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This is likely less of a concern as insulin resistance improves and should not dissuade people from eating protein. One trial showed that diets providing 20 grams and 50 grams of carbs equally helped healthy volunteers maintain ketosis.
However, we don’t know if the same is true for people with obesity, insulin resistance or diabetes.This energy is in the form of molecules called ‘ketones’. Supplements may be necessary for the majority of people on a keto diet.