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Volek says that the keto diet is safe for many people to try and that it may mimic the way early humans ate. However, Volek says that in some cases, you should proceed with caution. "If you have diabetes and are using diabetes medications to control blood sugar, you should work closely with your physician in order to adjust medications appropriately." The initial weight loss is partly due to losing water weight because you tend to retain less water on a low-carb diet. And some studies suggest that you may not continue to lose weight on keto long-term.
A strict keto diet requires close management by a health professional. It should be mentioned here that the duration of the KD may play a crucial role in its efficacy. This is perhaps related to the fact that full ketogenic metabolic adjustment (keto-adaptation) requires about 7 days . Dietary interventions with a KD lasting less than 2 weeks seem to be insufficient to reveal the real effects of ketosis. It is thus crucial to verify that the state of ketosis has been achieved via an evaluation of the level of KB in the urine and/or blood.