods that contain a lot of carbohydrates. Examples of acceptable foods include: 

  • Full-fat dairy products
  • Meat, seafood, and eggs
  • Non-starchy produce such as berries, spinach, avocado, and bell peppers
  • Coconut 
  • Plant-based oils
  • Nuts and seeds

But believe it or not, there is no such thing as a “diabetes diet.” That’s because everyone has an individualized eating style. There are a variety of foods, including foods allowed on a keto diet that can easily fit into a diet that promotes blood glucose management. 

What Are Keto Diet Advantages?

A keto diet can result in rapid weight loss by reducing carbohydrate intake. Foods such as bread, rice, pasta, beans, starchy produce, desserts, and sweetened beverages are all off-limits. Naysayers may say a caloric restriction in any food group can lead to weight loss. Still, some researchers say the metabolic effects of food, rather than the calories of specific foods, are the key to determining body weight over the long term, and carbohydrate restriction is more effective than fat restriction for weight loss treatment. 

What Are Keto Diet Disadvantages?

While a keto diet may have its advantages for weight loss, it also has disadvantages -- especially for people with type 2 diabetes. A 2022 journal article suggests that a keto diet may cause low blood sugars. This is especially true for people who have diabetes and are on insulin or oral medications that may result in hypoglycemia. 

Hypoglycemia, commonly known as “low blood sugar,” is a medical condition that occurs when blood glucose levels are less than 70 mg/dL. This condition is characterized by symptoms such as hunger, nausea, irritability, and fatigue, to name a few. If severe enough, hypoglycemia can impact the functioning of the nervous system and result in confusion, seizure, and coma.

Additionally, heart health should be of concern for anyone living with diabetes. According to the CDC, “people with diabetes are twice as likely to have heart disease or a stroke compared to people without diabetes,” and since keto diets are high-fat diets, this is of concern. Research shows conflicting data on a keto diet's impact on heart health. For this reason, robust long-term research could increase our knowledge of how a keto diet impacts overall heart health.

How to Use This Information

There are several pros and cons to adhering to a keto diet. If you are interested in incorporating keto-friendly foods into your existing diet that contains carbohydrates, go for it. However, if you have type 2 diabetes and are on any medications, please consult your doctor and dietitian before sticking to a strict keto diet. 




Photo Credit: Grace Cary / Moment via Getty Images

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Kim Rose

Kim Rose

Guest contributor, registered dietitian

Kim Rose is a registered dietitian nutritionist, certified diabetes care and education specialist, and certified nutrition support clinician in South Central, FL. After graduating from Florida State University, Rose volunteered for 1 year, living and working with underserved populations in various areas of Alabama. Her inclusive approach and philosophy revolve around “making nutrition easy and attainable.” Rose uproots common food-related misconceptions in her private nutrition practice and empowers her clients to build sustainable (and tasty) eating patterns for better blood sugar management. With over a decade of experience, she has taught thousands of clients, patients, and their family members to enjoy the foods they love and shares these nutrition tips on her social media channels.