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.