Is the ketogenic diet safe in type II diabetes?

    Last Updated: May 16, 2025

    A ketogenic diet may benefit people with type 2 diabetes by improving fasting glucose, HbA1c, and quality of life while also aiding in weight loss. However, its long-term safety is uncertain, and people who are taking insulin should monitor blood sugar closely; it's advisable to consult a doctor before starting the diet.

    A ketogenic diet may be useful for people with type II diabetes. A 2023 review showed that following a ketogenic diet could improve fasting glucose, HbA1c, and quality of life while also assisting with weight loss.[1] This supported findings from a 2022 meta-analysis which showed a ketogenic diet to be more effective than a low-carbohydrate diet in improving glycemic control in people with diabetes.[2]

    Safety in the long term has not yet been established, and one concern is that a ketogenic diet could increase cardiovascular risk factors in people with type 2 diabetes. In people who use insulin as part of their treatment for diabetes, blood sugar should be closely monitored during a ketogenic diet to avoid potentially dangerous hypoglycemic (low blood sugar) episodes.[3] While a ketogenic diet might help people with diabetes lose body fat and improve glycemic control, the restrictive nature of the diet can be difficult to adhere to in the long term, and it is not superior to other more balanced, calorically controlled diets that can achieve similar results.[1] People with diabetes who would like to try a ketogenic diet should discuss it with their doctor, who can help them assess the risks, benefits, and alternative options.