Ketosis for Diabetics – Is It Safe?

Ketosis for Diabetics – Is It Safe?

What is Ketosis?

Reaching ketosis is the number one goal of the ketogenic diet. In this altered metabolic state, your body burns fat for fuel instead of glucose. People want to reach ketosis because it comes with a wide range of health benefits, one of which is diabetes control. But is ketosis for diabetics safe or should you proceed with caution?
Well, as far as research evidence shows, ketosis for diabetics is both safe and effective. In fact, many keto dieters choose to go keto to either prevent or manage diabetes. The other leading reason for going keto is weight loss, which we know is also important when trying to manage diabetes.
Still, you want to know how the keto diet works for diabetes and what the research on this topic has to say. You may also want to learn how you too can manage diabetes with the help of ketosis. Well, keep reading to find out.

Is Ketosis for Diabetics Effective?

Ketosis is what happens to you when you follow a ketogenic diet. In this metabolic state, your liver starts using fat to make "ketone bodies" also known as ketones – molecules that replace glucose when carb intake is low.

Your body needs carbs to make glucose. Furthermore, it needs glucose to produce energy in the form of adenosine triphosphate (ATP). When there are no carbs in your diet, your body has no other options but to make ketones to function as an alternative source of energy.
Making ketones is nothing unusual for your body. In fact, it makes them during an overnight fast when up to 6% percent of your energy comes from ketones. But when you're in ketosis, up to 70% of your energy comes from ketone bodies.
But why does this matter for diabetes? It matters because ketosis for diabetics helps balance out blood glucose levels and normalize insulin sensitivity. Ketosis also causes weight loss because your body uses your fat stores in order to make ketones. Since many people with diabetes are overweight, losing weight with the help of ketosis can help.

Is Ketosis for Diabetics Safe?

Being in ketosis means your body works quite differently than usually. So, does this altered state pose any risk for someone with diabetes? According to the latest research on the safety of ketosis for diabetics, you have no reason to worry.
Take for example a study that examined the safety and tolerability of keto and compared it to a low-calorie diet [6]. The study involved two groups of 89 overweight diabetics between the ages of 30 and 65. One group was on the keto diet, the other on the low-carb diet. After four months, the group on the keto diet did better and tolerated the diet well.
A different study examined the safety of keto on a 3-year old girl with type 1 diabetes and epilepsy [7]. At the end of this study, the girl's levels of glycosylated hemoglobin (another marker of diabetes) and blood glucose levels improved, and she didn't experience any side effects.
With all this in mind, the keto diet and the ketosis it causes are not only safe but also valuable for people with diabetes and other conditions. Ketosis for diabetics is helpful mostly because it lowers blood sugar and even glycosylated hemoglobin. The diet is also easy to adhere to because it does not cause blood sugar spikes and drops.

Ketosis vs. Ketoacidosis

You may have heard about ketoacidosis, a dangerous complication of type 1 diabetes. This probably made you concerned about going keto. Ketoacidosis is a result of abnormally high levels of ketones and glucose in the blood. This combination causes the blood to become acidic which can be life-threatening if not treated immediately.
Ketosis, on the other hand, is quite different. When you’re ketosis, you have higher than usual level of blood ketones, but not high enough to cause acidic blood. Normally, your body is able to control the production of ketones with the help of insulin [8]. This is because insulin inhibits the production of ketones and ketones stimulate the release of insulin.
In Type 1 diabetes, this is a bit tricky. This type of diabetes is an autoimmune disorder in which the pancreas is not able to make enough insulin. Without enough insulin to control ketone production or blood sugar levels, people are at a greater risk of ketoacidosis. This is why taking insulin is so important for people with this type of diabetes.

Other conditions like severe infections, alcoholism, and severe dehydration can lead to ketoacidosis . But if you are healthy and have a well-functioning pancreas, your risk of ketoacidosis is pretty low. Even if you have 2 diabetes, your risk of ketoacidosis is low according to researchers [9].

How to Safely Reach Ketosis for Diabetics

If you are a diabetic who wants to treat your condition with a ketogenic diet, try doing the following things:
  • Start gradually – It's best for you to make a gradual switch to a low-carb, high-fat diet to avoid sharp changes in blood glucose. Reduce your intake of carbs by 20 grams every day until you reach the 30 grams per day sweet spot.
  • Monitor your blood glucose daily – You probably already do this. In case you don't, we suggest monitoring your blood glucose daily when you start a ketogenic diet. This will help you prevent hypoglycemia. You may want to adjust your insulin intake to prevent this.
  • Stay in touch with your doctor – Tell your doctor that you plan to make the switch to low-carb, high-fat eating. They will monitor your progress and adjust your medication accordingly.
  • Measure your ketones daily – There are many ways you can test for ketone levels. We suggest reading our article about measuring ketosis with ketone strips. There, we also list some alternatives you may be interested in.
  • Stay hydrated – You are very likely to experience more frequent urination in the early days of switching to a keto diet. This can put you at risk of dehydration as well as electrolyte imbalances. Make sure to drink enough fluids with electrolytes to stay healthy and feeling well.
Once you reach ketosis, you won't need to take your diabetes medication anymore or will need lower doses. You will also see an overall improvement in your condition and overall health. Still, keep an eye on any symptoms of hyper and hypoglycemia.


Benefits of Ketosis for Diabetics

Being in ketosis provides a wide range of health benefits for people with diabetes. Here are some of those benefits you'll likely experience.

1. Diabetes Control

This is obviously the leading and most important benefit of ketosis for diabetics. Lowering blood glucose levels is the primary way doctors treat diabetes. But they do so with medication which can cause side effects like an upset stomach, fatigue, and dizziness. Ketosis for diabetics does the same thing but without the side effects.

2. Diabetes Prevention

People who are at a higher risk of diabetes, such as those with insulin resistance, obesity, and high blood glucose, can prevent diabetes with a ketogenic diet. The diet helps you lose weight and lowers blood sugar levels – both of primary importance when trying to stop diabetes.

3. Kidney Health

People with diabetes are at a higher risk of kidney disease because high blood glucose can damage the blood vessels in the kidneys. A study in mice from 2011 shows that the ketogenic diet is able to reverse diabetic kidney disease after just two months of treatment [10].

4. Cardiovascular Health

Cardiovascular disease is another complication of untreated diabetes. One study involving 148 man and women shows that the diet works well for cardiovascular disease prevention [11]. A different study shows that a long-term keto diet decreased the levels of triglycerides, bad cholesterol, and blood sugar while increasing good cholesterol [12] – all things that prevent cardiovascular disease.

5. Cancer

Diabetes also carries the risk of a number of cancers. The keto diet can prevent this, not only because it controls diabetes but also because the diet kills cancer cells. Over 70% of animal studies show that a keto diet has an anti-tumor effect [13]. Studies on people showed equally positive results [14]. The reason why the diet works to fight cancer is because cancer cells can only survive on glucose, but not on ketones.


Ketosis for diabetics is completely safe in most cases. When you switch to a keto diet, your blood sugar levels decline, and your insulin levels stabilize. This, in turn, makes it possible for you to stop relying on diabetes medication to control your blood glucose.
The diet also allows your body to rely on ketones for energy. Studies show that it protects your heart, arteries, and kidneys. However, you still need to be careful when making the switch to a ketogenic lifestyle.
Monitor your blood sugar and ketone levels daily and look for any signs of ketoacidosis or hypoglycemia. Also, start eating low-carb, high-fat foods gradually to give your body more time to adjust.
All in all, the ketosis is a great tool for preventing and even managing diabetes types 1 and 2. Still, we need more studies on ketosis for diabetics to know for sure how it works in the long-run. For now, we know that ketosis for diabetics is a sure way to lose weight stabilize blood glucose and insulin levels — all effective in managing diabetes.

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