Keto Diet Plan for Diabetics: 7-Day Meal Plan & Food Guide

A keto diet plan for diabetics focuses on limiting carbohydrates while emphasizing protein, nonstarchy vegetables, and healthy fats. For some people with type 2 diabetes, reducing carbohydrate intake may help improve blood sugar levels and support weight management.

However, a ketogenic diet is not appropriate for everyone with diabetes. People who use insulin or medications that can cause hypoglycemia may need medication adjustments when significantly reducing carbohydrates. People taking SGLT2 inhibitors should generally avoid a ketogenic eating pattern because of the increased risk of diabetic ketoacidosis (DKA). ¹

For a deeper look at the benefits, risks, and evidence behind carbohydrate restriction, read our Keto Diet for Diabetes guide.

Key Takeaways

• A ketogenic diet usually restricts carbohydrates enough to promote nutritional ketosis.
• Reducing carbohydrate intake can improve blood glucose levels for some adults with diabetes, particularly in the short term.
• Food quality matters. Prioritize vegetables, quality proteins, fish, nuts, seeds, avocado, and unsaturated fats rather than relying heavily on processed meats and saturated fat.
• People taking insulin or medications that can cause hypoglycemia may need treatment adjustments as carbohydrate intake decreases.
• People taking SGLT2 inhibitors should avoid ketogenic eating patterns because of DKA risk.
• Nutritional ketosis is different from diabetic ketoacidosis.

Keto Diet Plan for Diabetics at a Glance

Focus	Choose More Often	Limit
Vegetables	Leafy greens, broccoli, cauliflower, zucchini, peppers	Potatoes, corn, large portions of starchy vegetables
Protein	Fish, chicken, turkey, eggs, tofu	Processed meats
Fats	Olive oil, avocado, nuts, seeds	Excess butter, coconut oil and other saturated fats
Dairy	Plain Greek yogurt, cheese in moderation	Sweetened yogurt and flavored milk
Carbohydrates	Small portions of high-fiber, minimally processed foods when appropriate	Bread, pasta, rice, sweets and refined grains
Beverages	Water, unsweetened tea, coffee	Soda, juice and sugar-sweetened drinks

How Does a Keto Diet Work for Diabetes?

A ketogenic diet dramatically reduces carbohydrate intake. With fewer carbohydrates available for energy, the body increasingly uses fat and produces compounds called ketones.

Because carbohydrates generally have the greatest immediate effect on blood glucose, reducing carbohydrate intake can lower post-meal glucose excursions in some people.

The American Diabetes Association (ADA) recognizes that reducing carbohydrate intake may improve glycemia for some adults with diabetes. However, there is no single ideal carbohydrate intake or eating pattern for everyone with diabetes. Nutrition should be individualized according to health status, medications, preferences, and metabolic goals. ¹

Research also suggests that the benefits of very-low-carbohydrate diets may be greatest in the short term. Long-term adherence can be challenging, and very-low-carb diets have not consistently demonstrated superior long-term glucose outcomes compared with other healthy eating patterns.

How Many Carbs Are in a Keto Diet?

There is no universal carbohydrate target for a ketogenic diet.

Very-low-carbohydrate ketogenic diets commonly contain approximately 20–50 grams of carbohydrate per day, although individual plans vary considerably. ¹

For someone with diabetes, the goal should not simply be to consume as few carbohydrates as possible.

Carbohydrate intake should be individualized based on:

• Diabetes type
• Blood glucose patterns
• Insulin or other medications
• Physical activity
• Weight and metabolic goals
• Kidney and cardiovascular health
• Ability to maintain the eating pattern safely

If you want an estimate based on your individual stats, activity level, and goals, use our Keto Diet Calculator to estimate daily carbohydrate, protein, fat, and calorie targets.

Best Foods for a Keto Diet Plan for Diabetics

A diabetes-friendly ketogenic diet should emphasize whole, nutrient-dense foods rather than simply choosing anything labeled “keto.”

Nonstarchy Vegetables

Build meals around vegetables such as spinach, broccoli, cauliflower, zucchini, asparagus, mushrooms, bell peppers, cabbage, green beans, and salad greens.

These foods provide vitamins, minerals and fiber while generally containing fewer digestible carbohydrates than starchy vegetables.

Protein

Good protein choices include:

• Salmon
• Tuna
• Sardines
• Chicken
• Turkey
• Eggs
• Tofu
• Tempeh
• Lean cuts of meat
• Plain Greek yogurt

Protein can help support fullness and preserve muscle mass.

Healthy Fats

Prioritize unsaturated fats from:

• Extra-virgin olive oil
• Avocado
• Almonds
• Walnuts
• Pecans
• Chia seeds
• Flaxseed
• Pumpkin seeds
• Fatty fish

A keto diet does not need to be dominated by bacon, butter, cheese, and processed meats. Food quality remains important even when carbohydrate intake is very low.

Foods to Limit on a Keto Diet

Foods commonly restricted on a ketogenic eating plan include:

• Sugar-sweetened beverages
• Candy
• Cakes and cookies
• White bread
• Breakfast cereals
• Pasta
• Rice
• Chips and crackers
• Fruit juice
• Sweetened yogurt
• Large portions of potatoes
• Highly processed snack foods

Some nutrient-dense carbohydrate foods—including fruit, legumes, whole grains, and dairy—may also be restricted on a strict keto diet.

This is one reason a ketogenic diet requires careful planning. Simply eliminating carbohydrate-rich foods without replacing their fiber, vitamins, minerals, and other nutrients can reduce overall diet quality.

7-Day Keto Diet Plan for Diabetics

The following 7-day keto meal plan for diabetics is an example rather than an individualized prescription. Portion sizes and carbohydrate needs should be adjusted according to your nutritional needs, medications, glucose response, and healthcare team’s recommendations.

Day	Breakfast	Lunch	Dinner	Snack
Day 1	Eggs with spinach and avocado	Grilled chicken salad with olive oil	Baked salmon with broccoli and cauliflower	Almonds
Day 2	Plain Greek yogurt with chia seeds and walnuts	Turkey lettuce wraps with avocado	Chicken with roasted zucchini and peppers	Celery with natural peanut butter
Day 3	Vegetable omelet with mushrooms and peppers	Tuna salad over mixed greens	Turkey meatballs with zucchini noodles	Cheese with cucumber slices
Day 4	Scrambled eggs with avocado	Salmon salad with leafy greens	Grilled chicken with cauliflower mash and green beans	Walnuts
Day 5	Plain Greek yogurt with flaxseed and a small portion of berries	Chicken and avocado lettuce wraps	Baked cod with asparagus and side salad	Hard-boiled egg
Day 6	Eggs with sautéed spinach and mushrooms	Tuna-stuffed avocado with salad	Turkey burger without bun, roasted cauliflower and salad	Almonds or pecans
Day 7	Vegetable and cheese omelet	Grilled chicken Caesar-style salad without croutons	Salmon with roasted Brussels sprouts and cauliflower	Plain Greek yogurt

Water should be the primary beverage throughout the day. Unsweetened coffee and tea can also fit into the plan.

How to Build a Diabetes-Friendly Keto Plate

A keto diet plan for diabetics does not need to include complicated recipes for every meal.

A simple approach is to build meals around three components:

1. Start with nonstarchy vegetables. Fill a substantial portion of your plate with leafy greens, broccoli, cauliflower, zucchini, asparagus, or other nonstarchy vegetables.

2. Add a quality protein. Choose fish, poultry, eggs, tofu, Greek yogurt, or another protein source appropriate for the meal.

3. Add healthy fat. Use olive oil, avocado, nuts, or seeds rather than making butter and processed meat your primary fat sources.

This approach keeps the diet focused on overall food quality rather than simply reaching the lowest possible carbohydrate number.

Keto Diet Grocery List for Diabetics

A basic shopping list can include:

Vegetables: Spinach, lettuce, broccoli, cauliflower, zucchini, asparagus, peppers, mushrooms, cabbage, and green beans.

Protein: Salmon, tuna, chicken, turkey, eggs, tofu, and plain Greek yogurt.

Healthy fats: Olive oil, avocado, almonds, walnuts, chia seeds, and flaxseed.

Flavorings: Herbs, spices, lemon, vinegar, mustard, and low-sugar seasonings.

Drinks: Water, sparkling water, unsweetened tea, and coffee.

Reading Nutrition Facts labels is particularly important because sauces, dressings, yogurt, nut butters, and packaged foods can contain more added sugar and carbohydrate than expected.

Keto Diet and Type 2 Diabetes

People with type 2 diabetes may experience lower blood glucose levels after reducing carbohydrate intake. Some may also lose weight if the eating pattern results in a sustained reduction in calorie intake.

The ADA states that reducing carbohydrate intake can be considered for some adults with diabetes to improve glycemia. However, research does not establish ketogenic diets as the best eating pattern for everyone with type 2 diabetes. ¹

A Mediterranean-style, lower-carbohydrate eating pattern may provide another option for people who want to reduce carbohydrates without following strict keto.

Sustainability matters. An eating pattern that produces short-term improvements but cannot be maintained may not be the best long-term strategy.

Keto Diet and Type 1 Diabetes

A ketogenic diet requires substantially more caution for people with type 1 diabetes.

People with type 1 diabetes require insulin regardless of how few carbohydrates they consume. Reducing carbohydrates can change mealtime insulin requirements, but it does not eliminate the body’s need for insulin.

Very-low-carbohydrate meals that are high in fat and protein can also produce delayed glucose rises, making insulin dosing more complicated.

Anyone with type 1 diabetes considering a ketogenic diet should work closely with their diabetes care team and understand how to monitor glucose and ketones.

Never stop or substantially reduce basal insulin simply because you are eating fewer carbohydrates.

Blood Sugar and Diabetes Medication Considerations

Blood glucose can begin changing quickly when carbohydrate intake drops. This is particularly important for people using insulin, sulfonylureas, meglitinides, SGLT2 inhibitors, or multiple glucose-lowering medications.

Insulin and certain other medications may need adjustment to prevent hypoglycemia. The ADA specifically cautions about ketogenic eating patterns in people taking SGLT2 inhibitors because very-low-carbohydrate intake can increase the risk of ketoacidosis. ²

Do not independently stop or change prescribed diabetes medications to accommodate a ketogenic diet. Discuss medication adjustments with your healthcare professional.

If you are monitoring your response to dietary changes, our Blood Sugar Charts can help you compare fasting and post-meal readings with commonly used glucose ranges. For longer-term trends, the A1C Calculator converts A1C to estimated average glucose (eAG).

Nutritional Ketosis vs. Diabetic Ketoacidosis

Nutritional ketosis and diabetic ketoacidosis are not the same condition.

Nutritional Ketosis	Diabetic Ketoacidosis (DKA)
Controlled production of ketones associated with carbohydrate restriction	Dangerous accumulation of ketones associated with insufficient effective insulin
Usually occurs without severe metabolic acidosis	Causes metabolic acidosis
Blood glucose may be normal or relatively stable	Glucose is often elevated, although DKA can occur with lower glucose levels
Intended effect of a ketogenic diet	Medical emergency

This distinction is especially important for people with type 1 diabetes and people taking SGLT2 inhibitors.

Symptoms of DKA can include nausea, vomiting, abdominal pain, rapid or deep breathing, dehydration, unusual fatigue, and confusion. Seek urgent medical care if DKA is suspected.

For a more detailed explanation of ketone levels, testing, and warning signs, see our guide to diabetes and ketones.

Who Should Be Cautious About a Ketogenic Diet?

A strict ketogenic diet is not appropriate for everyone.

The ADA advises caution with very-low-carbohydrate eating patterns in several groups, including people with certain medical conditions, during pregnancy or lactation, and in people taking medications that may increase ketoacidosis or hypoglycemia risk. ¹

If you have diabetes, discuss a major reduction in carbohydrate intake with your healthcare professional or a registered dietitian nutritionist experienced in diabetes care.

Is Keto Better Than a Regular Low-Carb Diet for Diabetes?

Not necessarily.

A ketogenic diet is an extreme form of carbohydrate restriction. A less restrictive low-carbohydrate diet may provide many of the practical benefits of reducing refined carbohydrates while allowing a wider variety of fruits, legumes, whole grains, and other nutrient-dense foods.

The best approach is one that helps you meet individualized glucose goals, provides adequate nutrition and fiber, supports cardiovascular health, works safely with your medications, and can realistically be maintained long term.

For some people, that may be keto. For others, a moderate low-carb or Mediterranean-style eating pattern may be easier to maintain.

Frequently Asked Questions

Bottom Line

A keto diet plan for diabetics can reduce carbohydrate intake and may improve blood glucose levels for some people, particularly those with type 2 diabetes. But stricter is not always better.

A well-designed plan should emphasize nonstarchy vegetables, quality protein, healthy fats, minimally processed foods, and adequate nutrition rather than simply eliminating carbohydrates.

Most importantly, diabetes medications and insulin requirements can change when carbohydrate intake drops substantially. People using insulin or other glucose-lowering medications should work with their healthcare team when making major dietary changes.

References

1. American Diabetes Association Professional Practice Committee for Diabetes. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S89–S131. DOI: 10.2337/dc26-S005. Official Diabetes Care article – Section 5 [↩] [↩] [↩] [↩] [↩]
2. American Diabetes Association Professional Practice Committee for Diabetes. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S183–S215. DOI: 10.2337/dc26-S009. Official Diabetes Care article – Section 9 [↩]