Effect of the Ketogenic Diet on the Prophylaxis and Treatment of Diabetes Mellitus: A Review of the Meta-Analyses and Clinical Trials

Overview

Journal Nutrients

Date 2023 Feb 11

PMID 36771207

Authors

Damian Dynka

Katarzyna Kowalcze

Filip Ambrozkiewicz

Agnieszka Paziewska

Affiliations

Soon will be listed here.

Abstract

The exponentially growing frequency of diagnosing diabetes mellitus means that a verification of the previous dietetic approach to treating the disease seems justified. The simultaneous growth of interest in the ketogenic diet and the development of knowledge in this field have contributed to the increasingly frequent application of the ketogenic diet in diabetes treatment. This paper also deals with that issue; its aim includes an extensive analysis of the influence of the ketogenic diet on the prophylaxis and treatment of diabetes. The paper has been prepared based on a wide, meticulous analysis of the available literature on the subject. Among other findings, a favorable effect of that nutrition model has been demonstrated on the values of glycated hemoglobin, glucose, insulin, or other metabolic parameters in diabetes patients. The effect of the ketogenic diet on the pharmacotherapy of type 1 and type 2 diabetes has been presented and compared with the standard nutritional management plan recommended for that disease. Further research is needed in this field, especially studies with a long follow-up period. The discussed articles report interesting therapeutic advantages to the ketogenic diet in comparison with standard diets.

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References

Katsarou A, Gudbjornsdottir S, Rawshani A, Dabelea D, Bonifacio E, Anderson B . Type 1 diabetes mellitus. Nat Rev Dis Primers. 2017; 3:17016. DOI: 10.1038/nrdp.2017.16. View

Westman E, Yancy Jr W, Humphreys M . Dietary treatment of diabetes mellitus in the pre-insulin era (1914-1922). Perspect Biol Med. 2006; 49(1):77-83. DOI: 10.1353/pbm.2006.0017. View

Olson C, Lum G, Hsiao E . Ketone Bodies Exert Ester-Ordinary Suppression of Bifidobacteria and Th17 Cells. Cell Metab. 2020; 31(6):1049-1051. DOI: 10.1016/j.cmet.2020.05.011. View

Paoli A, Mancin L, Bianco A, Thomas E, Mota J, Piccini F . Ketogenic Diet and Microbiota: Friends or Enemies?. Genes (Basel). 2019; 10(7). PMC: 6678592. DOI: 10.3390/genes10070534. View

Ang Q, Alexander M, Newman J, Tian Y, Cai J, Upadhyay V . Ketogenic Diets Alter the Gut Microbiome Resulting in Decreased Intestinal Th17 Cells. Cell. 2020; 181(6):1263-1275.e16. PMC: 7293577. DOI: 10.1016/j.cell.2020.04.027. View

Leow Z, Guelfi K, Davis E, Jones T, Fournier P . The glycaemic benefits of a very-low-carbohydrate ketogenic diet in adults with Type 1 diabetes mellitus may be opposed by increased hypoglycaemia risk and dyslipidaemia. Diabet Med. 2018; . DOI: 10.1111/dme.13663. View

Choi Y, Jeon S, 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(7). PMC: 7400909. DOI: 10.3390/nu12072005. View

Pondel N, Liskiewicz D, Liskiewicz A . Ketogenic diet – mechanism of action and perspectives for the use in the therapy: data from clinical studies. Postepy Biochem. 2020; 66(3):270-286. DOI: 10.18388/pb.2020_342. View

Phillips M, Deprez L, Mortimer G, Murtagh D, McCoy S, Mylchreest R . Randomized crossover trial of a modified ketogenic diet in Alzheimer's disease. Alzheimers Res Ther. 2021; 13(1):51. PMC: 7901512. DOI: 10.1186/s13195-021-00783-x. View

10.

Weber D, Aminazdeh-Gohari S, Kofler B . Ketogenic diet in cancer therapy. Aging (Albany NY). 2018; 10(2):164-165. PMC: 5842847. DOI: 10.18632/aging.101382. View

11.

Schiavo L, Pilone V, Rossetti G, Barbarisi A, Cesaretti M, Iannelli A . A 4-Week Preoperative Ketogenic Micronutrient-Enriched Diet Is Effective in Reducing Body Weight, Left Hepatic Lobe Volume, and Micronutrient Deficiencies in Patients Undergoing Bariatric Surgery: a Prospective Pilot Study. Obes Surg. 2018; 28(8):2215-2224. DOI: 10.1007/s11695-018-3145-8. View

12.

Dressler A, Reithofer E, Trimmel-Schwahofer P, Klebermasz K, Prayer D, Kasprian G . Type 1 diabetes and epilepsy: efficacy and safety of the ketogenic diet. Epilepsia. 2010; 51(6):1086-9. DOI: 10.1111/j.1528-1167.2010.02543.x. View

13.

Nuttall F, Almokayyad R, Gannon M . Comparison of a carbohydrate-free diet vs. fasting on plasma glucose, insulin and glucagon in type 2 diabetes. Metabolism. 2014; 64(2):253-62. DOI: 10.1016/j.metabol.2014.10.004. View

14.

Aylward N, Shah N, Sellers E . The ketogenic diet for the treatment of myoclonic astatic epilepsy in a child with type 1 diabetes mellitus. Can J Diabetes. 2014; 38(4):223-4. DOI: 10.1016/j.jcjd.2014.05.002. View

15.

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(1):110. PMC: 8218426. DOI: 10.1186/s13690-021-00632-1. View

16.

de Goffau M, Luopajarvi K, Knip M, Ilonen J, Ruohtula T, Harkonen T . Fecal microbiota composition differs between children with β-cell autoimmunity and those without. Diabetes. 2013; 62(4):1238-44. PMC: 3609581. DOI: 10.2337/db12-0526. View

17.

Landry M, Crimarco A, Perelman D, Durand L, Petlura C, Aronica L . Adherence to Ketogenic and Mediterranean Study Diets in a Crossover Trial: The Keto-Med Randomized Trial. Nutrients. 2021; 13(3). PMC: 8002540. DOI: 10.3390/nu13030967. View

18.

. Abridged for Primary Care Providers. Clin Diabetes. 2022; 40(1):10-38. PMC: 8865785. DOI: 10.2337/cd22-as01. View

19.

Myette-Cote E, Durrer C, Neudorf H, Bammert T, Botezelli J, Johnson J . The effect of a short-term low-carbohydrate, high-fat diet with or without postmeal walks on glycemic control and inflammation in type 2 diabetes: a randomized trial. Am J Physiol Regul Integr Comp Physiol. 2018; 315(6):R1210-R1219. PMC: 6734060. DOI: 10.1152/ajpregu.00240.2018. View

20.

Ruan Y, Chen L, She D, Chung Y, Ge L, Han L . Ketogenic diet for epilepsy: an overview of systematic review and meta-analysis. Eur J Clin Nutr. 2022; 76(9):1234-1244. DOI: 10.1038/s41430-021-01060-8. View