The Prevalence of Diabetes
Diabetes is a global threat to human health. As of 2015, nearly 42 percent of Americans, or 114.4 million people, are now living with diabetes or prediabetes, the latter of which can lead to type 2 diabetes within five years if untreated. More concerning, contemporary diabetes treatments don’t cure the disease, they manage it, ensuring Americans stay sick as well as hamstrung by the skyrocketing costs related to medical treatments and prescriptions. However, there is potential for drastic improvement in our nation’s health; recent studies show the ketogenic diet can not only control the disease without medication, but also, in some cases, completely reverse it.
U.S. Diabetes by the Numbers
- 42 percent of Americans (114.4 million citizens), have diabetes or prediabetes
- 30.3 million Americans (9.4 percent) have diabetes
- 84.1 million have prediabetes
Global Diabetes by the Numbers
It is estimated that 415 million people are living with diabetes in the world. That is roughly 1 in 11 of the world’s adult population. And that figure is expected to rise to 642 million people living with diabetes worldwide by 2040.
Countries with highest prevalence of Diabetes:
The International Diabetes Federation (IDF) currently reports these five countries with the highest number of people with diabetes:
- China: 109 million
- India: 69 million
- USA: 29 million
- Brazil: 14 million
- Russian Federation: 12 million
Diabetes Defined
Diabetes is a metabolic disorder caused by a dysfunction with the hormone insulin. It appears in two main forms: type 1 diabetes (T1D) and type 2 diabetes (T2D). Untreated, both forms of diabetes can be life-threatening.
Type 1 Diabetes
Also known as insulin-dependent diabetes and juvenile-onset diabetes (due to common childhood onset), type 1 diabetes is an autoimmune condition caused by the body attacking its own pancreas with antibodies. This attack results in an inability for the pancreas to create insulin; type 1 diabetes occurs when about 90 percent of the body’s insulin-producing cells have been destroyed. Genetic predisposition, environmental factors, and faulty beta cells can play a role in developing type 1 diabetes. Type 1 diabetes can trigger a number of other health risks, including damage to the kidneys, nerves, and eye blood vessels as well as stroke and heart disease.
Type 2 Diabetes
Type 2 (adult-onset) diabetes develops when the body becomes resistant to insulin or when the pancreas is unable to produce enough insulin. While it is unknown why type 2 diabetes is developed, it is known that genetics and environmental factors (such as race, age, family history, high blood pressure, abnormal cholesterol, maintaining an overweight physique, obesity, and inactivity) can play a role.
Diabetes Symptoms
- Increased hunger (especially after eating)
- Increased thirst
- Dry mouth
- Fatigue
- Headaches
- Blurred vision
- Numbness or tingling in the feet or hands
- Sores that do not heal
- Unexplained weight loss
- Frequent urination
Diabetes-Related Complications
- Hypoglycemia (very low blood glucose)
- Hyperosmolar hyperglycemic nonketotic syndrome (HHNS or very high blood glucose)
- Diabetic retinopathy
- Diabetic neuropathy
- Kidney disease
- High blood pressure
- Stroke
- Gastroparesis
The Cost of Diabetes
The cost of diagnosed diabetes is reported at $327 billion annually (a 26 percent increase over a five year period.) The ADA reports that people diagnosed with diabetes spend an average of $16,752 per year on medical costs. About half of that (57%) is related to treatment, including the cost of diabetes medication. Insulin therapy is a common treatment for people with type 1 and type 2 diabetes, but insulin prices have skyrocketed in recent years.
Today’s Most Common Diabetes Treatments
While there is no “cure” for diabetes, there is very successful control of both type 1 and type 2 diabetes, which dramatically lowers the risk of developing diabetes-related complications. Among the medical community at large, insulin and medication are the first lines of defense to normalize blood-glucose levels and manage diabetes, along with recommendations for weight loss, physical activity, and healthier eating habits.
The History of Treating Diabetes Through a Ketogenic Diet
In the early 1900s, before the advent of insulin, the medical community advocated for prescribed dietary modifications, now known to us as the ketogenic diet. New Jersey-based physician named Frederick M. Allen (1879-1964) was the first to realize that diabetes was more than a problem with blood glucose; rather, it was a global disorder of metabolism. He went on to develop the best therapy for diabetes available before insulin: a restricted (400) calorie, ketogenic-style diet providing mainly fat and protein, with the minimum amount of carbohydrates needed to sustain life. Between 1914 and 1918 he treated 100 diabetics at New York City’s Rockefeller Hospital with this diet. Many other physicians began prescribing it, including Elliott Proctor Joslin, the first U.S. doctor to specialize in diabetes and the founder of today’s Joslin Diabetes Center.
Although Allen’s diet wasn’t idyllic (the severe calorie restriction brought patients to the brink of starvation in order to control the disease), it extended the lives of severe diabetics long enough to receive insulin when it became available. It also pointed to an important fact: diet can affect diabetes.
The Ketogenic Diet and Diabetes Today
While Dr. Allen’s diet was essentially ketogenic, today’s keto diet is not a starvation diet; it prescribes a sustainable daily caloric intake, based on an individual’s weight, age, and other factors, broken into macronutrients of 75 percent fat, 20 percent protein, and 5 percent carbohydrates. However, even with greater caloric intake, the keto diet has proven to be influential in the management and reversal of type 2 diabetes, and the reduction in medications in type 1 diabetes.
A variety of clinical studies prove the reduction of carbohydrates, a key factor in the ketogenic diet, can lead to a variety of benefits for type 2 diabetics, including:
- Blood-sugar regulation
- Lower blood-glucose levels
- Improved glucose tolerance
- Lower blood pressure
- Improved insulin sensitivity
- A drop in insulin
- Improvements in high-density lipoprotein (HDL), or “good” cholesterol, without adding to low-density lipoprotein (LDL), or “bad” cholesterol
- Improved cholesterol levels over the long term due to increased numbers of HDL (high-density lipoprotein) particles
- Decreased triglycerides and LDL (low-density lipoprotein) particles
- Weight loss
- Reduced dependency on medication*
*It’s important for patients and doctors to discuss any dietary changes while on medication. Consuming too few carbohydrates can be dangerous when taking certain medications for diabetes.
The Future of Diabetes Treatment
Due to the results of clinical studies and ongoing success stories, the momentum behind treating diabetes with a ketogenic diet is building.
Fairly new digital clinic Virta Health, founded in 2014 with the goal to “reverse” type 2 diabetes without medications or surgery by utilizing a low-carbohydrate ketogenic diet, is becoming an influence in the healthcare industry. It provides diabetes patients online access to physicians, health coaches, peer support, and ongoing information and feedback. It’s also conducting an ongoing study of the effects of a ketogenic diet on patients with type 2 diabetes. The primary outcome after one year of the study has shown that type 2 diabetes can be controlled without the use of medications and following a continuous care model.
These positive results combined with a growing population in need of affordable, manageable long-term solutions for diabetes suggest the ketogenic diet will continue to become an important part of the treatment plan for and mitigation of diabetes in the coming years.
Articles and Studies
- A low-carbohydrate, ketogenic diet to treat type 2 diabetes
- Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes.
- Type 2 diabetes clinical trial links
- Searchable database of clinical trials on all topics
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
- Lipid metabolism. I. Role of insulin in lipid metabolism
