The Ketogenic Diet and Its Effects on Patients With Type 2 Diabetes Mellitus – A Review Of Literature
DOI:
https://doi.org/10.12775/QS.2025.40.59832Keywords
ketogenic diet, type 2 diabetes mellitus, weight loss, keto, lipid profileAbstract
Purpose of the Study:This paper aims to analyze the impact of the keto diet on glycemic control, weight loss, medication use, and lipid profile in patients with type 2 diabetes (T2DM), as well as to assess its long-term safety and side effects.
Research: This article is based on review of clinical trials, meta-analyses, and systematic reviews found on Pubmed, Google Scholar and other databases. After the evaluation of the articles, observational studies, experimental studies and meta-analyses, the key benefits and limitations of the keto diet in the T2DM were selected.
Results:The keto diet improves glycemic control by lowering HbA1c, fasting blood glucose, and insulin resistance in T2DM patients. It also showed positive effects on lipid metabolism. In addition keto diet has been found to lead to greater weight reduction than other diets. This weight loss, along with improved metabolic parameters, often results in a reduced need for diabetes medications. However, there is limited data on the long-term safety and effectiveness of the keto diet for managing diabetes, and it may be difficult to maintain due to its strict carbohydrate restrictions. The diet’s strict limitations may also cause challenges for certain individuals, such as pregnant women, making it less sustainable for everyone. Furthermore, concerns include potential increases in LDL cholesterol and hypoglycemia, particularly during the initial stages of the diet. Additionally, the keto diet may lead to deficiencies in vitamins, minerals, fiber, and antioxidants, which are usually obtained from carbohydrates, making supplementation necessary to mitigate these deficiencies.
Conclusions:The keto diet appears to be valuable for glycemic control, weight loss, and reducing medication use in T2DM patients. However, long-term data is lacking, and there are concerns about its sustainability and potential side effects, particularly regarding cardiovascular health and micronutrient deficiencies.
References
(1) McGaugh E, Barthel B. A Review of Ketogenic Diet and Lifestyle. Mo Med. 2022 Jan-Feb;119(1):84-88.
(2) McDonald TJW, Cervenka MC. Ketogenic Diet Therapies for Seizures and Status Epilepticus. Semin Neurol. 2020 Dec;40(6):719-729.
(3) Bolla AM, Caretto A, Laurenzi A, Scavini M, Piemonti L. Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes. Nutrients. 2019 Apr 26;11(5):962.
(4) Tay, J.; Thompson, C.H.; Luscombe-Marsh, N.D.; Wycherley, T.P.; Noakes, M.; Buckley, J.D.; Wittert, G.A.; Yancy, W.S.; Brinkworth, G.D. Effects of an energy-restricted low-carbohydrate, high unsaturated fat/low saturated fat diet versus a high-carbohydrate, low-fat diet in type 2 diabetes: A 2-year randomized clinical trial. Diabetes Obes. MeTable 2018, 20, 858–871.
(5) Choi, Y., Jeon, S., & Shin, S. (2020). 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, 12.
(6) Hallberg SJ, McKenzie AL, Williams PT, Bhanpuri NH, Peters AL, Campbell WW, Hazbun TL, Volk BM, McCarter JP, Phinney SD, Volek JS. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study. Diabetes Ther. 2018 Apr;9(2):583-612. doi: 10.1007/s13300-018-0373-9. Epub 2018 Feb 7. Erratum in: Diabetes Ther. 2018 Apr;9(2):613-621.
(7) Webster CC, Murphy TE, Larmuth KM, Noakes TD, Smith JA. Diet, Diabetes Status, and Personal Experiences of Individuals with Type 2 diabetes Who Self-Selected and Followed a Low Carbohydrate High Fat diet. Diabetes Metab Syndr Obes. 2019;12:2567-2582
(8) Zhou, C., Wang, M., Liang, J., He, G., & Chen, N. (2022). 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. International Journal of Environmental Research and Public Health
(9) Yuan, X., Wang, J., Yang, S. et al. 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 10, 38 (2020).
(10) Dashti, H. M. et al. Beneficial effects of ketogenic diet in obese diabetic subjects. Mol. Cell Biochem. 302, 249–256 (2007).
(11) Mohamed Rafiullah, Mohthash Musambil, Satish Kumar David, Effect of a very low-carbohydrate ketogenic diet vs recommended diets in patients with type 2 diabetes: a meta-analysis, Nutrition Reviews, Volume 80, Issue 3, March 2022, Pages 488–502,
(12) Okemah, J., Peng, J., & Quiñones, M. (2018). Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review. Advances in Therapy, 35, 1735 - 1745.
(13) Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K., Ostolaza, H., & Martín, C. (2020). Pathophysiology of Type 2 Diabetes Mellitus. International Journal of Molecular Sciences, 21.
(14) Chandrasekaran, P., & Weiskirchen, R. (2024). The Role of Obesity in Type 2 Diabetes Mellitus—An Overview. International Journal of Molecular Sciences, 25.
(15) Joshi, S., Ostfeld, R., & McMacken, M. (2019). The Ketogenic Diet for Obesity and Diabetes-Enthusiasm Outpaces Evidence.. JAMA internal medicine.
(16) Alluwyam, A., & Estrella, E. (2024). Ketogenic Diet and Its Potential Role in Preventing Type 2 Diabetes Mellitus and Its Complications: A Narrative Review of Randomized Controlled Trials. Cureus, 16.
(17) Li, S., Lin, G., Chen, J. et al. The effect of periodic ketogenic diet on newly diagnosed overweight or obese patients with type 2 diabetes. BMC Endocr Disord 22, 34 (2022).
(18) Dyson, P. (2020). Very low carbohydrate ketogenic diets and diabetes. Practical Diabetes.
(19) Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of Type 2 Diabetes - Global Burden of Disease and Forecasted Trends. J Epidemiol Glob Health. 2020 Mar;10(1):107-111
(20) Tamraz, M.; Al Ghossaini, N.; Temraz, S. The Ketogenic Diet in Colorectal Cancer: A Means to an End. Int. J. Mol. Sci. 2023, 24, 3683.
(21) Saris, C.G.J.; Timmers, S. Ketogenic diets and Ketone suplementation: A strategy for therapeutic intervention. Front. Nutr. 2022, 9, 947567.
(22) Puchalska, P.; Crawford, P.A. Metabolic and Signaling Roles of Ketone Bodies in Health and Disease. Annu. Rev. Nutr. 2021, 41, 49–77.
(23) Shaikh S, Mohamed MM, Mujeeb A, Shaikh F, Harris B. Euglycemic Diabetic Ketoacidosis Precipitated by a Keto Diet: Importance of Dietary History in Diagnosis. Cureus. 2020;12(9)
(24) Mellenia, K., & Santoso, A. (2024). Ketogenic Keys to Body Composition: Nutritional Insights and Comparative Dietary Effects. Bioscientia Medicina : Journal of Biomedicine and Translational Research.
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Copyright (c) 2025 Anna Walczak, Zuzanna Kościuszko, Adam Sobiński, Matylda Czerwonka, Katarzyna Kurza, Julianna Podolec, Silvia Ciraolo, Agnieszka Kulczycka-Rowicka, Joanna Wojda, Katarzyna Lesiczka-Fedoryj
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