A deep dive into the keto diet with respect to insulin, insulin resistance, pre-diabetes, type 2 diabetes and type 1 diabetes. What role can keto play? Find out! You might be surprised!
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Keto Diet and Insulin
Today we are going to talk about the keto diet and insulin. AND WHY STOP THERE? We’ll also dive into insulin resistance, diabetes and what keto has to do with it all!
First, let me say my disclaimer. I am not a doctor and do not give medical advice. What I’m going to be sharing is from my own experience and research.
Most non-diabetics have no idea what insulin does and what insulin resistance is.
That is rather frightening given that according to the CDC, if current trends continue, as many as 1 in 3 adults could have diabetes by the year 2050 [1].
That is astounding.
As you all probably know, I was diagnosed with adult-onset Type 1 diabetes after being misdiagnosed as pre-diabetic in 2017.
We are going to walk through prediabetes, type 2 diabetes, insulin, insulin resistance, and finally a few words about Type 1.
I urge you to really take to heart what comes next because you could be next.
I first want to talk about insulin and insulin resistance so that you can have a better foundation when we discuss diabetes.
What is Insulin
The dictionary defines insulins as the hormone produced which regulates the amount of glucose in the blood.
Basically, when glucose enters your blood either by the carbs you ate or the glucose your liver created, your blood sugar rises, your pancreas releases insulin, and your blood sugars return to normal either by having utilizing the energy or storing it.
So, insulin allows your body to utilize energy from glucose OR store it for later – and we all know what “storing for later” means, right? Your body only needs to much “energy”. If you have too much energy, it will simply store it.
To be blunt, if you overeat, you can put on weight.
I hear all the time when people say “inulin makes you gain weight”. Well, yes and no. That statement sort of takes the accountability out of the equation. Other people say “It’s all what you eat”. Well, it is both.
Can insulin, especially higher than normal insulin, contribute to weight gain. YES. But if the “extra energy” wasn’t there, it is less likely to do so.
So I’m in both camps and I think that is the right place to be.
Without insulin, your body cannot utilize glucose.
Now, a common misconception among keto folks is – no big deal, just remove carbs. Not so simple. Your body creates glucose (gluconeogenesis) as there ARE some systems that require glucose.
Your body NEEDS insulin. Period.
What is Insulin Resistance
Insulin Resistance is when the body does not respond well to insulin.
Imagine a lock and a key. The lock is your cells, the key is insulin. Insulin unlocks the door and allows the energy to get into the cells. If that lock gets all gummed up, the insulin (ie. they key) does not always fit into it and blood sugars rise.
When you are insulin resistant and your body is not responding, the result is the pancreas releasing MORE insulin because it wants your blood sugars in a certain range.
Now, a great tool in combatting insulin resistance is intermittent fasting which I do daily. [9]
What is a normal blood sugar?
Well, that is debatable, I suppose. The ADA says that [4]:
- Your A1C should be less than 7% which means your blood sugar average is less than 154 mg/dl
- Pre meal blood sugar of 80-130
- Post meal blood sugar less than 180
ACK!!!! COME ON!!!
All of this absolutely sucks. Why? Well, for starters, studies have been done that shown the following:
- People with blood sugars above 140 are more likely to have diabetic neuropathy which is a painful condition.[5]
- Even below 140 (110-125) Beta cell destruction happens.
I scanned my blood sugar while writing this to show you what MY blood sugar chart looks like for the last 8ish hours.
And I happen to get a perfect 80! Notice how mine stays between 70ish and 110.
That is MY goal.
For me personally?
I aim for an A1C of 5.0 and blood sugars below 100. At all times. Mine is currently 5.0, down from 5.7.
Now, check out this 24-hour period from a week ago when I ate crap carbs. Yes, I had a “cheat” day which is RARE. Look at how my blood sugars are crazy high and low and are all over the board.
Just looking at these two charts alone should tell you how wonderful keto is at stabilizing (and lowering) blood sugars for me.
If you want a comprehensive write up on blood sugars, please check out What are Normal Blood Sugars! Great article!
What is Prediabetes?
Basically, prediabetes is when your blood sugars are higher than what they should be, but not quite high enough to be considered Type 2 diabetes.
Personally, I feel the type 2 range is WAY too high, but that is just me.
The good news is that if you are prediabetic, the chances of reversal are very high.
Often, noticing prediabetes is a fluke.
Meaning, perhaps you have some random blood testing and it shows a higher than normal A1C or a fasting blood sugar that is higher than normal.
Symptoms can often be overlooked. The CDC does give us some conditions, however, to be on the lookout for with respect to prediabetes[2]. It might not be the worst idea in the world to have an A1C test or fasting blood sugar test done If any of the following apply,.
- If you are overweight.
- If you are older than 45
- 1 or more relatives with Type 2 Diabetes
- If you are not physically active or minimally physically active
- Having had Gestational Diabetes
- If you have PCOS
The classic case of prediabetes, as well as Type 2 Diabetes, usually involves being overweight, having poor food choices and not being physically active.
HAVING SAID THAT, this is not always the case. Diabetes does not discriminate.
Having prediabetes and type 2 diabetes does NOT mean you are “fat or lazy” or whatever other stigma comes along with it. You don’t have to be overweight.
Perhaps you eat amazing. You may be an athlete.
These “classic” case scenarios need to be rewritten to match current times.
What is Type 2 Diabetes?
According to the ADA, Type 2 Diabetes is when your blood sugars are much higher than normal and is the most common form of diabetes. It also refers to insulin resistance that occurs over time.
The pancreas will do its best to produce MORE insulin to keep up with blood sugars, but ultimately it simply cannot. [3]
Now, if you reference the ADA “recommendations” that I just mentioned, you’ll see that your body will be in rough shape once you hit the parameters of type 2.
Keto and Diabetes
So, you’ve probably been wondering what all this has to do with keto. Well, a lot.
If you recall, humans are moving towards a population that is hugely made up of prediabetics and type 2 diabetics.
A 24-week study was conducted and the result showed that a low carb diet let to improved blood sugars, lower A1C, lower fasting glucose, lower fasting insulin and a reduction in medication.
And then the low carb HIGH FAT had all these and then even GREATER improvements in A1C and body weight. [7]
That is amazing.
I want to take a quote directly from another study:
In studies that have evaluated well-formulated very-low-carbohydrate diets and documented high rates of compliance in individuals with T2D, results have been nothing short of remarkable.
These results include lower insulin requirements, weight loss, lower blood sugars, etc.. An interesting note was the high level of ketones, the greater the glycemic control. [8] Just something to think about.
In a nutshell:
- lower carb intake lowers insulin needs.
- Lower carb intake with a keto diet can aid in weight loss, lower A1C and lower blood sugar levels
- Intermittent Fasting helps to increase insulin sensitivity.
All of these together will most certainly help to reverse Type 2 Diabetes and prediabetes.
Keto and Type 1 Diabetes
So how does all this fit in with Type 1 Diabetes?
There are plenty of people, like myself, who have Type 1 Diabetes and participate in a keto diet.
One must take special care to CLOSELY monitor blood sugars, however.
But this should be the case anyway. We just need to be more careful about DKA (Diabetic Ketoacidosis), not to be confused with ketosis. They are 2 very different things.
My insulin requirements are minuscule compared to what they are when I do not eat keto.
That alone is incredibly beneficial.
RELATED – Ketones and Blood Sugar (a more in-depth Type 1 discussion)
Conclusion
Given where humans are headed and the increased crap that is being served up as food, the keto diet is definitely worth looking into for a variety of health reasons.
Now, I don’t think one must stay in ketosis forever. I think practicing weekly carb up days is incredibly beneficial! As a woman, it helps my hormones and as a general human it helps keep my metabolism from getting sluggish.
RELATED – Benefits of a Carb Up Day
BUT, the keto diet needs to be done right. Meaning, lots of healthy fats, good protein sources, veggies, low carb, etc. It does not mean a free for all of bacon and butter.
References
[1] https://www.cdc.gov/media/pressrel/2010/r101022.html
[2] https://www.cdc.gov/diabetes/basics/prediabetes.html
[3] https://www.diabetes.org/diabetes-basics/type-2/
[5] https://care.diabetesjournals.org/content/24/8/1448.full
[6] https://diabetes.diabetesjournals.org/content/52/1/102.full
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633336/
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826507/
[9] https://www.sciencedirect.com/science/article/pii/S095528630400261X?via%3Dihub
Trina Krug is a Holistic Nutritionist, Integrative Health Coach and host of the Carbless Conversations Podcast. With a Master’s Degree in Complementary and Alternative Medicine, her single mission in life is to facilitate self-healing in herself and those around her through awareness, lifestyle shifts and low-carb eating. As a current Doctor of Science student, she continues her studies in functional nutrition.