Ketogenic Lifestyle for Remission of Type 2 Diabetes
by Taranum Sultana

Type 2 Diabetes (T2D) is a disease of high blood glucose (sugars), or a carbohydrate intolerance disorder. It is a serious condition that persists for a long time and gets worse over time for many patients; therefore, it is traditionally considered as a chronic progressive condition. Complications related to diabetes are serious and can be life-threatening.

Worldwide, the number of people with type 2 diabetes has climbed from 108 million in 1980 to 463 million adults (20–79 years) in 2019. This is expected to climb to 700 million by 2045. As per Diabetes Canada, currently, one in three Canadians has diabetes or pre-diabetes.

Currently, treatment of type 2 diabetes mainly relies on reducing blood sugar levels through medication. In addition, several medical professionals advise necessary lifestyle changes to manage this condition.

However, recent research suggests that people can successfully put their diabetes into remission through dietary changes and weight loss.

Diabetes remission refers to achieving healthy blood sugar levels without using any medicine.

Recent clinical trials have shown that a low carbohydrate, or ketogenic diet, effectively controls blood glucose and eliminates the use of drug treatments to reduce blood glucose levels.

A well-planned ketogenic diet normalizes blood glucose levels naturally by switching body fuel source from carbohydrates to fats. Consumption of higher amounts of healthy fats, moderate proteins, and low amounts of complex carbohydrates lowers insulin production.

The Role of Insulin and Insulin Resistance

One of the roles of insulin, a hormone produced by the pancreas, is to control blood glucose levels in our bodies. Insulin removes excess blood glucose and stores it into liver and muscle cells to be utilized as an energy source. It also regulates fat storage by directing fat cells to convert excess glucose into fat.

Consumption of carbohydrates, particularly refined, quickly raises blood glucose that spikes the insulin level, which in turn helps cells use glucose and reduce its concentration in the blood. However, continuous elevated blood glucose levels cause higher insulin levels that may lead to insulin resistance (IR). Insulin resistance is a state in which body cells don’t respond well to insulin and can’t use glucose from your blood.

An early indicator of IR is abdominal fat. Eventually, IR may lead to pre-diabetes, type 2 diabetes, or other chronic health conditions, such as non-alcoholic fatty liver, cardiovascular diseases, Alzheimer’s, and cancer.

Rationale for Ketogenic Diet for Type 2 Diabetes

Over the past two decades, several studies have consistently shown the strong association between dietary carbohydrates, insulin resistance, and type 2 diabetes.

The most recent analysis of low carbohydrate diets for type 2 diabetes highlights multiple studies, ranging from two-week interventions to two years, demonstrating reductions in HbA1c values, improvements in glycemic control, and weight loss. Most notable is the reduction in diabetic medications to the point at which many patients have completely eliminated them.

Ketogenic Lifestyle and Nutritional Ketosis

A well-formulated ketogenic diet consists of high-quality healthy fats (70–80%), low in carbohydrates (5–10%) with moderate or adequate protein intake (15–20%).

Eating a high carbohydrate diet keeps the blood glucose and consequent insulin level high, depletes your energy, focus, and sets you up for weight gain. Unlike carbohydrates, dietary fats do not require insulin to enter body cells to be used for energy. Therefore, a low carbohydrate diet reduces spikes of blood insulin level, giving your body increased ability to burn the dietary fats and the fat deposits in the body.

A very low-carbohydrate diet, or ketogenic diet, enables the body to burn fat as primary fuel instead of carbohydrates. When the body uses fat as fuel, it converts fats into energy molecules called ketones by a process called nutritional ketosis. Ketones provide energy to fuel important organs like the brain, heart, and muscles.

Recent research proposed that ketones reduce oxidative stress (i.e. free radicals) and inflammation, both of which are key drivers of type 2 diabetes. Therefore, nutritional ketosis effectively puts type 2 diabetes into remission by lowering high blood glucose, insulin resistance, and inflammation.

Practical Strategies for Achieving Nutritional Ketosis

There are several key things to consider before you start introducing dietary changes and adapt to ketogenic lifestyle. These include consulting your physician for getting the basic blood work done, such as fasting levels of glucose, insulin and lipid profile, and Hb1Ac. This is followed by introducing gradual carbohydrate restriction into a daily routine and removing refined and processed carbohydrates. You likely have to reduce insulin doses or other medications once you start eating low carb. Therefore, I strongly recommend seeking medical advice before making any dietary changes. A physician can help you safely reduce your medications to avoid low blood sugar or blood pressure.

Next step is to start adapting to a ketogenic lifestyle. A well-formulated ketogenic diet, based on real and whole foods, can help you maintain and sustain nutritional ketosis over a long term. Incorporate healthy fats, lots of leafy greens, and protein sources such as eggs, meat, and fish in your diet. In fact, incorporating the dietary changes is an overwhelming task for most people, so consulting a certified health coach would greatly aid in transition to keto lifestyle.

If you would like more information on using dietary changes to support diabetic remission or for weight loss, I’d be glad to help. If you have questions, please feel free contact me via the email address below.

Dr. Taranum Sultana is a Certified Ketogenic Nutrition SpecialistSM (CKNS) from the American Nutrition Association. She has extensive international research and teaching experience in biochemistry and molecular biology. She practices as a keto coach in Regina and regularly writes in WHOLifE Journal to raise awareness of the benefits of ketogenic nutrition and intermittent fasting. To contact her call (306) 737-8704, email info@ketowellness.ca, and visit ketoandwellness.ca.