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Can keto diet lower a1c? Since the keto diet is the most popular of the low-carb diets today, you may think it helps diabetic patients. A1C is a simple blood test for hemoglobin a1c, which measures average blood sugar levels over the last 3 months. It’s a very common test used to diagnose diabetes and pre-diabetes.

The ketogenic diet is the most popular of the low-carbohydrate diets in fashion today. It replaces the primary source of energy in your body (carbohydrates), with fat intake and moderate protein intake. This lowering of carb intake can change the way in which your body processes energy and can potentially ease diabetic symptoms.

However, does this all have a basis in fact, or is it wishful thinking?

What Does the Keto Diet do For People With Diabetes?

Can keto diet lower a1c for people with diabetes

The keto diet has been studied for its effects on type 2 diabetes. On the surface, the dietary approach of the low-carbohydrate ketogenic diet may be effective in improving average blood glucose levels while reducing the need for insulin. However, the conventionally adopted healthy diet does come with its own set of risks as food intake changes.

You should speak to your physician before switching to it. You can also browse our articles on the physical and mental effects of the keto diet on the body.

What is Ketoacidosis and How Is It Different from Ketosis?

If you have diabetes, you should understand that there is a difference between nutritional ketosis and ketoacidosis. Both of these processes involve ketones, yet the latter is dangerous. The former is a process which basically digests fats and produces ketones for energy in the human body. However, ketoacidosis occurs when there isn’t enough insulin in the body and ketones build up to a dangerous amount. THis can actually be a life-threatening process.

The symptoms include excessive thirst and frequent urination. It can also result in confusion, fatigue, or weakness. It’s more common among people suffering from type 1 diabetes than type 2 diabetes.

Hence, it’s important to regulate the ketone levels in the body so that ketosis doesn’t evolve into ketoacidosis. This process occurs every day in the course of life depending on your protein and carbohydrate intake. It’s the state which leads to body weight loss, specifically that of belly fat and lower levels of a1c.

Common Problems People Face During the Keto Diet

Possibility of Kidney Stones

This is a well known side effect of the keto diet. Research published in the Journal of Child Neurology observed that children following the diet can be a treatment for epilepsy. However, 13 children out of the nearly 200 tested also developed kidney stones.

Possibility of Low Blood Sugar

A study published in Diabetic Medicine showed that the answer to can keto lower a1c for people with diabetes was yes, it can also cause hypoglycemic episodes. This is a dangerous drop in blood sugar. It echoes several dietitians as well.

Yo-yo Dieting

The keto diet can produce rapid weight loss since carbohydrate stores are depleted and fat reserves are bunt. This may result in dieters going back to their regular eating habits thinking the weight will stay off for good. This can result in rapid weight gain.

The best chance of keeping the weight off is to stay on the keto diet long-term. The weight won’t come back the longer you keep the diet going.

The yo-yo dieting can sometimes result in discomfort and unintended effects for dieters.

Dehydration + Loss of Electrolytes

The deprivation of carbohydrates in the keto diet leads to dehydration. Not just because carbs contain a high water content, but because the keto diet burns a lot of fats which can lead to a lot of body water loss.

This can cause the keto flu, constipation, headache, fatigue, etc.

Nutrient Deficiencies

Since carbohydrate intake is lower in the keto diet, you may deprive your body of starchy vegetables and healthy fruits. This can result in a nutrient deficiency. For example, you may not get enough potassium which can upset the electrolyte balance in your body and the blood pressure control.

Try adding in avocado, spinach, or low-carb sources of fiber like flaxseed. This can make up for the deficiency.


This keto side effect may be the most troublesome of all. Many rich sources of fiber and whole grains are restricted when you’re on the ketogenic diet. Hence, without them, regular laxation and microbiome support are in short supply. What’s more constipation can also give way to diarrhea during  the keto diet. This is more often than not predisposed to happen during the first few weeks of the diet.

Is the Keto Diet Safe for Adults with Diabetes?

Research has suggested that those with type 2 diabetes can control their weight and their health using the keto diet. This can lower their blood sugar levels and also keep them active. This may even reduce cardiovascular diseases. The research shows that they need less medication and can lower their levels of a1c when they follow the keto diet long term.

Can the Keto Diet Lower a1c For Patients with Type 2 Diabetes?

Can keto diet lower a1c hemoglobin levels

Let’s take a look at how the keto diet can lower a1c hemoglobin levels in the body. It does lower the grams of carbohydrates or the carbs per day that you consume. However, does it do more than that? To understand that, we need to understand how the keto diet works.

The High-Fat Ketogenic Diet

People with type 2 diabetes suffer from obesity or for overweight individuals in general. The ketogenic diet may seem unhelpful on the surface here, because it’s a high-fat diet. However, the goal of the diet is to use fat as an energy source. Hence, most of your energy comes not from carbohydrate intake, but fats. This may be a great treatment for type 2 diabetes patients.

However, this doesn’t mean that you should load up on unhealthy fats. It means you should eat more healthy fats. Here are some suggestions for healthy fat sources:

  • Eggs
  • Fish (salmon)
  • Avocado
  • Cottage Cheese
  • Nuts and nut butters
  • Olives and olive oil
  • Seeds

Keto Diet Effects on Blood Glucose Control

How can keto diet lower a1c levels in diabetics

The keto diet decreases the body’s average blood glucose levels due to its carb restriction in patients. Managing the carbohydrate doses that your body needs is very important here. Especially for those suffering from diabetes mellitus, it’s important to regulate intake of excess sugar.

How many grams of carbs you eat should be determined on an individual basis. Everyone’s body is different. This should be a consultation with your physician.

If you have high average blood glucose levels in general, then eating too many carbs is dangerous. You should switch over the focus to fats.

Potential Adverse Effects of the Ketogenic Diet for Type 2 Diabetes Patients

As mentioned above, it’s important to regulate your ketone levels otherwise ketosis may evolve into ketoacidosis. This can result in diabetic ketoacidosis (DKA). This is usually prevalent in type 1 diabetics when blood glucose levels are exceedingly high. However, it can also result due to a reduction in insulin levels.

DKA is possible in type 2 diabetics as well. Being ill when on a low-carb diet can also increase the risk of DKA. You should test your blood sugar levels throughout the day to make sure they’re in the target range.

The American Diabetes Association recommendations are that your ketone levels should be tested if your blood sugar levels are higher than 240 mg/dL. You can test these levels at home using urine strips if possible.

Know that DKA is a medical emergency and is not to be treated lightly. If you experience the symptoms of DKA, you should see the doctor immediately. Any complications can cause a diabetic coma.

Warning Signs of DKA

  • Dry Mouth
  • Frequent Urination
  • Nausea
  • Breathing Difficulties
  • Breath has a fruit like color
  • Consistently high blood glucose levels

Monitoring Your Diabetes During the Keto Diet

Unlike the typical low calorie diet, the high-fat diet used in keto requires more careful monitoring. This is required so you don’t overdose on the grams of carbs you’re allowed. You can even start the diet in a hospital. Your doctor will need to monitor the blood glucose levels and ketone levels to make sure there are no negative side effects.

Once your body has adjusted to the diet, you can see your doctor once or twice a month for testing or medication adjustments. If your symptoms have improved, it’s important to keep up with the regular blood glucose monitoring. For patients with diabetes, the frequency of testing can vary. Hence, you should always consult with your physician. This can help with blood glucose management of type 2 diabetes.

Beneficial Effects of the Keto Diet for Type 2 Diabetes Patients

Can keto diet lower a1c levels in diabetes patients

 Several research studies have been carried out to find out that the keto diet is beneficial for patients with type 2 diabetes. These results have also been endorsed by the American Diabetes Association.

1. A 24-week study was carried out in 2008 by researchers from Duke University and the Department of Veterans’ Affairs Medical Center. It was to determine the effects of a low-carbohydrate diet on patients with type 2 diabetes. These patients were also diagnosed with obesity.

The study concluded that a reduced carb intake led to improvements in:

  • glycemic control
  • diabetes medication elimination
  • weight loss in overweight and obese individuals

Lifestyle modifications in this diet were proven effective for improving obesity and type 2 diabetes.

2. In a 2013 review, it was reported that studies showed that the keto diet led to improvements in blood sugar control. The keto diet did this better than other diets. In fact, the keto diet regulated a1c levels, weight loss, and discontinued insulin requirements.

This showed how can keto diet lower a1c levels.

3. In 2017, a study showed that low-carb and ketogenic diets outperformed other conventional low-fat diets over 32 weeks. This was both in terms of weight loss and a1c levels.

Impact on Diabetes Medication

Keto diets can improve blood sugar control, and by extension, the amount of medication needed. Scientists have warned, however, that following the keto diet alongside an insulin resistant countering regimen can result in a higher risk of hypoglycemia. This occurs when the blood sugar levels in your body drop to 70 mg/dL or less.

It’s best for you to discuss your diet changes with your physician. Don’t consume less carbohydrates without this consultation when you’re being medicated for diabetes.

Impact on Weight

The keto diet burns fat stored in the body. This is beneficial for those trying to lose weight. It may be helpful for those whose excess weight has influenced prediabetes and type 2 diabetes.

Even light to moderate weight loss and exercise can support glycemic control. The overall wellbeing and energy distribution across the body can be affected positively for people with type 2 diabetes this way.

Research has shown that people who undertake a ketogenic diet show a huge improvement in blood sugar control as well.

Other Benefits of the Keto Diet

The keto diet has several other benefits for diabetic patients including:

  • lower blood pressure
  • improved insulin sensitivity and lowered insulin resistance
  • reduced dependency on medication
  • improvements in high-density lipoprotein (HDL), or “good” cholesterol, without adding to low-density lipoprotein (LDL), or “bad” cholesterol
  • a drop in insulin

The long-term effects of a keto diet for diabetic patients can also include a reduction in:

  • Metabolic Diseases
  • Chronic Diseases
  • Heart Disease
  • Cardiovascular Diseases

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