The ketogenic diet is a special type of nutrition in which carbohydrates are almost completely excluded, and protein food in the diet decreases, but the fat content increases. When switching to a keto diet, the body enters a special state called ketosis.
Ketosis is a physiological state of the body, which is manifested by an increase in the level of ketone bodies in the blood above 0.5 mmol when following a ketogenic diet and ketone bodies are alternative sources of energy. The metabolism of ketone bodies enhances metabolism, has an anticonvulsant effect, improves cellular metabolism, and has a beneficial effect on diabetes mellitus and other disorders of carbohydrate metabolism.
Keto Diet for Diabetics
The effect of the keto diet on diabetes has been confirmed by scientific data from American scientists as the majority of Americans suffer from disorders of carbohydrate metabolism.
When following the usual diet, the body receives energy, mainly due to glucose metabolism. The brain alone consumes up to 25% of the incoming glucose. When access to glucose consumption is limited, as occurs on a keto diet, the body adapts to receive energy from an alternative source - ketone bodies, which are formed when fats are broken down. In this case, the brain can consume up to 50% of the metabolic energy released, which in turn shifts the metabolism to the production of ketones to maintain homeostasis.
Prediabetes is a metabolic syndrome characterized by resistance of the body's cells to insulin. Too much insulin is produced, but it does not have the activity needed to promote proper glucose uptake by cells.
A keto diet for diabetes would be optimal, especially in the first stage of type 2 diabetes. Since more and more insulin is released during the formation of the metabolic syndrome, but in general, it is not fully active, and then accumulates in the blood. This in turn leads to obesity.
Carbs and the Keto Diet for Diabetes
Carbohydrates are divided into simple and complex. Simple or harmful carbohydrates include regular food sugar, glucose, and fructose, and hard or beneficial carbohydrates include starch and fiber. Excessive consumption of simple carbohydrates leads to obesity and type 2 diabetes. Since a lot of free glucose circulates in the blood, its absorption is disrupted.
Complex carbohydrates are beneficial because a lot of energy is consumed during their absorption, and they also provide a long-lasting energy effect. When you eat carbohydrates, the pancreas produces a hormone - insulin, which acts as a switch that unlocks cells for glucose uptake. In recent years, the amount of carbohydrate intake has increased significantly, and as a result, the incidence of diabetes has increased, especially in America and Europe.
Ketosis and Ketoacidosis
During periods of fasting or excessive physical exertion, the body's stores of glucose are used up, and the inability to replenish them forces the body to produce ketone bodies to counteract the lack of energy. This state is called ketosis.
Rapid formation of ketone bodies, changes in blood pH, and electrolyte imbalance on the acidic side lead to ketoacidosis - a dangerous condition of the body.
Diabetic ketoacidosis can be when insulin production decreases, the number of ketones with glucose in the blood increases, and alcoholic, when alcohol consumption and fasting increase, the level of ketones rises, but there is no increase in blood sugar.
The state of ketoacidosis is especially dangerous for people with type 1 diabetes, as the level of glucose in the bloodstream rises, the level of insulin is insufficient, in addition, fats are burned for energy, which leads to an increase in the content of ketones in the body. the blood. At the same time, glucose is not absorbed by cells, and it circulates in the bloodstream, while the blood is saturated with ketone bodies, the pH of the blood shifts to the acidic side, upsetting the acid-base balance. This condition is very serious and can lead to a coma or ketoacidosis. Ketoacidosis coma is a state of acute intoxication with damage to the cardiovascular and hepato-renal systems.
With controlled nutritional ketosis, the body burns a large amount of fat for energy after using up the entire glycogen supply in the liver and muscle.
Type 1 diabetes and the keto diet
Type 1 diabetes is an autoimmune disease in which the hormone insulin is produced or formed in the pancreas by beta cells, but the body perceives it as foreign and destroys it with the help of immune cells. These patients are forced to receive hormone replacement therapy with insulin injections for the rest of their lives. As a rule, type 1 diabetes affects children and young adolescents during puberty, that is, it appears only at an early age. To maintain life, continuous hormonal therapy with basal and bolus insulin is required, that is, short- and long-acting insulins. Tablets prescribed for type 2 diabetes mellitus are not suitable for the treatment of type 1 diabetes, as they can cause serious disorders of the pancreas or poison the body.
According to the effect of the keto diet on type 1 diabetes, adequate studies have not been conducted, considering the state of hypoglycemia, in which the liver will not be able to react to the release of glycogen due to its absence and this is dangerous and risky for the health of patients. Since they cannot stop insulin therapy and need to carefully follow a diet that should contain carbohydrates along with proteins and fats, a ketogenic diet is not recommended for people with type 1 diabetes.
A patient with type 1 diabetes needs to eat at least 150 grams of carbohydrates with food to replenish glycogen reserves. If you are on a keto diet with type 1 diabetes, then the permissible carbohydrate intake of fewer than 50 grams will not cover the needs of the body and will be fraught with negative health consequences. For example, hypoglycemia may occur, and if it is not stopped in time by ingestion of glucose, the condition may go into a hypoglycemic coma. This coma is a dangerous condition for the brain and carries a serious risk to life. However, studies were conducted on two patients with type 1 diabetes - a girl with epilepsy and a teenage boy. In the course of the keto diet, the frequency and strength of seizures decreased significantly in the girl. The boy had been following a strict keto diet for six months with restricting vegetables, vegetable oils, sweeteners, dairy, lean meats, and eating only fatty meats and eggs, and his insulin production in his pancreas had been restored. In addition to strictly following the diet, the patient also took vitamin D. In the future, the fate of these people is unknown.
Other studies have shown that even reducing carbohydrate intake leads to good glycated hemoglobin results, but it is not necessary to follow a keto diet, it is sufficient to stick to a low-carbohydrate diet.
Glycated hemoglobin shows the mixture of hemoglobin with glucose for three months. The higher the constant level of glucose in the blood, the higher the glycated hemoglobin index at the maximum permissible rate of glucose up to 6%.
Type 2 diabetes and the keto diet
Type 2 diabetes mellitus is an acquired disease due to a violation of the diet and a sedentary lifestyle, which is manifested by a decrease in the activity of insulin produced by the pancreas. To treat such a type of diabetes, endocrinologists prescribe special medications - pancreatic stimulants, a strict diet excluding fast carbohydrates, and physical activity. Therefore, the keto diet for type 2 diabetes, on the contrary, is considered one of the best and recommended. With its use, many independent studies have been conducted, during which the effectiveness of the ketogenic diet has been demonstrated by reducing the proportion of glycated hemoglobin in the blood and reducing body weight. Especially in the first year of switching to the keto diet.
In older patients with diabetes, on the keto diet, there were improvements in cholesterol tests, an increase in high-density lipoproteins, a decrease in low-density lipoproteins, and a decrease in the load on the pancreas by decreasing doses of hypoglycemic drugs.
But when following the keto diet in type 2 diabetes mellitus for more than 2-3 years, particularly positive dynamics were not observed and glycated hemoglobin remained at the same level. Also, when the ketogenic diet was stopped, the body's ability to break down and digest carbohydrates decreased.
With the keto diet for type 2 diabetics, studies have also been conducted, as a result of which it has been confirmed that the long-term diet, up to one year, improves cholesterol, blood glucose, weight loss, and significantly reduces the doses of hypoglycemic drugs used and for comparison, A group of patients on a low-carbohydrate diet and a group on a ketogenic diet were used. The difference was significant: in the first group, the indicators of weight, glucose, and lipids remained unchanged, while the second group showed very good results in all parameters.
The keto diet for type 2 diabetics also requires daily monitoring of blood glucose levels, so that its level can drop quickly and suddenly. In such cases, the use of fast carbohydrates will be an urgent help, but if the keto diet is followed, then this is an unacceptable option, therefore, in consultation with an endocrinologist, you will have to reduce the doses of hypoglycemic drugs.
Disadvantages of the keto diet for diabetes
A poor, monotonous diet.
Lack of nutrients and vitamins in food.
Low or no fiber intake, which is especially necessary for diabetics;
Digestive problems, in particular, intestinal motility disorders, and constipation.
Excessive consumption of protein foods can lead to kidney problems, which are particularly prone to diabetes.
risk of dehydration. With keto and diabetes, it is very important not to leave the body without fluids, as this can lead to problems with blood vessels and increased blood pressure.
It is difficult for people with diabetes to tolerate the rejection of carbohydrates, especially emotionally.
The phenomenon of "morning dawn"
With keto and diabetes, glucose levels often rise during fasting. This is due to adaptive glucose levels or the 'dawn effect'. This syndrome is equally characteristic of patients with type 1 and types 2 diabetes, when glucose levels increase themselves in the morning hours before awakening, despite sleeping and eating less during these hours. Also, perfectly healthy people who do not suffer from metabolic syndrome or do not have a history of diabetes, in general, are prone to this phenomenon.
This condition is explained by a violation of circadian rhythms, the stress experienced the night before, excessive consumption of carbohydrates at dinner,, increased form and form, and auctioned action of hormones, such as cortisol, stress hormones adrenaline, thyroid hormones, and glucagon - an anti-insulin. Due to these hormonal fluctuations, glucose synthesis by the liver increases, and excess glucose is released into the blood. To stabilize this condition, it is recommended to shift the hours of taking hypoglycemic drugs or insulin injections to a later time in the evening. Also, reduce such foods at dinner, which can cause an increase in sugar levels.
The danger of this syndrome is that the constant fluctuations in glucose levels from low to high and vice versa have a very negative effect on blood vessels and peripheral nerve endings which leads to complications of diabetes.
Those who follow a keto diet with diabetes should also remember that with a pathologically low blood glucose level, the body makes a compensatory reaction. This condition is called the Somogyi effect and manifests itself at any time of the day, regardless of when the drugs were taken.
The keto diet for diabetics, although it assumes that there are no or little carbohydrates in the diet, the liver still produces glycogen through gluconeogenesis. Gluconeogenesis is the formation of glucose from non-carbohydrate compounds - amino acids from muscle tissue or glycerol during the breakdown of fats.
However, you should switch to the keto diet gradually, without trying to get into ketosis as quickly as possible, so that your blood glucose level remains smooth. The level of glucose in the blood, which persists for a long time in a diabetic patient, indicates physiological insulin resistance, that is, "working sugar".
The keto diet for diabetics with prolonged adherence reduces the level of "working sugar" and normalizes the sensitivity of cells to insulin.
Keto Diet Examples for Diabetes
Swedish physician Andreas Einfeldt gave an example of changes in blood sugar levels when eating recommended food for diabetics and products from the keto menu. After he ate a cereal sandwich with cucumber and low-fat yogurt with an apple, his blood sugar level jumped to 9 mmol an hour later. And after frying the meat in oil with fatty sauce and stewed vegetables, the sugar index was 4 mmol. This points to the actual benefits of the keto diet for type 2 diabetics.
The keto diet for diabetes includes the use of foods such as meat, fatty fish, fats and fats, fatty cream, cheese, eggs, and olives. Nuts, especially fatty ones, vegetable oils, leafy green vegetables, avocados, cucumbers, and cabbage. Minimum consumption of seasonal berries is also permitted as is water, including mineral water, tea, and coffee drinks.
The menu should be prepared for a week once and carefully consider the list of necessary products. Also, diabetics who adhere to the keto diet are advised to take into account the peculiarities of metabolism, physical activity, and calorie intake.
Recommendations regarding the ratio of protein, fat, and carbohydrates, in principle, are the same for everyone and for diabetics as well. If you eat 5-6 times a day in portions, each serving should contain no more than 5 grams of carbohydrates, 25-28 grams of protein, and 30 grams of fat.
It is recommended to switch to the keto diet for diabetics in consultation with an endocrinologist and under his close supervision.
0 Comments