The effect of periodic ketogenic diet on newly diagnosed overweight or obese patients with type 2 diabetes

Li, Sumei; Guo-xin, Lin; Chen, Jinxing; Chen, Zhenxin; Xu, Feipeng; Zhu, Feng; Zhang, Jintian; Yuan, Shouping

doi:10.1186/s12902-022-00947-2

Cited by 30 publications

(28 citation statements)

References 24 publications

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“…Following detailed assessments, 13 articles were excluded because (i) intervention/comparator was not relevant (n = 8); (ii) they were not randomized studies (n = 2); (iii) population was not relevant (n = 2); and (iv) was based on a conference presentation (n = 1). The remaining 25 articles [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ] which were based on 22 unique RCTs, met our inclusion criteria and were included in the meta-analysis ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“… Low carbohydrate versus low fat diet and HbA1c levels [ 31 , 32 , 33 , 34 , 35 , 36 , 41 , 42 , 42 , 44 , 46 , 47 , 50 , 51 , 52 , 54 ]. …”

Section: Figurementioning

confidence: 99%

“… Low carbohydrate versus low fat diet and body weight [ 31 , 32 , 33 , 34 , 35 , 38 , 39 , 40 , 41 , 43 , 44 , 45 , 46 , 48 , 50 , 51 , 52 , 53 ]. …”

Section: Figurementioning

confidence: 99%

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Comparison of the Effectiveness of Low Carbohydrate Versus Low Fat Diets, in Type 2 Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2022

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The clinical benefit of low carbohydrate (LC) diets compared with low fat (LF) diets for people with type 2 diabetes (T2D) remains uncertain. We conducted a meta-analysis of randomized controlled trials (RCTs) to compare their efficacy and safety in people with T2D. RCTs comparing both diets in participants with T2D were identified from MEDLINE, Embase, Cochrane Library, and manual search of bibliographies. Mean differences and relative risks with 95% CIs were pooled for measures of glycaemia, cardiometabolic parameters, and adverse events using the following time points: short-term (3 months), intermediate term (6 and 12 months) and long-term (24 months). Twenty-two RCTs comprising 1391 mostly obese participants with T2D were included. At 3 months, a LC vs. LF diet significantly reduced HbA1c levels, mean difference (95% CI) of −0.41% (−0.62, −0.20). LC diet significantly reduced body weight, BMI, fasting insulin and triglycerides and increased total cholesterol and HDL-C levels at the short-to-intermediate term, with a decrease in the requirement for antiglycaemic medications at intermediate-to-long term. There were no significant differences in other parameters and adverse events. Except for reducing HbA1c levels and adiposity parameters at short-to-intermediate terms, a LC diet appears to be equally effective as a LF diet in terms of control of cardiometabolic markers and the risk of adverse events in obese patients with T2D.

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Section: Resultsmentioning

confidence: 99%

“… Low carbohydrate versus low fat diet and HbA1c levels [ 31 , 32 , 33 , 34 , 35 , 36 , 41 , 42 , 42 , 44 , 46 , 47 , 50 , 51 , 52 , 54 ]. …”

Section: Figurementioning

confidence: 99%

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Comparison of the Effectiveness of Low Carbohydrate Versus Low Fat Diets, in Type 2 Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2022

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“…However, results from the included studies showed some variations. Li S et al [ 19 ] reported that after 12-week consumption of KDs, a significant difference in BMI values was observed compared with those subjected to a diabetic diet (26.21 ± 5.74 vs 29.42 ± 5.97, respectively). This significant difference in the BMI was attributed to the fact that the KD stimulated different degrees of starvation and the ketone body became a vital way for energy supply throughout the body.…”

Section: Reviewmentioning

confidence: 99%

A Comparative Study Evaluating the Effectiveness Between Ketogenic and Low-Carbohydrate Diets on Glycemic and Weight Control in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Zaki¹,

Iftikhar²,

Bashir³

et al. 2022

Cureus

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Diabetes mellitus (DM) has become a worldwide public health burden and a significant cause of motility and morbidity. The most common type of diabetes is type 2 diabetes, which is estimated to have a prevalence of one in every ten adults living with diabetes in the United States. The risk factors for type 2 diabetes are obesity and being overweight. Therefore, the primary strategy used to manage type 2 diabetes is weight loss. Different measures, such as dietary therapies and physical training, have been used to manage type 2 diabetes through weight and glycemic control. The dietary therapies used to manage type 2 diabetes are ketogenic and low-carbohydrate diets. Despite studies showing that both ketogenic and low-carbohydrate diets significantly impact weight and glycemic control, the difference between the two diets has not been fully established. Therefore, this systematic review has demonstrated and compared the effectiveness of ketogenic and low-carbohydrate diets on glycemic and weight control. The literature search was conducted on five electronic databases, PubMed, ScienceDirect, Embase, Web of Science, and Google Scholar, from 2000 to 2022. Specified keywords related to the ketogenic diet (KD), low carbohydrates, and type 2 diabetes were used to search for relevant and original articles. The identified articles were analyzed using the eligibility criteria before they were included in the study. The eligibility criteria yielded 15 studies that were included in this systematic review. The results obtained by conducting a meta-analysis showed that low-carbohydrates had a greater reduction in the HbA1c than other diets (standardized mean difference [SMD]: -0.27%; 95% CI; -0.60%, 0.07%: P = 0.008, I2 = 66%). Similarly, a significant decrease in HbA1c percentage was recorded in patients that consumed KDs compared to those who consumed the control diets (SMD: -1.45%; 95% CI; -2.73%, -0.17%: P < 0.00001). The results also show that the KD significantly impacts weight loss than control diets. The results show that the KD is more effective in reducing glycated haemoglobin and body weight (BW) than a low-carbohydrate diet. Therefore, we can summarize that the KD is a more effective dietary therapy. However, there is a need to balance the weight loss and glycemic control benefits obtained from the KD with the increased cardiovascular risks for patients with type 2 diabetes.

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“…Choi YJ et al also reported that KD had an insignificant reduction in BMI compared with control interventions (SMD: -0.63 kg/m2; 95% CI; -1.31 kg/m2, 0.08 kg/m2; P = 0.08, I2 = 87%) [37]. However, a previous study by Li S et al [39] reported that after a 12-week follow-up, patients in the KD group recorded a significantly lower BMI than patients subjected to a diabetic diet (26.21 ± 5.74 vs. 29.42 ± 5.97, respectively). The significant change recorded in this study can be explained by the fact that KD stimulated different starvation degrees.…”

Section: Discussionmentioning

confidence: 92%

Clinical Assessment of Intermittent Fasting With Ketogenic Diet in Glycemic Control and Weight Reduction in Patients With Type II Diabetes Mellitus: A Systematic Review and Meta-Analysis

Zaki¹,

Iftikhar²,

Abdalrubb³

et al. 2022

Cureus

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Diabetes mellitus (DM) is a global epidemic causing significant morbidity and mortality. The most occurring DM is type 2 diabetes mellitus (T2DM) which has similar symptoms as type 1 diabetes mellitus (T1DM). However, it is less marked, making it difficult to diagnose during the early stages. The management of T2DM is usually based on weight and glycemic control, which can be achieved through dietary interventions such as intermittent fasting (IF) and the ketogenic diet (KD). Therefore, this systematic review and meta-analysis aim to demonstrate the role of IF and KD in glycemic and weight control among patients with T2DM.Two methods, including an electronic database search through ScienceDirect, Google Scholar, PubMed, Scopus, Embase, and Web of Science, and a manual search were used to identify relevant studies published between 2000 and 2022. The search yielded 1299 articles, of which only 12 met the inclusion criteria. In addition, study quality appraisal was performed using Review Manager software (RevMan 5.4.1).The pooled results have shown that IF had a similar effect on HBA1c reduction as control interventions (standardized mean differences [SMD]: 0.36%; 95% CI; -0.37, 1.10; P = 0.33, I2 = 87%). Similarly, an insignificant difference in weight reduction between IF and control interventions was recorded (SMD: -1.05%; 95% CI; -2.29, 0.19; P = 0.10, I2 = 96%). On the other hand, KD significantly reduced body weight compared with control diets (SMD: -1.91 kg; 95% CI; -2.96 kg, -0.85 kg; P = 0.0004, I2 = 96%). Similarly, KD had a better effect on the HBA1c percentage reduction than control diets (SMD: -2.00%; 95% CI; -3.76, -0.25; P = 0.03, I2 = 97%).IF and KD have shown reductions in HBA1c and body weight among patients with T2DM. However, the interventions are subject to side effects and should be used with caution and under the supervision of a health professional.

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The effect of periodic ketogenic diet on newly diagnosed overweight or obese patients with type 2 diabetes

Cited by 30 publications

References 24 publications

Comparison of the Effectiveness of Low Carbohydrate Versus Low Fat Diets, in Type 2 Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Comparison of the Effectiveness of Low Carbohydrate Versus Low Fat Diets, in Type 2 Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials

A Comparative Study Evaluating the Effectiveness Between Ketogenic and Low-Carbohydrate Diets on Glycemic and Weight Control in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Clinical Assessment of Intermittent Fasting With Ketogenic Diet in Glycemic Control and Weight Reduction in Patients With Type II Diabetes Mellitus: A Systematic Review and Meta-Analysis

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