Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 27;21(9):32.
doi: 10.1007/s11892-021-01399-z.

Efficacy of Ketogenic Diets on Type 2 Diabetes: a Systematic Review

Delphine Tinguely  1 , Justine Gross  2 , Christophe Kosinski  3
Affiliations

Efficacy of Ketogenic Diets on Type 2 Diabetes: a Systematic Review

Delphine Tinguely et al. Curr Diab Rep. .

Abstract

To assess the pleiotropic effects of ketogenic diets (KD) on glucose control, changes in medication, and weight loss in individuals with type 2 diabetes, and to evaluate its practical feasibility RECENT FINDINGS: KD results in improved HbA1c already after 3 weeks, and the effect seems to persist for at least 1 year. This is associated with a reduction in glucose-lowering medications. The weight loss observed after a short time period seems to be maintained with a long-term diet. Adequate support (supportive psychological counseling, enhancing positive affectivity, reinforcing mindful eating) is necessary to achieve a benefit and to assure adherence. Despite the documented decrease in HbA1, a definitive causal effect of KD remains to be proven. KD should be performed under strict medical supervision. Future research should clarify how compliance can be maximized and how ketosis can be optimally monitored.

Keywords: Atkins diet; Glucose intolerance; Keto; Ketogenic diet; Type 2 diabetes; Very-low-carb diet.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Potential pathophysiological mechanisms and metabolic effects of ketogenic diet in subjects with type 2 diabetes indicated by clinical trials [– and –31]. Changes are indicated as: ↘, significant decrease; ↔, trend or no significant difference; ↗, significant increase. Abbreviations: HbA1c, glycated hemoglobin; FPG, fasting plasma glucose; HOMA, Homeostasis Model Assessment; LDL, low-density lipoprotein; TAG, triacylglycerol
See this image and copyright information in PMC

References

    1. • American Diabetes A. 5. Facilitating behavior change and well-being to improve health outcomes: standards of medical care in diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S53-S72. 10.2337/dc21-S005. Most recent American guidelines for lifestyle management in prediabetes and diabetes. - PubMed
    1. Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, Horton ES, Castorino K, Tate DF. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065–2079. doi: 10.2337/dc16-1728. - DOI - PMC - PubMed
    1. Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, Federici M, Filippatos G, Grobbee DE, Hansen TB, Huikuri HV, Johansson I, Jüni P, Lettino M, Marx N, Mellbin LG, Östgren CJ, Rocca B, Roffi M, Sattar N, Seferović PM, Sousa-Uva M, Valensi P, Wheeler DC, ESC Scientific Document Group. Piepoli MF, Birkeland KI, Adamopoulos S, Ajjan R, Avogaro A, Baigent C, Brodmann M, Bueno H, Ceconi C, Chioncel O, Coats A, Collet JP, Collins P, Cosyns B, di Mario C, Fisher M, Fitzsimons D, Halvorsen S, Hansen D, Hoes A, Holt RIG, Home P, Katus HA, Khunti K, Komajda M, Lambrinou E, Landmesser U, Lewis BS, Linde C, Lorusso R, Mach F, Mueller C, Neumann FJ, Persson F, Petersen SE, Petronio AS, Richter DJ, Rosano GMC, Rossing P, Rydén L, Shlyakhto E, Simpson IA, Touyz RM, Wijns W, Wilhelm M, Williams B, Aboyans V, Bailey CJ, Ceriello A, Delgado V, Federici M, Filippatos G, Grobbee DE, Hansen TB, Huikuri HV, Johansson I, Jüni P, Lettino M, Marx N, Mellbin LG, Östgren CJ, Rocca B, Roffi M, Sattar N, Seferović PM, Sousa-Uva M, Valensi P, Wheeler DC, Windecker S, Aboyans V, Baigent C, Collet JP, Dean V, Delgado V, Fitzsimons D, Gale CP, Grobbee DE, Halvorsen S, Hindricks G, Iung B, Jüni P, Katus HA, Landmesser U, Leclercq C, Lettino M, Lewis BS, Merkely B, Mueller C, Petersen SE, Petronio AS, Richter DJ, Roffi M, Shlyakhto E, Simpson IA, Sousa-Uva M, Touyz RM, Zelveian PH, Scherr D, Jahangirov T, Lazareva I, Shivalkar B, Naser N, Gruev I, Milicic D, Petrou PM, Linhart A, Hildebrandt P, Hasan-Ali H, Marandi T, Lehto S, Mansourati J, Kurashvili R, Siasos G, Lengyel C, Thrainsdottir IS, Aronson D, di Lenarda A, Raissova A, Ibrahimi P, Abilova S, Trusinskis K, Saade G, Benlamin H, Petrulioniene Z, Banu C, Magri CJ, David L, Boskovic A, Alami M, Liem AH, Bosevski M, Svingen GFT, Janion M, Gavina C, Vinereanu D, Nedogoda S, Mancini T, Ilic MD, Fabryova L, Fras Z, Jiménez-Navarro MF, Norhammar A, Lehmann R, Mourali MS, Ural D, Nesukay E, Chowdhury TA. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255–323. doi: 10.1093/eurheartj/ehz486. - DOI - PubMed
    1. Evert AB, Dennison M, Gardner CD, Garvey WT, Lau KHK, MacLeod J, et al. Nutrition therapy for adults with diabetes or prediabetes: a consensus report. Diabetes Care. 2019;42(5):731–754. doi: 10.2337/dci19-0014. - DOI - PMC - PubMed
    1. Laffel L. Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes Metab Res Rev. 1999;15(6):412–426. doi: 10.1002/(sici)1520-7560(199911/12)15:6<412::aid-dmrr72>3.0.co;2-8. - DOI - PubMed

Publication types