The influence of the ketogenic diet on the therapy of type 2 diabetes. A literature review
DOI:
https://doi.org/10.12775/JEHS.2024.56.008Keywords
type 2 diabetes, ketogenic diet, nutrition, diabetes mellitusAbstract
INTRODUCTION: Diabetes mellitus type 2 (DM2) is a widespread and chronic disorder with high mortality and associated morbidity rates worldwide. DM2 individuals are more susceptible to developing heart disease, cardiovascular disease, diabetic neuropathy, and several other related complications, which are major causes of diabetes related death. New therapies and possibilities for the treatment of the diabetes are constantly being searched for, among which the ketogenic diet is increasingly becoming popular. There are studies being conducted all worldwide on the effects of this diet on the treatment of diabetes.
PURPOSE: The aim of the study is to present the current state of knowledge about the influence of the ketogenic diet on the therapy of type 2 diabetes.
MATERIALS AND METHOD: The available literature in PubMed was reviewed to write the article, using the keywords ,,ketogenic diet”, ,,diabetes mellitus”, ,,ketogenic diet diabetes”, ,,diabetes nutrition”.
CONCLUSION: A ketogenic diet has notable advantages on body weight and glycemic control, as well as on the enhancement of lipid profiles in overweight DM2 patients. This diet can decrease body weight, waist circumference, HbA1c, and triglycerides, and increase HDL levels. In addition, the ketogenic diet may have further benefits in improving body composition to attenuate the onset and progress of DM2 bz reducing body weight, lowering glycemic levels, and enhancing lipid profiles. More studies are needed in the future to support and even confirm the links between the ketogenic diet and patienst suffering from DM2.
References
Chen L., Magliano D.J., Zimmet P.Z. The worldwide epidemiology of type 2 diabetes mellitus—Present and future perspectives. Nat. Rev. Endocrinol. 2011;8:228–236. doi: 10.1038/nrendo.2011.183.
Dyńka D, Kowalcze K, Ambrozkiewicz F, Paziewska A. Effect of the Ketogenic Diet on the Prophylaxis and Treatment of Diabetes Mellitus: A Review of the Meta-Analyses and Clinical Trials. Nutrients. 2023 Jan 18;15(3):500. doi: 10.3390/nu15030500. PMID: 36771207; PMCID: PMC9919384.
Pondel, N.; Li´skiewicz, D.; Li´skiewicz, A. Dieta ketogeniczna–mechanizm działania i perspektywy zastosowania w terapii: Dane z bada ´n klinicznych. Post˛epy Biochem. 2020, 66, 270–286
Alharbi, A.; Al-Sowayan, N. The Effect of Ketogenic-Diet on Health. Jan. Food Nutr. Sci. 2020, 11, 301–313. [
Divers, J.; Mayer-Davis, E.J.; Lawrence, J.; Isom, S.; Dabelea, D.; Dolan, L.; Imperatore, G.; Marcovina, S.; Pettitt, D.J.; Pihoker, C.; et al. Trends in Incidence of Type 1 and Type 2 Diabetes Among Youths-Selected Counties and Indian Reservations, United States, 2002–2015. MMWR Morb. Mortal. Wkly. Rep. 2020, 69, 161–165.
Kotwas, A.; Karakiewicz, B.; Zabielska, P.; Wieder-Huszla, S.; Jurczak, A. Epidemiological factors for type 2 diabetes mellitus: Evidence from the Global Burden of Disease. Arch. Public Health 2021, 79, 110.
Ranjan, A.; Schmidt, S.; Damm-Frydenberg, C.; Holst, J.J.; Madsbad, S.; Nørgaard, K. Short-term effects of a low carbohydrate diet on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes: A randomized open-label crossover trial. Diabetes Obes. Metab. 2017, 19, 1479–1484.
Westman, E.C.; Yancy, W.S.; Mavropoulos, J.C.; Marquart, M.; McDuffie, J.R. The effect of a low-carbohydrate, ketogenic diet versus a lowglycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr. Metab. 2008, 5, 36.
Handelsman, Y.; Henry, R.R.; Bloomgarden, Z.T.; Dagogo-Jack, S.; DeFronzo, R.A.; Einhorn, D.; Ferrannini, E.; Fonseca, V.A.; Garber, A.J.; Grunberger, G.; et al. American Association of Clinical Endocrinologists and American College of Endocrinology Position Statement on the association of SGLT-2 inhibitors and diabetic ketoacidosis. Endocr. Pract. 2016, 22, 753–762.
Moriconi, E.; Camajani, E.; Fabbri, A.; Lenzi, A.; Caprio, M. Very-low-calorie ketogenic diet as a safe and valuable tool for long-term glycemic management in patients with obesity and type 2 diabetes. Nutrients 2021, 13, 758.
Krejˇcí, H.; Vyjídák, J.; Kohutiar, M. Low-carbohydrate diet in diabetes mellitus treatment. Vnitr. Lek. 2018, 64, 742–752.
Yancy, W.S., Jr.; Foy, M.; Chalecki, A.M.; Vernon, M.C.; Westman, E.C. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr. Metab. 2005, 2, 34.
Wong, K.; Raffray, M.; Roy-Fleming, A.; Blunden, S.; Brazeau, A.S. Ketogenic Diet as a Normal Way of Eating in Adults With Type 1 and Type 2 Diabetes: A Qualitative Study. Can. J. Diabetes 2021, 45, 137–143.
Tóth, C.; Clemens, Z. Type 1 diabetes mellitus successfully managed with the paleolithic ketogenic diet. Int. J. Case Rep. Images 2014, 5, 699–703.
Cogen, F.R. Incorporation of the Ketogenic Diet in a Youth With Type 1 Diabetes. Clin. Diabetes 2020, 38, 412–415.
Tóth, C.; Clemens, Z. A child with type 1 diabetes mellitus (T1DM) successfully treated with the Paleolithic ketogenic diet: A 19-month insulin freedom. Int. J. Case Rep. Images 2015, 6, 753–758.
Castaneda, R.L.A.; Mack, K.J.; Lteif, A. Successful treatment of type 1 diabetes and seizures with combined ketogenic diet and insulin. Pediatrics 2012, 129, e511–e514.
Zhou, C.; Wang, M.; Liang, J.; He, G.; Chen, N. Ketogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails. Int. J. Environ. Res. Public Health 2022, 19, 10429
Rafiullah, M.; Musambil, M.; David, S.K. Effect of a very low-carbohydrate ketogenic diet vs recommended diets in patients with type 2 diabetes: A meta-analysis. Nutr. Rev. 2022, 80, 488–502.
Li, M.; Yuan, J. Effects of very low-carbohydrate ketogenic diet on lipid metabolism in patients with type II diabetes mellitus: A meta-analysis. Nutr. Hosp. 2022, 39, 916–923. (In English) [
Saslow, L.R.; Mason, A.E.; Kim, S.; Goldman, V.; Ploutz-Snyder, R.; Bayandorian, H.; Daubenmier, J.; Hecht, F.M.; Moskowitz, J.T. An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals With Type 2 Diabetes: A Randomized Controlled Trial. J. Med. Internet Res. 2017, 19, e36.
Goday, A.; Bellido, D.; Sajoux, I.; Crujeiras, A.B.; Burguera, B.; García-Luna, P.P.; Oleaga, A.; Moreno, B.; Casanueva, F.F. Shortterm safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus. Nutr. Diabetes 2016, 6, e230.
Li, S.; Lin, G.; Chen, J.; Chen, Z.; Xu, F.; Zhu, F.; Zhang, J.; Yuan, S. The effect of periodic ketogenic diet on newly diagnosed overweight or obese patients with type 2 diabetes. BMC Endocr. Disord. 2022, 22, 34.
Gardner, C.D.; Landry, M.J.; Perelman, D.; Petlura, C.; Durand, L.R.; Aronica, L.; Crimarco, A.; Cunanan, K.M.; Chang, A.; Dant, C.C.; et al. Effect of a ketogenic diet versus Mediterranean diet on glycated hemoglobin in individuals with prediabetes and type 2 diabetes mellitus: The interventional Keto-Med randomized crossover trial. Am. J. Clin. Nutr. 2022, 116, 640–652, Erratum in Am. J. Clin. Nutr. 2022 Nov. 09.
Saslow, L.R.; Kim, S.; Daubenmier, J.J.; Moskowitz, J.T.; Phinney, S.D.; Goldman, V.; Murphy, E.J.; Cox, R.M.; Moran, P.; Hecht, F.M. A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes. PLoS ONE 2014, 9, e91027
Saslow, L.R.; Daubenmier, J.J.; Moskowitz, J.T.; Kim, S.; Murphy, E.J.; Phinney, S.D.; Ploutz-Snyder, R.; Goldman, V.; Cox, R.M.; Mason, A.E.; et al. Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. Nutr. Diabetes 2017, 7, 304
Landry, M.J.; Crimarco, A.; Perelman, D.; Durand, L.R.; Petlura, C.; Aronica, L.; Robinson, J.L.; Kim, S.H.; Gardner, C.D. Adherence to Ketogenic and Mediterranean Study Diets in a Crossover Trial: The Keto-Med Randomized Trial. Nutrients 2021, 13, 967
Lacombe J., Armstrong M.E.G., Wright F.L., Foster C. The impact of physical activity and an additional behavioral risk factor on cardiovascular disease, cancer and all-cause mortality: A systematic review. BMC Public Health. 2019;19:900. doi: 10.1186/s12889-019-7030-8.
Dashti H.M., Mathew T.C., Khadada M., Al-Mousawi M., Talib H., Asfar S.K., Behbahani A.I., Al-Zaid N.S. Beneficial effects of ketogenic diet in obese diabetic subjects. Mol. Cell Biochem. 2007;302:249–256. doi: 10.1007/s11010-007-9448-z.
DiNicolantonio J.J., O’Keefe J.H. Effects of dietary fats on blood lipids: A review of direct comparison trials. Open Heart. 2018;5:e000871. doi: 10.1136/openhrt-2018-000871
Choi Y.J., Jeon S.M., Shin S. Impact of a Ketogenic Diet on Metabolic Parameters in Patients with Obesity or Overweight and with or without Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials. Nutrients. 2020;12:2005. doi: 10.3390/nu12072005.
Yuan X., Wang J., Yang S., Gao M., Cao L., Li X., Hong D., Tian S., Sun C. Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: A systematic review and meta-analysis. Nutr. Diabetes. 2020;10:38. doi: 10.1038/s41387-020-00142-z.
Gupta L., Khandelwal D., Kalra S., Gupta P., Dutta D., Aggarwal S. Ketogenic diet in endocrine disorders: Current perspectives. J. Postgrad. Med. 2017;63:242–251. doi: 10.4103/jpgm.JPGM_16_17.
Veech R.L. The therapeutic implications of ketone bodies: The effects of ketone bodies in pathological conditions: Ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism. Prostaglandins Leukot Essent Fat. Acids. 2004;70:309–319. doi: 10.1016/j.plefa.2003.09.007.
Yuan X., Wang J., Yang S., Gao M., Cao L., Li X., Hong D., Tian S., Sun C. Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: A systematic review and meta-analysis. Nutr. Diabetes. 2020;10:38. doi: 10.1038/s41387-020-00142-z.
Yancy W.S., Vernon M.C., Westman E.C. A pilot trial of a low-carbohydrate, ketogenic diet in patients with type 2 diabetes. Metab. Syndr. Relat. Disord. 2003;1:239–243. doi: 10.1089/154041903322716723.
Paoli A., Rubini A., Volek J.S., Grimaldi K.A. Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur. J. Clin. Nutr. 2013;67:789–796. doi: 10.1038/ejcn.2013.116.
Saslow L.R., Mason A.E., Kim S., Goldman V., Ploutz-Snyder R., Bayandorian H., Daubenmier J., Hecht F.M., Moskowitz J.T. An online intervention comparing a very low-carbohydrate ketogenic diet and lifestyle recommendations versus a plate method diet in overweight individuals with type 2 diabetes: A randomized controlled trial. J. Med. Intern. Res. 2017;19:e36. doi: 10.2196/jmir.5806.
Westman E.C., Yancy W.S., Jr., Mavropoulos J.C., Marquart M., McDuffie J.R. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr. Metab. 2008;5:36. doi: 10.1186/1743-7075-5-36.
Gershuni V.M., Yan S.L., Medici V. Nutritional ketosis for weight management and reversal of metabolic syndrome. Curr. Nutr. Rep. 2018;7:97–106. doi: 10.1007/s13668-018-0235-0.
Shilpa J., Mohan V. Ketogenic diets: Boon or bane? Indian J. Med. Res. 2018;148:251–253. doi: 10.4103/ijmr.IJMR_1666_18.
Zhou C, Wang M, Liang J, He G, Chen N. Ketogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails. Int J Environ Res Public Health. 2022 Aug 22;19(16):10429. doi: 10.3390/ijerph191610429. PMID: 36012064; PMCID: PMC9408028.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Aleksandra Madej, Hanna Senat, Patrycja Grabowska, Patrycja Bolla, Aleksandra Senat, Zuzanna Marczyńska, Mateusz Dorochowicz
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 295
Number of citations: 0
