Ketogenic diet ‘viable patient choice’ for type 2 diabetes

keto diet


LOS ANGELES — Adherence to a ketogenic eating plan, with proper medical support, could yield diabetes remission and sustained cardiometabolic improvements in a person with type 2 diabetes, according to a speaker at the World Congress of Insulin Resistance, Diabetes and Cardiovascular Disease.

“Carbohydrate restriction is a viable patient choice for type 2 diabetes,” Sarah Hallberg, DO, MS, ACSMCEP, FNLA, FOMA, medical director and founder of Medically Supervised Weight Loss Indiana and medical director of Virta Health, said during a presentation. “Nutritional ketosis supports diabetes reversal by reducing insulin resistance while providing alternative fuel to glucose with favoring signaling properties.”


A low-carbohydrate diet is often referred to as a “fad diet” in the popular press, despite the fact that it has been around for more than a century, Hallberg said. Before the discovery of insulin, people with diabetes could expect to live several years with what was then a uniformly fatal disease if they adhered to a strict low-carbohydrate diet.

Today, Hallberg said, a low-carb or ketogenic eating plan is sometimes presented incorrectly.

“One of my biggest frustrations is when we hear about low-carbohydrate and people are talking about something that is less than 40% [carbohydrates],” she said. “If [the diet is] somewhere around 40%, it is really a high-fat, high-carbohydrate diet. A low-carb diet is much lower than that.”

A very low-carbohydrate diet, or ketogenic diet, is defined as less than 50 g per day, or 10% of total daily intake, Hallberg said. A low-carbohydrate diet is daily intake of 51 g to 130 g per day, or less than 25%. Anything above 25% is considered a moderate-carbohydrate diet.

Keto misconceptions

Contrary to popular misconceptions, a ketogenic diet is not a high-protein or no-carbohydrate eating plan, Hallberg said. A well-formulated ketogenic diet is defined as a high, whole food fat plan (70% to 80%) that is low in carbohydrates (5% to 10%) with moderate or adequate protein intake (15% to 20%).

“One of the things we often hear is that this is a no-carb diet, and that is not true,” she said. “[Those who follow a ketogenic plan] eat a lot of leafy greens and a lot of nonstarchy vegetables each day. We insist on five servings of them. When we’re talking about under 50 g total carbohydrate intake a day, you can get a lot of vegetables in for that less than 50 g. What are you not eating? I tell my patients no GPS: No grains, no potatoes and no sugar.”

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