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Review
. 2015 Feb 27;7(2):e251.
doi: 10.7759/cureus.251. eCollection 2015 Feb.

The Efficacy of Ketogenic Diet and Associated Hypoglycemia as an Adjuvant Therapy for High-Grade Gliomas: A Review of the Literature

Kunal Varshneya  1 , Christine Carico  1 , Alicia Ortega  1 , Chirag G Patil  2
Affiliations
Review

The Efficacy of Ketogenic Diet and Associated Hypoglycemia as an Adjuvant Therapy for High-Grade Gliomas: A Review of the Literature

Kunal Varshneya et al. Cureus. .

Abstract

Background: A high-fat, low-carbohydrate diet, often referred to as a ketogenic diet (KD), has been suggested to reduce frequency and severity of chronic pediatric and adult seizures. A hypoglycemic state, perpetuated by administration of a KD, has been hypothesized as a potential aid to the current standard treatments of high-grade gliomas.

Methods: To understand the effectiveness of the ketogenic diet as a therapy for malignant gliomas, studies analyzing components of a KD were reviewed. Both preclinical and clinical studies were included. The keywords "ketogenic diet, GBM, malignant glioma, hyperglycemia, hypoglycemia" were utilized to search for both abstracts and full articles in English. Overall, 39 articles were found and included in this review.

Results: Studies in animal models showed that a KD is able to control tumor growth and increase overall survival. Other pre-clinical studies have suggested that a KD sustains an environment in which tumors respond better to standard treatments, such as chemoradiation. In human cohorts, the KD was well tolerated. Quality of life was improved, compared to a standard, non-calorie or carbohydrate restricted diet. Hyperglycemia was independently associated with diminished survival.

Conclusion: Recent clinical findings have demonstrated that induced hypoglycemia and ketogenic diet are tolerable and can potentially be an adjuvant to standard treatments, such as surgery and chemoradiation. Other findings have advocated for KD as a malignant cell growth inhibitor, and indicate that further studies analyzing larger cohorts of GBM patients treated with a KD are needed to determine the breadth of impact a KD can have on GBM treatment.

Keywords: glioblastoma; high-grade glioma; hyperglycemia; hypoglycemia; ketogenic diet; neurosurgery.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Ketogenic diet: metabolism
Figure 2
Figure 2. Energy allocation during ketogenic diet administration
See this image and copyright information in PMC

References

    1. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009. Dolecek TA, Propp JM, Stroup NE, Kruchko C. Neuro Oncol. 2012;14:0–49. - PMC - PubMed
    1. Long-term survival with glioblastoma multiforme. Krex D, Klink B, Hartmann C, et al. Brain. 2007;130:2596–2606. - PubMed
    1. Glioblastoma survival in the United States before and during the temozolomide era. Johnson DR, O'Neill BP. J Neurooncol. 2012;107:359–364. - PubMed
    1. Multicenter phase II trial of temozolomide in patients with anaplastic astrocytoma or anaplastic oligoastrocytoma at first relapse. Temodal Brain Tumor Group. Yung WK, Prados MD, Yaya-Tur R, et al. J Clin Oncol. 1999;17:2762–2771. - PubMed
    1. Recurrent glioblastoma multiforme: a review of natural history and management options. Hou LC, Veeravagu A, Hsu AR, Tse VC. Neurosurg Focus. 2006;20:0. - PubMed