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

Abstract

A ketogenic diet, characterized by low calories with high levels of fat, adequate levels of protein, and low levels of carbohydrates, has beneficial effects on body weight control in overweight patients. In the present study, a meta-analysis was conducted to investigate the role of a ketogenic diet in body weight control and glycemic management in overweight patients with type 2 diabetes mellitus (T2DM). In summary, we systematically reviewed articles from the Embase, PubMed, Web of Science and Cochrane Library databases and obtained eight randomized controlled trials for meta-analysis. The results show that a ketogenic diet had significantly beneficial effects on the loss of body weight (SMD, -5.63, p = 0.008), the reduction of waist circumference (SMD, -2.32, p = 0.04), lowering glycated hemoglobin (SMD, -0.38, p = 0.0008) and triglycerides (SMD, -0.36, p = 0.0001), and increasing high-density lipoproteins (SMD, 0.28, p = 0.003). Overall, these results suggest that a ketogenic diet may be an effective dietary intervention for body weight and glycemic control, as well as improved lipid profiles in overweight patients with T2DM. Hence, a ketogenic diet can be recommended for the therapeutic intervention of overweight patients with T2DM.

Keywords: body weight control; glycated hemoglobin; glycemic management; high-density lipoprotein; therapeutic intervention; very low-carbohydrate diet.

Figure 1

Flow chart of literature selection.

Figure 2

Risk of bias summary.

Figure 3

Forest plots for the effects of post-intervention versus baseline on weight change in overweight T2DM patients. (A) Changes in body weight; (B) Changes in waist circumference; (C) Changes in BMI. The green squares represent individual effect sizes, and the black diamonds represent pooling effect sizes.

Figure 4

Forest plots for the effects of post-intervention versus baseline on glycemic control in overweight T2DM patients. (A) Changes in HbA1c; (B) Changes in fasting glucose; (C) Changes in fasting insulin; (D) Changes in HOMA-IR. The green squares represent individual effect sizes, and the black diamonds represent pooling effect sizes.

Figure 5

Forest plots for the effects of post-intervention versus baseline on lipid profiles in overweight T2DM patients. (A) Changes in fasting triglycerides; (B) Changes in HDL; (C) Changes in total cholesterol; (D) Changes in LDL. The green squares represent individual effect sizes, and the black diamonds represent pooling effect sizes.