Can Type 2 Diabetes Be Reversed with Keto?
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Can Type 2 Diabetes Be Reversed with Keto?

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Can Type 2 Diabetes Be Reversed with Keto?

Posted 3 years ago

Brian Stanton

Brian Stanton


Tony O’Neill, PT, DPT, MSc, RDN

Tony O’Neill, PT, DPT, MSc, RDN

Author and Scientific Reviewer

Expert Approved

If you or someone you love has recently been diagnosed with type 2 diabetes, you might be feeling confused. What does this mean for your future?

Is your metabolism permanently broken? Can it be fixed? Will you be around to play with your grandkids? 

Big, important stuff is on your mind. And so, maybe for the first time in your life, you’re ready to put your health first. 

To this end, you’re considering going Keto. You’ve heard evidence—both anecdotal and scientific—on the Ketogenic diet reversing diabetes. Still, you’re skeptical. 

That’s understandable. There are plenty of fad diets out there, and it’s wise to regard them with suspicion. 

But when you look at the data, Keto doesn’t fall into the fad category. Multiple randomized controlled trials (the gold standard of science) suggest that it can, through multiple mechanisms, help with diabetes.[*] [*]  

This article will cover how, exactly, Keto can help with this metabolic disorder. Then you can decide for yourself if a low-carb diet is right for you. 

What Is Type 2 Diabetes?

Type 2 diabetes is a metabolic disorder characterized by high blood sugar and insulin levels. Often, the risk of type 2 diabetes is increased by obesity, and may additionally lead to high blood pressure, and high triglyceride levels. This state of metabolic unrest can also be known as metabolic syndrome.[*]

When someone has type 2 diabetes (which about 1 in 10 Americans do) their risk for chronic disease skyrockets.[*] This means a higher risk of heart disease, cancer, Alzheimer’s, and many other degenerative conditions.[*] 

At its core, the problem of type 2 diabetes is a problem with insulin function. Insulin is your blood sugar boss. It gets released by the pancreas after you eat to store excess blood sugar (usually from digesting carbs) as either glycogen (stored glucose) or fat.[*] 

But when blood sugar keeps spiking (on a high-carb diet), your glycogen storage capacity in muscle and liver tissue quickly fills up, like an overhead compartment stuffed with luggage. As a result, insulin has only one place to shove the excess sugar when you over-consume calories or simple carbs: Into the belly of the plane as body fat.  

In other words, the cells that normally hold blood sugar as glycogen stop listening to insulin. They just can’t store any more of it! But fat cells still can. 

This is called insulin resistance, and it’s at the center of type 2 diabetes. When someone is insulin resistant, blood sugar stays high, insulin levels stay high, and runaway fat storage ensues. 

What’s the root cause of insulin resistance, and therefore type 2 diabetes? For the most part, it’s diet and lifestyle factors. Specifically, the “standard American diet” loaded with nutrient-poor, high-carb foods like processed sugars and grains, combined with the sedentary lifestyle practiced by millions of Americans.

This “standard American diet” and sedentary lifestyle frequently lead to weight gain and obesity, which has dangerous and damaging inflammatory effects on the body and its metabolic processes, including the insulin resistance which may lead to a type 2 diabetes diagnosis. 

A low-carb Keto diet, however, is the opposite of the Standard American Diet. Let’s see how it might help with diabetes. 

How Keto Can Help With Diabetes

The Ketogenic diet (or Keto diet) is a high-fat, low-carb eating plan in which you eat 60-70% of your calories from fat, 20-30% from protein, and 5-10% from carbohydrates.[*] Keeping your macros in these ratios trains your metabolism to enter a fat-burning state called ketosis. 

Think of ketosis as the opposite of diabetes. Instead of fostering high blood sugar, ketosis is generally a state of lower blood sugar, maintained within a healthy range. Ditto for insulin and its resultant fat-storage mode.[*]  

Here are three specific ways that Keto improves diabetes:

#1: Weight loss

Standard diabetes protocols attempt to stimulate weight loss through calorie reduction. Unfortunately, long-term calorie restriction leads to a sustained metabolic slowdown, and the weight comes back when normal portions are resumed.[*] 

Keto, however, has been shown to help with weight loss and weight maintenance in obese and diabetic populations.[*] In one study sponsored by Virta Health, type 2 diabetics lost an average of 30.4 pounds after one year of supervised Keto dieting.[*] 

Why does Keto get these results? One big reason: By reducing hunger hormones like ghrelin and neuropeptide Y.[*] The result is less hunger, less overeating, less weight gain. 

#2: Blood sugar control

High blood sugar, or hyperglycemia, is the primary clinical feature of type 2 diabetes.[*] It’s diagnosed by measuring fasting blood glucose or average blood glucose (HbA1c).

What raises blood sugar? Carbs! Diets high in “simple” carbs like sugars, refined flours and grains, high-sugar fruits, and dairy have been shown to worsen hyperglycemia in diabetics.[*] 

Keto is the opposite of a high-carb diet. By keeping carbs low, the Keto diet removes the dietary driver of diabetic hyperglycemia.

#3: Insulin function

Those with late-stage type 2 diabetes often need insulin injections to manage their blood sugar levels. But since insulin itself isn’t the problem, but rather the body’s healthy management OF insulin, this is more of a bandaid than a cure. 

Instead of piling on more insulin, Keto addresses the root cause of the problem: high blood sugar levels and inflammation that lead to insulin resistance. Eliminating carbs can help normalize blood sugar, then normal insulin function can slowly be restored as the body heals, and the fat-storing cycle of insulin resistance is broken. 

Evidence? The Keto diet has been shown, in multiple studies, to improve insulin function—even to the point of helping diabetics eliminate the need for supplemental insulin.[*] [*] This helps create conditions for sustainable weight loss.

Clinical Evidence for Keto Reversing Diabetes

Time to review some hard evidence now. Here’s a small yet informative sample of the research suggesting Keto can reverse diabetes:

  • The Virta Health study. Researchers put 218 type 2 diabetics on a Ketogenic diet for a full year. By the end of the study, 60% had reversed their diabetes (measured by HbA1c reductions), and they’d lost 30.4 pounds on average. Incredibly, 94% reduced or eliminated insulin therapy.[*]
  • The Nutrition & Metabolism study. Eighty-four type 2 diabetics were randomized to eat either a low-carb Keto diet or a calorie-restricted, higher-carb diet. After 24 weeks, the Keto dieters had significant improvements in blood sugar, insulin, and body weight compared to the higher-carb group.[*]
  • The consensus report. A recent consensus report published in the journal Diabetes Care cited low-carb diets as the nutritional intervention with the “most evidence” for improving blood sugar levels in diabetic populations.[*]

There are other examples, but the conclusion is fairly clear: When it comes to reversing diabetes, the Keto diet is extremely promising. 

Quick Tips For Going Keto 

By now you’re probably feeling a surge of motivation to try the Keto diet. Is it really as simple as eating low carb and high fat?

Yes and no. While the basic premise is easy to grok, in reality, it requires some planning and effort. Nothing good in life comes easy, right? 

Here are some tips to get you started:

  • Track your macros. Use the Carb Manager app to log your daily meals, stay on point with macros, and ensure hidden carbs don’t derail your Ketogenic goals. 
  • Track your ketones. Confirm you’re in ketosis by measuring ketone levels in blood, breath, or urine.[*] Blood tests are the gold standard, and we recommend the Keto-Mojo meter. And if you want to measure ketones in the breath (which correlate with blood ketones levels) consider the BIOSENSE breath meter.  These affordable and accurate at-home meters, by the way, integrate with Carb Manager to help you visualize the correlation between your diet and ketone levels over time.
  • Write things down. Planning and tracking your exercise, meals, energy levels, and sleep takes willpower out of the equation and helps you stay accountable to your health.  
  • Get enough electrolytes. Low-carb diets are diuretic, meaning you excrete more water, sodium, and potassium through urine.[*]  Deficiency, unfortunately, can cause “Keto flu”-like symptoms. Increase salt intake by adding salt or bouillon cubes to your water, and increase potassium intake by eating potassium-rich foods like spinach and meat. Other electrolytes like magnesium and calcium are also crucial for strong bones, a properly functioning nervous system, energy production, and much more. See this article for tips on getting enough electrolytes on your keto diet. 

One last thing. Adapting to burning fat for energy can take 2 to 4 weeks, and maybe more if you’re very insulin resistant.[*] This doesn’t mean you’ll be suffering for a month, but it does mean your desired benefits probably won’t manifest overnight. 

Hang in there. Your health is worth it. 

Looking to get started with some tasty Keto recipes? We’ve got thousands of Keto and low-carb recipes available in the Carb Manager “kitchen”. Check them out

Disclaimer: If you have a diabetes diagnosis it is important that you consult, and work with, your doctor or healthcare provider should you choose to manage your health with the Keto diet.

Comments 29

  • RogueKale

    RogueKale 2 years ago

    I think this is an excellent article however I don’t think calling it reversing a diabetes diagnosis correct. On Keto you can get to a point where you don’t need insulin or Glucophage however the person would still be considered a diabetic just diet controlled.

    • UnbelievableRadish707411

      UnbelievableRadish707411 a year ago

      Once you have achieved this goal and being off meds for 5 years you are considered cured “Dr. Wakeman, Duke University”

    • OutstandingMacadamia836794

      OutstandingMacadamia836794 2 years ago

      I agree. Type 2 Diabetes can go into remission but it cannot be cured.

  • OutstandingKale287971

    OutstandingKale287971 2 years ago

    Hi. I am a 48 year old man and tried the Keto diet more than a little over two years ago for only a month and lost 30 lbs quite fast. The purpose at that time was for holidays. Then I resumed normal eating and sedentary lifestyle… By April of this year, I was up to 230 lbs again (I’m 5’ 10”) and wanting to lose the weight for good now for my health and well being. As I am very familiar with the Keto diet, I decided I knew the plan well and could follow my own diet beginning around mid April. I don’t believe that a person has eat really high fat for this to work… And from what I have done proves it. I rarely eat bacon or anything like that. Sometimes lots of cheese (and Metamucil lol) I concentrate on eating Very low carbs and finding recipes or foods that I enjoy and eat what I like in small amounts a couple times a day. I do exercise periodically, but not always, it’s not convenient always… And in five months time now… I have lost 48 lbs and am down to 182 lbs and still losing weight. I was aiming for 175 but that’s at the top of my BMI so we’ll see where it goes? I have grown to absolutely love eating like this! And I don’t miss Carbs one little bit! And to add, I Never have so called cheat days… I believe that’s not a good thing. The closest thing I have periodically to a cheat day is on occasion I might eat a lot more keto food for one particular day than I really should… At least that way, I’m not overloading my body with a bunch of foreign carbs my body never gets and I really don’t feel too bad about it… I am feeling just about the best I ever have now and fit all my ‘skinny’ jeans even now! I am happy to eat like this for ever now! :)

    • UnbelievableRadish707411

      UnbelievableRadish707411 a year ago

      I love that you have done this for your health, congratulations! I have always thought I couldn’t give up potatoes, pasta, rice, and sweets, but at 78 I am trying. I am 10 days into low fat, my blood sugars have dropped from the 130’s to under 100 and have lost 5 lbs. Can hardly wait til my next A12 check up. People like you are so encouraging to me. Thanks for sharing.

    • Sarah

      Sarah 2 years ago

      Great approach backed by great results! Your occasional high-calorie (instead of carb-heavy cheat) days are key in keeping your metabolic rate from plummeting: once a week should do it.

  • BKRN

    BKRN 2 years ago

    The pandemic affected my mood and weakened my keto resolve. Junk food crept into my diet. Result: a pre-diabetic diagnosis. This early-warning refocused my motivation. I’m back to Keto and feeling confident that I can reverse my condition

    • Sarah

      Sarah 2 years ago

      It takes years to develop insulin resistance and get diagnosed as pre-diabetic, so be patient in reversing that condition.

  • FantasticMacadamia218641

    FantasticMacadamia218641 2 years ago

    I’m 65 years old. I was diagnosed with type 2 diabetes in 1995. I ignored it. I am now insulin dependent, have severe diabetic neuropathy to the point of not being able to walk very much and the chronic pain is mind numbing. My A1C is 6.5. I take 40 - 45 units of Lantus insulin every night. 5’10”, 240 lbs. My goal weight is 175. I’ve always known that a ketogenic diet is the best for diabetes, but that carrot cake with cream cheese frosting always got the better of me. I started logging my food and eating more sensibly. After four days my Blood Glucose count is rarely over 150... I take my BG readings about six times a day. Normally they would be around 350 at night after indulging in that favorite dessert. Now they’ve dropped dramatically. Please take type 2 diabetes seriously... The side effects will cause unwanted pain, amputation, or death. On a lighter note, I hope to reach my goal weight so I can walk easier.

    • Darlokee

      Darlokee a year ago

      You wrote my story, I too ignored my dx for too long. Neuropathy is nothing to take lightly and I’m hoping Keto will help eliminate some of the pain. Best wishes on your journey.

  • SuperCauliflower561193

    SuperCauliflower561193 2 years ago

    A review of the role of the NLRP3 Inflammasome would have been useful here. NIH has great studies on this as does Dr Jason Fung.

    • Dava44

      Dava44 3 years ago

      I’m 45 and started keto after my diagnosis. My A1C was over 12. A year later I’m off all medication and have an A1C of 5.5. It worked for me.

      • epcotguru

        epcotguru 2 years ago

        Dava44 that is SO exciting! I am proud of you for such an amazing accomplishment and am inspired by you.

    • pkmoar55carb

      pkmoar55carb 3 years ago

      I'm 66 years old started keto again September 1st after being diagnosed with type 2 diabetes early stage. Was very faithful to my macros and currently down 56 lb however my triglycerides are spiked and my doctor is not happy about that and blames the thought level in keto diet. Additionally I was reading that type 2 diabetics need to calculate their carb intake more strictly and cannot use net carbs as a guide. Up till a week ago I was still trying to manage 20 carbs a day. Now I'm just super frustrated and confused and don't know what to do. Should I addressed my macros and if so to what? Shall I be only going on full carbohydrate count or do net carbs count for diabetics? Is there a different formula?

      • UnbelievableRadish707411

        UnbelievableRadish707411 a year ago

        I am type two and follow Dr. Waksman’s always count total carbs not net. In 10 days I am down 5 lbs. and my blood glucose has gone from an average 130-135 down to 80-100. Keep trying and don’t give up do what works for YOU.

      • NANA

        NANA 3 years ago

        I do 30 total grams per day. My BG is alot better with at number.

    • RemarkableAvocado688304

      RemarkableAvocado688304 3 years ago

      I am a diabetic type 2. I was told I needed to go on insulin and referred to a specialist nurse. I stopped taking things with sugar in my diet but didn’t see any difference in my reading. The day after I started Keto I saw an immediate result , my reading was below 10 It hadn’t been below that for years. After downloading as much as I could about Keto (overload) - I even downloaded this app but it wasn’t until a couple of days ago that I started to look at it. I am deleting everything else as this one is the best. I have been on Keto for about a month now but this will help me to be more balanced. Thankyou

      • Mokins

        Mokins 3 years ago

        That was really helpful. I am pre diabetic and got it all under control on a keto diet 5 years ago. Last year I went back to eating a lot of sugar and now need to start all over again. I am finding it so much harder this time. The app is saying to stay under 20g carbs which I am going to track carefully and I am going to go back to reading lots to remind myself why this really is the solution. Thank you.

        • UnbelievableRadish707411

          UnbelievableRadish707411 a year ago

          Great job! So encouraging to me at 78. In 10 days down 5 lbs but most important blood glucose in down from avg 130-135 to 90-100. Next trip to Doc to see if I can get off Trulicity.

        • JulieB616

          JulieB616 3 years ago

          This is encouraging that you are jumping back in!!!! Kudos to you! I’m so glad it worked five years ago and you can do it again! I’m just getting started and love seeing everyone’s journey.

      • G8K9mama

        G8K9mama 3 years ago

        Carb manager really helps and this article. Thank you.

        • Millie

          Millie 3 years ago

          Excellent article. Thanks.

          • Eloise

            Eloise 3 years ago

            I’m very happy to read this article. I’ve been trying keto for the second time. I am type 2 diabetic and have been staying on 20 to 22 carbs per day. I have not seen much lowering of bs or weight loss. Gonna stick with it after reading this. Thanks for the reinforcement.

            • MarvellousMacadamia498420

              MarvellousMacadamia498420 3 years ago

              So how many carbs per day?

              • Rosie

                Rosie 3 years ago

                It really depends on each individual and how active you are. For me, I stay between 40 and 60 carbs a day. I workout either class or 3 to 4 Mile walk 5 times per week. Movement for a type2 is crucial for many reasons. I am combining the Noom psychology with low carb eating plans as I need this to be sustainable for life. Good luck.

            • Graham

              Graham 3 years ago

              Great summary!

              • Ross150

                Ross150 3 years ago

                In a nutshell, it depends on what your body needs. One answer doesn’t fit all. So go thru the CarmManagers start up wizard, answer truthfully, and it will tell you what you need.

              • SillyGrammy

                SillyGrammy 3 years ago

                Most research will say that you need to be eating under 50gr a day. If you're just starting a Keto diet and/or trying to lose weight you need to start under 20gr a day. You might want to go to your account settings in this app and go through the Getting Started section. It will ask you questions and then let you know how many grams you should be eating daily. Mine says I should be eating 15gr max. I also believe we all should do as much research on Keto as we can do that we can eat the healthiest and understand why. I wish you all the best.

              • MarvellousMacadamia498420

                MarvellousMacadamia498420 3 years ago

                I’m new. That was over my head. In a nutshell, how many carbs are recommended on this?