That’s when she came across the ketogenic diet, a popular high-fat, low-carb eating plan sometimes referred to as the “keto diet.” Lofton, 40, says that while she hasn’t lost much weight, her blood sugar is in the mid-100s milligrams per deciliter (mg/dL) — the healthiest level she’s reached in years. She had previously recorded her highest blood sugar levels between 600 and 800 after being rushed to the emergency room in 2016. “This looks like something that for me is sustainable,” says Lofton, a medical biller who weighs 300 pounds. “I haven’t lost much weight, but for me my biggest priority has been to get my sugar numbers down.” She says she’s proud that her A1C — the two- to three-month average of blood sugar levels — is 8.7, down from 10.4 about a year ago. Although the improved level still signals diabetes (anything above 6.5 is defined as diabetes), Lofton is hopeful that the keto diet can continue to help her improve her health. RELATED: How to Stabilize Your Blood Sugar
The Pros and Cons of the Keto Diet for People With Diabetes
The basis of the keto diet is achieving ketosis, a natural state in which the body turns to burning fat instead of carbs (or sugar) for energy. During ketosis, ketones, or fat metabolites, are released in the blood. People on the keto diet are tasked with getting 60 to 80 percent of their calories from fat, 15 to 30 percent of their calories from protein, and less than 5 to 10 percent of their calories from carbs. Essentially, ketosis rewires your metabolism, turning your body into a fat-torching machine. But the keto diet isn’t safe for everyone, and it isn’t recommended as a top diet for people with type 2 diabetes due to the potential medication reactions that can occur, as well as the need to take supplements and track essential micro- and macronutrients to best manage the disease. Also, people with kidney damage should not try the keto diet because ketones can overwhelm the kidneys. Most dietitians recommend gradual weight loss because it’s typically more sustainable in the long term, but the keto diet approach could be a good option for fast weight loss if done under the care of a dietitian and with clearance from your healthcare provider. “When you get into that category of restriction, one must heed caution in terms of making sure their nutrient needs are met, so usually you have to look at supplementation,” like adding in fiber and electrolytes, says Mayo Clinic Dietitian Katherine Zeratsky, RDN. “I think people find out that (like) with other restrictive diets, it’s not sustainable.”
Why Lofton Chose the Keto Diet Over Other Diet Plans
Lofton recognizes the keto diet isn’t the best fit for all people looking to lose weight or control blood sugar levels, but she’s found the plan liberating because it’s curbed much of the hunger she felt on other diets. She explains she had attempted the American Diabetes Association’s recommended carb limit of 60 grams (g) per meal, but she still gained weight and her blood sugar kept rising. Unsure of what to try next, she noticed that some of her friends on Facebook began posting their weigh loss success stories after trying keto. In March 2017, she decided to try the approach for herself. The high-fat, medium-protein diet appealed to Lofton: According to the keto diet guidelines, she could still eat red meat and cheese — and that, for her, was easier than eating lots of broccoli — and she knew she could try something else if she didn’t see results. RELATED: 14 Diet and Weight Loss Mistakes — and How to Avoid Them Lofton says she went on the keto diet during a time when other health issues — such as a diagnosis of uterine cancer that led to a hysterectomy — were uprooting her life, but she hoped it would lead to a positive life change. She swapped out all her carb-laden snacks, like donuts and bagels, at her office for 100-calorie packets of cream cheese. Pizza and pasta were out for dinner, too. Now, she prefers to cook a homemade cabbage stew that her husband loves or grill a bunless burger patty on her George Foreman grill and put vegetables and guacamole on top. She says cutting carbs and sugar out of her diet in a drastic way was difficult at first, and at first she had mixed success with sticking to the ultra-low-carb diet. But the diet has made her consider what she’s putting in her body, especially because she no longer has to battle hunger and seemingly insatiable cravings. “I’m feeling more full for longer periods of time,” she says, “and I don’t feel like I’m deprived at all. I don’t miss rice, I don’t miss potatoes. I don’t miss those things.” Once, she went to the movie theater with her family and decided to try an experiment to see how her blood sugar would respond to some popcorn. Why should she stick with the diet unless she saw results, she reasoned. Her blood sugar shot up 100 points. She says she thought to herself, “Well, shoot, I never want popcorn again.” “[The diet] helps me make better decisions,” she says.
What to Know if You’re Considering Beginning the Ketogenic Diet
If you have type 2 diabetes and are interested in attempting the keto diet, here are a few things you should know, Zeratsky says: You may need to supplement your diet. On the keto diet, your body may be deprived of essential nutrients, like electrolytes, vitamins, and fiber. You can replenish these nutrient stores with supplement pills sold at health food stores. Speak with your doctor or a registered dietitian to determine which supplements may be best for you. Clear it with your healthcare provider first. In particular, make sure to tell your physician about any medication, for diabetes or otherwise, that you’re on, in case there’s a reaction or negative effect that could happen as a result of cutting carbs and upping fat intake so drastically. Say goodbye to bread — and rice, and pasta, and more. Going low-carb means understanding that nearly every food item contains carbs. When eaten in excess, foods that may seem harmless and even advised in a more common balanced, healthy diet — for instance, almonds or cashews — have enough carbs to throw you off track if you’re following a keto eating approach. Take vegetables, which are important on keto and have carbs. Figuring out which nonstarchy (low-carb) vegetables are best can be one of the many carb-counting challenges of adhering to this restrictive approach. Know that keto isn’t proven safe in the long term. For many people, diabetes is a lifelong condition, so eating well is key for managing the disease well. Keto is often used as a short-term diet, so people with diabetes should consider this. It’s unclear whether keto is a safe and effective long-term approach to maintaining weight loss and regulating blood sugar, because researchers haven’t studied this yet. RELATED: The Best and Worst Foods for People With Type 2 Diabetes
Setting Weight Loss and Blood Sugar Goals for the Future
While the keto diet can be difficult to stick with due to its carb restrictions, and potentially unfit for some people with type 2 diabetes, Lofton says she finally feels empowered to take her health into her own hands now that she has found an eating style that works for her. Her goal now is to get her fasting blood sugar level under 100 mg/dL, the upper limit of what’s considered healthy for someone without diabetes, and to begin to lose weight. She says she plans to stick with the plan long term, hoping to steadily lose weight to get to a healthier body mass index (BMI), noting that lowering her blood sugar remains her priority. Because four other members of her family also have diabetes, Lofton says she wants to help them see that they can use multiple methods to lose weight. She says she hopes that teaching them about eating protein-rich snacks, like nuts, and fat-rich ingredients, like avocado, and helping them have authority over their eating habits, will improve their health as well. “I definitely recommend keto for my friends and my family,” she says, “And I’m going to show (my stepmom) the basics about how to prepare a few easy meals. … I think it helps to be open to all philosophies and take bits and pieces for what works for you.”
