Does a ketogenic diet reduce insulin resistance long-term?

By Dr. Stephen Phinney and the Virta Team

Insulin resistance improves promptly for most people when they begin a ketogenic diet, and the effect appears to be attributable to the ketones per se (Newman, 2015), not just the reduced intake of carbohydrate. If an individual loses a substantial amount of weight, insulin resistance can be further reduced.

The degree to which this improved insulin sensitivity remains long-term is dependent upon the individual. Factors such as the duration that someone was insulin resistant and current physical activity level may play a role in their level of carbohydrate tolerance after a successful period of time on a well-formulated ketogenic diet. While it may not be necessary for everyone to remain in ketosis forever, some individuals will find that to maintain their metabolic health long-term, continuing a well-formulated ketogenic diet is most effective. If one chooses to add carbohydrates back into the diet, it may be best to do so as a modest amount of carbohydrate over time. In the course of doing so, it will be important to monitor biomarkers like fasting blood glucose, serum triglycerides, and HbA1c to assess carbohydrate tolerance and prevent the re-development of insulin resistant conditions such as metabolic syndrome and type 2 diabetes.

Learn more about reversing type 2 diabetes with a ketogenic diet.


Newman JC, Verdin E. β-hydroxybutyrate: Much more than a metabolite. Diabetes Res Clin Pract. 2014; 106(2):173-181.

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  1. Avatar

    Odd, I just read a keto diet has shown to cause insulin resistance, or at least increase it.


    1. Virta Health

      Hi Arien! You may find this post and video helpful in answering your question:


  2. Avatar


    could you please upgrade this article with more info.
    You can find like 100 references and articles that say high fat diets impair insulin resistance, especially saturated fat and here its one reference at newman. Looking at that paper there isnt much either. It references other studies that talk about better weightloss therefore better biomarkers and it seems like its more about avoiding glucose/ avoiding problems not actually improving insulin resistance, especially independent of weightloss as a property of keto.

    Does keto improve IR independent of weightloss?
    Have you put your patients to the test? Small keto wean off phase, introduction back to carbs for a couple of days then doing oral glucose tolerance test?
    If they succeed would that not be huge? Would that not mean curing diabetes?

    Kind regards


  3. Avatar

    Keto Diet (aka low carb & high fat) reverses Type 2 Diabetes and Insulin resistance as shown by the literature time and time again:

    A high-monounsaturated-fat/low-carbohydrate diet improves peripheral insulin sensitivity in non-insulin-dependent diabetic patients
    M Parillo, AA Rivellese, AV Ciardullo, B Capaldo… – Metabolism, 1992 – Elsevier
    It is commonly believed that high-carbohydrate (CHO) diets improve peripheral insulin
    sensitivity; however, this concept is based on anecdotal evidence. Furthermore, it has been
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