Keto vs. Diabetic Diet

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Written by Brenda Peralta, Registered Dietitian and medically reviewed by Abby Courtenay

Imge of Keto vs. Diabetic Diet



While keto and the diabetic diet are very different approaches to eating (one focuses on reducing carbs and the other on having a balanced diet), they have certain things in common. 

So, when it comes to the battle of diets. Which is better, keto or the diabetic diet?

In this article, we will compare the two, exploring their similarities, differences, benefits, side effects, foods to eat or avoid, and costs. We’ll wrap up with the ultimate questions, which is the healthiest to follow?


What is the diabetic diet?

Glucose comes from the foods you eat. When you eat high glucose food like bread, pasta, and potatoes, your body secretes insulin to store the glucose found in your blood in your cells. This creates stable glucose levels. 

When your insulin doesn’t work, or your body cannot produce any, there is no way to remove the glucose from your blood. This creates high glucose levels. If this happens for a long time, you can be diagnosed with diabetes. 

To manage this condition, people are prescribed a diabetic diet. While there is no formal definition, this eating pattern focuses on having whole grain carbs instead of refined grains. 

For example, you consume whole wheat bread instead of white bread. 

Besides the carbs you consume, you also eat lean protein (eggs, Greek yogurt, chicken, fish, seafood, and red meat) and healthy fats (avocado, nuts, seeds, oils, and olives) to help control your sugar levels.

The ultimate goal of this diet is to have normal glucose levels (below 100 mg/dL). 

In some cases, a keto diet can help with diabetes. Speak to your doctor about whether this might be true for you, depending on your unique situation.


Similarities between the diabetic diet and keto


Weight loss

Both can be effective for weight loss. However, on keto, you might find yourself having faster results in the beginning compared to the diabetic eating style. In the long term, both seem to result in similar weight loss.


Glucose levels 

Both diets can help control your glucose levels. Since you reduce highly processed foods that are high in simple carbs, you can go from having very high glucose levels to having more stable and standard levels. 


Simple carb reduction

Finally, one of the similarities between them is that they encourage you to eliminate simple carbs such as sugars, sweets, and desserts. 

On keto, they are avoided because increasing your carb intake affects your ketosis state. 

People following a diabetic eating style eliminate these foods because they increase your glucose levels. 


Differences between a diabetic diet and keto


Macronutrient distribution 

One of the biggest differences is the macronutrient distribution.

On keto, you reduce your carb intake to very low levels. This means that on keto, you have the following macro distribution: 5-10% carbs, 20% protein, and 70-80% fats. 

Since your body doesn’t have enough carbs to run on, you rely on fats to provide you with the necessary energy for your body. This metabolic switch is known as ketosis.

On the other hand, on a diabetic eating regime there is no standard macronutrient distribution, and no daily carb limit to stay under.


End result

The other major difference is their ultimate goals. 

With keto, the main goal is to limit carbs to enter ketosis.

On the other hand, the purpose of a diabetic diet is to control your glucose levels.

Benefits of a diabetic diet and keto

There are several benefits of following the diabetic and keto eating plan. Here is a list of the health benefits you can obtain when following either:

  • Weight loss
  • Better glucose control 
  • Reduction in the risk of diabetes, or managing to control the disease
  • Better sleep
  • Higher energy levels 
  • Reduced risk of hearts disease 
  • Reduced cravings

Either way, you can use these diets to improve your health since you eliminate most processed foods from your eating pattern, especially those that are high in sugars like cookies, pastries, and desserts. 


Side effects of a diabetic diet and keto

Following a diabetic eating style doesn’t have any side effects you need to be aware of. Since its primary goal is to have a healthy lifestyle, there should not be any health concerns that come along with it. 

On the other hand, since a major food group is significantly reduced on keto, you can experience some side effects. 

Here are some of the most common ones:

  • Keto flu. You might experience headaches, fatigue, foggy brain, and nausea during the first few days. 
  • Nutrient deficiency. By reducing carbs, you might stop eating foods that are good sources of certain nutrients, increasing the risk of nutritional deficiency. 
  • Constipation. When you reduce carbs, you often reduce fiber, which plays a crucial role in fighting constipation. 


Keto vs. diabetic diet foods

Another difference between keto and diabetic diets is the types of foods you can include. 

In the following table, you can compare the foods you can have and the ones to avoid. 

Beans and legumes In moderation
Condiments and sauces ✓ (low-carb) ✓ (sugar-free)
Dairy ✓ (low-carb) ✓ (sugar-free)
Sugar-free drinks
Sugar-sweetened beverages X X
Alcoholic drinks ✓ (low-carb) ✓ (low-carb/sugar-free)
Fish and seafood
Fruits In moderation ✓ (low glycemic index)
Grains and starches In moderation ✓ (low glycemic index)
Herbs and spices
Meat and poultry
Nuts and seeds
Oils and fats
Processed foods ✓ (low-carb) ✓ (low-carb)
Sugar-free sweeteners
Natural sweeteners X X
White and brown sugars X X
Starchy vegetables

In moderation



As you can see, they limit several foods, especially when talking about simple carbs like added sugars or pastries. 

For someone on keto, these foods would kick you out of ketosis, while someone with diabetes will avoid these foods due to high sugar levels. 

However, there are some differences in which foods to eat. On keto, most carbs, even if they are complex, are avoided to stay within the carb budget. You can check this list to see whether specific foods are keto-approved.

In contrast, you can still consume carbs on a diabetic eating regime as long as they are complex (legumes, brown rice, and sweet potato) since they are less likely to cause a very large spike in your blood sugar levels. 


Keto vs. diabetic diet costs

The diabetic eating method might be cheaper compared to keto. 

Foods you normally consume in keto like avocado, nuts, and seeds tend to be more expensive when compared to regular fruits, vegetables, and grains. 

However, this depends on where you do your shopping and what types of foods you tend to purchase. 

A diabetic eating regime can be equally as expensive, especially if you purchase special sugar-free products or those that are specially formulated for people with diabetes. 


Which one is healthier?

Since the diabetic eating plan is more balanced, meaning you can include grains, fruits, meats, fats, and vegetables, it is generally considered healthier and sustainable in the long run. 

However, keto can also have its benefits if done right. If you focus on consuming  high-quality fats like avocado, nuts, seeds, and olive oil instead of sour cream, cream cheese, and high fatty meats (like bacon), you can have a healthy keto experience as well. 

Either way, you’ll want to talk with your doctor before making any changes to your diet, especially if you have a health condition like diabetes or prediabetes.


Bottom line

Both the diabetic and keto diets can help control glucose levels. 

The diabetic eating plan has more benefits like no side effects, being cheaper, and more flexibility to include a balance of different types of foods. With a doctor’s permission, keto can also be a healthy option for some people, if done correctly (low in saturated fats and processed foods).
And remember, any healthy diet should include different colored fruits and vegetables so you’re getting a variety of different nutrients.