Type 1 diabetes and epilepsy: Efficacy and safety of the ketogenic diet

Dressler, Anastasia; Reithofer, Eva; Trimmel-Schwahofer, Petra; Klebermasz, Katrin; Prayer, Daniela; Kasprian, Gregor; Rami, Birgit; Schober, Edith; Feucht, Martha

doi:10.1111/j.1528-1167.2010.02543.x

Cited by 32 publications

(24 citation statements)

References 11 publications

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“…Although work with rodents has produced mixed results (Al-Khalifa et al, 2009, 2011; Garbow et al, 2011; Park et al, 2011; Poplawski et al, 2011), clinical studies have found exclusively positive outcomes: after KD treatment, patients with type I or II diabetes had improved control of blood glucose, and many could have their medications reduced or eliminated (Gumbiner et al, 1996; Yancy et al, 2005; Westman et al, 2008; Dressler et al, 2010). In addition, type I diabetic patients (and, based on one report, children with epilepsy) prefer foods that are high in fat and low in carbohydrates (Amari et al, 2007; Snell-Bergeon et al, 2009), which might be attempted self-medication.…”

Section: Nociception and Inflammation: Multiple Mechanisms Likelymentioning

confidence: 99%

The Nervous System and Metabolic Dysregulation: Emerging Evidence Converges on Ketogenic Diet Therapy

Ruskin¹,

Masino²

2012

Front. Neurosci.

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A link between metabolism and brain function is clear. Since ancient times, epileptic seizures were noted as treatable with fasting, and historical observations of the therapeutic benefits of fasting on epilepsy were confirmed nearly 100 years ago. Shortly thereafter a high fat, low-carbohydrate ketogenic diet (KD) debuted as a therapy to reduce seizures. This strict regimen could mimic the metabolic effects of fasting while allowing adequate caloric intake for ongoing energy demands. Today, KD therapy, which forces predominantly ketone-based rather than glucose-based metabolism, is now well-established as highly successful in reducing seizures. Cellular metabolic dysfunction in the nervous system has been recognized as existing side-by-side with nervous system disorders – although often with much less obvious cause-and-effect as the relationship between fasting and seizures. Rekindled interest in metabolic and dietary therapies for brain disorders complements new insight into their mechanisms and broader implications. Here we describe the emerging relationship between a KD and adenosine as a way to reset brain metabolism and neuronal activity and disrupt a cycle of dysfunction. We also provide an overview of the effects of a KD on cognition and recent data on the effects of a KD on pain, and explore the relative time course quantified among hallmark metabolic changes, altered neuron function and altered animal behavior assessed after diet administration. We predict continued applications of metabolic therapies in treating dysfunction including and beyond the nervous system.

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Section: Nociception and Inflammation: Multiple Mechanisms Likelymentioning

confidence: 99%

The Nervous System and Metabolic Dysregulation: Emerging Evidence Converges on Ketogenic Diet Therapy

Ruskin¹,

Masino²

2012

Front. Neurosci.

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“…The case reports of children with T1DM on ketogenic diets are presented in tables 1 and 2. Four children had severe neurological disease and ketogenic diets were started for epilepsy management after multiple medication failures 7 11–13. The other six children were otherwise healthy and commenced on low-carbohydrate diets by their parents 1…”

Section: Commentarymentioning

confidence: 99%

“…The recommended NICE target of HbA 1c ≤48 mmol/mol (6.5%) was achieved in seven children but authors reported frequent hypoglycaemic episodes 1 7 11–13. Distinguishing diabetic ketoacidosis (DKA) from diet-induced ketosis was challenging.…”

Section: Commentarymentioning

confidence: 99%

Can a ketogenic diet be safely used to improve glycaemic control in a child with type 1 diabetes?

et al. 2018

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“…For patients with Type 1 diabetes there may be some concern that a ketogenic diet would promote ketoacidosis, which could be potentially lethal. Much less research has been done in patients with Type 1 diabetes on low-carbohydrate diets, but there is at least one case report of a patient with Type 1 diabetes and epilepsy who was treated with the classic (low-protein, low-carbohydrate) ketogenic diet to treat epilepsy [26]. The diet produced robust ketogenesis and normalized glucose and hemoglobin A1c.…”

Section: Low-carbohydrate Diets In Animal Models Of Obesity and Diabetesmentioning

confidence: 99%

Mechanisms by Which the Ketogenic Diet Reverses Obesity and Diabetes

Moreno¹

2017

EMIJ

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Since the beginning of the 20th century, when low-carbohydrate diets were first implemented to treat Type 1 diabetes, the role of dietary composition in regulating glucose homeostasis and, increasingly, energy balance, has been the subject of great interest to both biomedical researchers and, increasingly, to the public. In fairly extreme circumstances (e.g., Type 1 diabetes untreated with insulin) low-carbohydrate diets (which are generally high-fat diets) can be useful to reduce blood glucose, but since the advent of insulin therapy, and increasing appreciation of the cardiovascular consequences of hyperlipidemia, clinical practice has dramatically favored highcarbohydrate, low-fat diets for diabetes (especially Type 2 diabetes, largely associated with obesity). This clinical advice, at the time, seemed fairly radical. In a famous treatise, "The Physiology of Taste" published in 1825, Brillat-Savarin, argue that consumption of "natural" diets (e.g., meat and vegetables) promote health, whereas "cultivated" diet (e.g., derived from rice and wheat) increasingly led to deterioration of health associated with affluence.Similarly, in 1837 Sylvester Graham published "A treatise on bread and breadmaking", essentially a tirade against food with grains (as well as meat), which were not suited to the assumption that gluttony was among the greatest sins (clearly a theme in subsequent American diet fads). Similarly throughout the 20th century popular diets (including those promotes by Adelle Davis in the 1950s, Robert Atkins in the 1970s, the paleo diet, and increasingly many more) have emphasized lowcarbohydrate, high-fat diets especially for weight loss (viewed by the public as a more compelling concern than glucose homeostasis). While these diets have little if any clinical evidence for efficacy, low-calorie, low-protein diets that produce ketogenesis are extremely effective to reverse obesity, hyperglycemia, and diabetic complications. The mini-review examines possible mechanisms mediating these remarkable effects, particularly focusing on epigenetic effects on hypothalamic neurons.

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Type 1 diabetes and epilepsy: Efficacy and safety of the ketogenic diet

Cited by 32 publications

References 11 publications

The Nervous System and Metabolic Dysregulation: Emerging Evidence Converges on Ketogenic Diet Therapy

The Nervous System and Metabolic Dysregulation: Emerging Evidence Converges on Ketogenic Diet Therapy

Can a ketogenic diet be safely used to improve glycaemic control in a child with type 1 diabetes?

Mechanisms by Which the Ketogenic Diet Reverses Obesity and Diabetes

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