You get it?
Ketogenic diets don’t have anything to do with the paleo diet usually. However, I think they may play a legitimate role in weight loss for overweight type 2 diabetics. They could also be helpful in rapid control of blood sugars in out-of-control diabetics (excluding diabetic ketoacidosis).
Has anyone devised a ketogenic paleo diet yet? I don’t recall one off the top of my head.
Registered Dietitian Franziska Spritzler recently reviewed the concept of low-carb ketogenic diets. She thinks they are a valid approach to certain clinical situations. Among dietitians, this puts her in a small but growing minority.
I hesitate to mention this, but I will anyway. Many, if not most, dietitians too easily just go along with the standard party line on low-carb eating: it’s rarely necessary and quite possibly unhealthy. Going along is much easier than doing independent literature review and analysis. I see the same mindset among physicians.
Franziska breaks the mold.
Paleo Diabetic 
The Perfect Health Diet book has an outline for a “paleo” type ketogenic diet with more carbs (they use a lot of coconut oil). For flexibility and nutrients it looks pretty good. Amy Kubal at Whole9 is an RD, and she can design a ketogenic diet for you as well if you hire her consulting services. I know Chris Kresser has had success working with a physician and a family of a woman with Alzheimer’s. I believe he used a Perfect Health Diet template with added coconut oil or MCT oil and… shoot, maybe leucine… one of those ketogenic amino acid supplements. She had some improvements. All of this is entirely experimental, so people have to make their own decision about it. In the case of diseases with no cure and no real treatment other than supportive, I think it sometimes makes sense to explore these options, when I don’t see too many risks from a ketogenic diet when applied correctly.
I agree, Emily.
-Steve
I would consider a more Phinney/Volek approach to doing keto right. The “paleo” ness woud simply be using whole foods not processed, and eliminating non-paleo food groups. I have been doing a primal (include dairy) nutritonal ketogenic diet for months. My labs are also available for review. It requires a very high level of fat do correctly. It is a hard line and not for everyone. Being in ketosis is one thing, but in a good zone of nutritional ketosis that gives you massive energy requires greatly reduced carbs (far beyond perfect health diet ideas) and reduction of protein. I have concluded that most ketogenic diet side affects beyond the initial carb flu are the result of two things: To much protein and mucin deficiency and am careful with my protein and also to include marrow, collagen, gelatin, etc…
Since making this correction the results have been wonderful. And I now have a full set of labs to demonstrate the results to even the most die hard MDs.