The problem with Type II diabetes is not so much the excessive glucose level (although that does cause damage to the body, hence the insulin response to lower it), but rather the excessive insulin response (and the damage that causes) that develops over the years as the cells of the body become resistant to insulin. A well-formulated ketogenic diet, in which carbohydrate intake is restricted below 20 g/day, should in most cases lower serum glucose, simply because you are not flooding your body with it in the form of carbohydrate. The lower serum glucose allows the chronically elevated serum insulin to drop as well, and over time, many people report that their insulin resistance has greatly lessened or been completely reversed.
If you are experiencing any symptoms of hypoglycaemia (low blood sugar), then you can probably reduce the amount of insulin you are taking and not need additional drugs to bring your serum glucose under control. As they embark on their ketogenic diet, most patients are successfully able to reduce their insulin and other diabetes drugs, and often even to eliminate them altogether.
One of the great benefits of a ketogenic diet is that the brain does really well when fed β-hydroxybutyrate instead of glucose. This greatly reduces the risk of hypoglycaemia, because in ketosis the brain’s need for glucose is greatly diminished, if not eliminated.