Improvement in Glycemic and Lipid Profiles in Type 2 Diabetics with a 90-Day Ketogenic Diet

Abstract

Because low-carbohydrate diets are effective strategies to improve insulin resistance, the hallmark of type 2 diabetes, the purpose of reporting these clinical cases was to reveal the meaningful changes observed in 90 days of low-carbohydrate (LC) ketogenic dietary intervention in female type 2 diabetics aged 18-45. Eleven women (BMI 36.3 kg/m2) who were recently diagnosed with type 2 diabetes based on HbA1c over 6.5% (8.9%) volunteered to participate in an intensive dietary intervention to limit dietary carbohydrates to under 30 grams daily for 90 days. The main outcome was to determine the degree of change in HbA1c, while secondary outcomes included body weight, blood pressure, and blood lipids. The volunteers lost significant weight (85.7±3.2 kg to 76.7±2.8 kg) and lowered systolic (134.0±1.6 to 123.3±1.1 mmHg) and diastolic (89.9±1.3 to 82.6±1.0 mmHg) blood pressure. HbA1c dropped to 5.6%. Most blood lipids were significantly altered, including HDL cholesterol (43.1±4.4 to 52.3±3.3 mg/dl), triglycerides (177.0±19.8 to 92.1±8.7 mg/dl), and the TG : HDL ratio (4.7±0.8 to 1.9±0.2). LDL cholesterol was not significantly different. AST and ALT, plasma markers of liver health, were reported for eight patients and revealed no significant changes. These findings indicate that a short-term intervention emphasizing protein and fat at the expense of dietary carbohydrate functionally reversed the diabetes diagnosis, as defined by HbA1c. Furthermore, the intervention lowered body weight and blood pressure, while eliciting favorable changes in blood lipids.

Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis

“…Therefore, the HbA1c level showed essential clinical significance in evaluating the blood glucose control, revealing the potential problems in the treatment and thereby guiding the therapeutic schedule 30,31 . Eight of the selected studies showed a reduction of HbA1c after KD consumption, the changes ranging from −0.6% to −3.3%; HbA1c reduced <1.5% in the majority of the studies included in the current analysis besides the study conducted by Walton (−3.3%; weight random 5.1%) 15 . The possible explanation for such strong improvement of HbA1c could be that Walton's study had enrolled a limited number of patients and thus the compliance of patients to KD therapy can be guaranteed.…”

Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes: A Review from Clinicians Using the Approach in Practice

“…Arguably the most significant and relevant therapeutic domain for nutritional ketosis is diabetes mellitus. In a recent small trial of patients with recently diagnosed type 2 diabetes, after 90 days of consuming less than 30 g of carbohydrate per day, mean weight loss was 9 kg, systolic and diastolic blood pressure reduced by 10.7 and 7.3 mmHg respectively, and mean Haemoglobin A1c (HbA1c) came down from 8.9% to 5.6% [78]. However, this study had just 11 patients and no control group, so while the validity of the findings is not in doubt, their generalizability and reproducibility remain to be determined.…”

Ketogenic Diet-mediated Steroid Metabolism Reprogramming Improves the Immune Microenvironment and Myelin Growth of Spinal Cord Injury Rats Through Gene Analysis and Co-expression Network Analysis

“…In the brain, ketone bodies (such as β-hydroxybutyrate) contribute to sterol synthesis [34], which is essential for the growth of myelin membranes [55 (35)]. Studies have shown that diabetic patients can signi cantly increase HDL cholesterol and lower blood pressure through a 90-day KD diet, while LDL cholesterol shows no signi cant difference [36]. However, long-term ketogenic diet increases the risk of type 2 diabetes and metabolic syndrome.…”