Ketogenic diet and insulin, diabetes, and insulin resistance.

Insulin is not only a drug to treat diabetes as some people might think. In fact, in some cases we could think of it as a “supplement” more than a drug. The reason being that “insulin” is a hormone produced by your body. Insulin is in charge of many functions related to metabolism. Therefore, something which affects your metabolism will, most likely, affect insulin production or action in some way. One of the easiest things to identify as an influence for our metabolism is a diet. This means any diet change (especially drastic ones) will have an impact on our insulin levels. Summary, anyone planning on doing a ketogenic diet should be aware of the interaction between a ketogenic diet and insulin.

What is Insulin and what does it do? 

Insulin is a hormone produced in your pancreas, which is located below your stomach. The cells within it (also called Beta cells or β-cells) are the ones responsible for releasing insulin into your bloodstream. The release of insulin is triggered by the amount of glucose present in the body.

Insulin is in charge of letting glucose inside the cells so your muscles and organs can use it for energy. It is also in charge of driving excess glucose away to transform it into fat for later use. However, insulin levels will also influence the opposite process. Allow me to elaborate:

High glucose will cause high levels of insulin, this will help your body’s cells to absorb glucose. But, since your body can not absorb glucose indefinitely, the excess glucose will be “sent away” for storage (in the fat cells).

On the other hand, low levels of glucose promote a low level of insulin, this will tell your body’s cells that “there is no quick source of energy available”, and will encourage the use of your stored energy (from fat).

I like to think about insulin as the gatekeeper or bouncer from a club, the club being your cells. He decides who’s allowed inside and who goes away.

Health issues related to insulin

Science has not been able to identify all the specific reasons that lead to type 1 diabetes, however there’s one thing in common: Your body attacks the β-cells in your pancreas leaving your body without its source of insulin. This could happen due to an autoimmune disease  or any other disease that causes your antibodies to attack your pancreas.

The main reason for type 2 diabetes is a loss in insulin’s efficacy. There are two reasons for this to happen. In the first case the pancreas is not supplying enough insulin to keep the blood glucose in check, this leads to high amounts of glucose in the bloodstream. Since high amounts of glucose are toxic, this damages the organs and hinders the insulin production causing, in term, diabetes. On the second case, the high amounts of glucose in the bloodstream cause a high amount of insulin. High amounts of insulin makes, over time, the cells to build up a “tolerance” (so to speak), requiring more insulin to do the same job. In the end this results in a very inefficient insulin, which leads to high glucose and causes diabetes.

The symptoms of diabetes include: Thirst, hunger, unexplained weight loss, fatigue, wounds that take too long to heal, persistent urinary tract infections (UTI) or yeast infections.

Although sometimes this is not considered as a major health issue, it is DEFINITELY A RED FLAG, insulin resistance is the process explained above, in which the cells build up tolerance reducing insulin’s action.

Ketogenic diet and insulin

Insulin’s primary job is tightly related to glucose. The levels of glucose in the bloodstream are related to carbohydrate consumption. Since the ketogenic diet greatly restricts the amount of carbohydrates, this alone regulates more or less the glucose levels.

Nevertheless, insulin is still doing its job driving energy from cells and promoting the use of energy sources (glucose and fatty acids).

What does this mean for ketogenic dieters?

First and foremost, for diabetics on the ketogenic diet it means they’ll probably require less amount of insulin and diabetes medication. For the average people this means they will keep their glucose and insulin levels in check through diet, improving their health.

By the way, keeping insulin levels in check, as well as other benefits such as losing weight and reducing cholesterol, helps your body deal with insulin resistance.

Finally, there’s an “issue” (which is actually not) that appears somewhat often on ketogenic dieters: Increased fasting glucose levels.

This sometimes scares people, but it should not. Turns out, your body releases glucose in two phases; When you restrict the amount of carbohydrates and limit the glucose levels in your bloodstream, there is “less demand” for insulin, which results in the suppression of one of the insulin’s release phase. As consequence`, fasting glucose levels might increase, but, postprandial (after meals) glucose levels decrease, as they trigger an insulin release.

Suppressing insulin may look counterproductive since it resembles what happens with diabetes. But there’s a big difference. On diabetes, you have no say in what your body does, while on the ketogenic diet, you are causing it. And if you’re wondering… YES, if you increase your intake of carbohydrates, the insulin and glucose levels will return to their previous state.

THIS POST elaborates more on the subject.