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Long-term effects of a keto diet Other complications might include: an increased risk of dyslipidemia, an imbalance of lipids an elevated risk of fatty liver disease more frequent hypoglycemic episodes Some researchers have suggested that since a keto diet often involves additional fat, there might be a People with diabetes already have an There is a lack of evidence about the long-term safety and effectiveness of the keto diet, and healthcare professionals have called for more primary studies and evidence before recommending this diet for people with type 2 diabetes