Curtin University dietetics students Meagan Chegwidden and Charlotte Rowley are currently doing their community placement at Diabetes WA. The pair recently presented a lunchtime talk for staff about the advantages and disadvantages of the ketogenic diet for people with diabetes. Please note that the below information is the product of the students’ research and is not the official position of Diabetes WA. For more information on diet, visit our Eating for Good Health page or call 1300 001 880 to speak with one of our credentialled diabetes educators.

Is the Ketogenic diet safe for people with diabetes?

Currently people are attempting the ketogenic diet to get quick weight loss. Back in the 1920s the ketogenic diet was developed for children with severe epilepsy. The ketogenic diet restricts carbohydrates. Carbs are the body’s favourite energy source, but when they are cut out of the diet, the body switches to breaking down fats. This process produces ketone bodies which are thought to reduce the number and severity of epileptic seizures by possibly blocking nerve impulses. This diet is still being used as an epileptic therapy in extreme cases with children having to be admitted to hospital when placed on the diet for close monitoring. Emerging research has shown potential uses in cancer treatment.

This image of the Australian Guide to Healthy Eating has been modified to represent the restrictions of the ketogenic diet.

A significant side-effect of these therapies is weight loss when energy requirements are not being met. People are now using the ketogenic diet to quickly lose weight. Due to increased popularity, a range of different ketogenic-type diets are currently trending, including the CSIRO low carbohydrate diet, the medium chain fatty acid ketogenic diet, the modified Atkins diet and the classic ketogenic diet. All versions of the ketogenic diet follow the same restrictive principle, and will be very different to what people may normally eat making it hard to stick to for any length of time.
The diet calls for all sources of carbohydrates to be greatly reduced, this includes the entire grains food group, most of the dairy food group, all starchy vegetables, most fruits and vegetarian alternatives such as beans and chickpeas. The consequences of this restriction is nutritional deficiency, as shown in the table below.

Nutritional Deficiency

Other potential hazards that people may experience:
• Weight regain
• Difficult to tolerate
• Hypoglycaemia
• Cannot be used in disorders of fat metabolism
• Lethargy
• Constipation
• Cardiomyopathy
• Nausea and vomiting
• Retarded growth
• Anorexia
• Excessive ketosis/acidosis
• Bone mineral loss
• Higher risk of infection
• Renal issues
• Sudden death

It is recommended that people with diabetes speak to their GP or diabetes educator before making any changes to their regular diet. For people with diabetes the most concerning side effect of the ketogenic diet is hypoglycaemia. It is important to be aware of the possible need to adjust medications, and ensure that a hypo kit is with you if following this diet.
For the many reasons already mentioned, it is likely to be challenging to stick with the ketogenic diet and may not be for everyone, but for those who are going to try it, like any other diets, when you stop, weight regain is very common.

Visit here for more information and the Dietitians Association of Australia (DAA) position on the topic.
If you would like individualised help and support on your weight loss journey follow this link to find an Accredited Practising Dietitian (APD).