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Global Translational Medicine Keto diet in management of Type 2 diabetes

those with a normal baseline for T2DM. Lymphocytes, the discontinuation or reduction of pharmaceutical doses
unable to adapt to decreased insulin responsiveness due administered during T2DM oral antibiotic therapy . Daly
[1]
to the interplay between IR and obesity, contribute to the et al. assert that , particularly when compared to the
[74]
onset of T2DM. pre-dietary phase, the model suggests an 85% decline in
insulin availability. In the treatment of T2DM with oral
7.2. Impact of low-carbohydrate diets on glucose anti-diabetic therapies, a low-carbohydrate diet has been
metabolism and triglyceride levels in type 2 observed to yield a similar effect. During the induction
diabetes phase, this dietary concept not only lowered insulin and

The present status of the low-carbohydrate diet’s efficacy blood glucose levels over a 24-h period but also enhanced
for individuals with T2DM remains inconclusive (Table 4). cell insulin sensitivity . This effect is expected to exert a
[75]
The previous research often featured non-randomized substantial impact, particularly on the reduction of body
study designs and provided short-term statistical fat mass, as evident in both obese and healthy subjects .
[12]
information, thereby presenting challenges in establishing The detection of HbA1c is widely acknowledged as
definitive conclusions. The sustained regulation of glycemia an efficient screening factor for identifying the risk of
stands as an important parameter for individuals with serious health problems associated with T2DM. The
T2DM and warrants both pharmaceutical intervention implementation of a low-carbohydrate diet plays a pivotal
and appropriate dietary considerations. Different diet role in influencing this characteristic across various
plans have been recommended for type 2 diabetes mellitus cases, indicating effective glucose management . Low-
[75]
(Table 5). The management of T2DM involves not only carbohydrate diets, characterized by a minimal percentage
the administration of oral anti-diabetic drugs but also of carbohydrates, have shown promise in improving blood
necessitates the inclusion of insulin therapy. sugar control. Notably, when adhering to a dietary regimen
A low-carbohydrate diet is anticipated to result in providing sugars in a proportion serving approximately 25%
substantial declines in insulin levels, potentially leading to of regular energy requirements, favorable and significant

Table 4. Studies on the effects of low carbohydrate diets in Type 2 diabetic patient

Duration Amount of fat intake Amount of carbohydrate intake Lipid profile HbA1c Body weight References
(per day, per diet, or limits) (per day, per diet, or limits)
24 weeks No data ≤20 g HDL ↑ + + [61]
6 months Fats account for nearly half of the 75 – 95 g HDL ↑ + + [62]
energy requirement of calories
consumed of 600 – 1800 kcal.
4 months No restrictions <20 g TRIGL ↓ + + [63]
14 months No restrictions 21 g TRIGL ↓ + + [64]
12 months No data ≤40 g No data + + [65]
8 weeks 30% of daily energy demand 25% of daily energy demand No data + + [66]
3 months 70 – 75% of fat 5% CHO (≤30 g/day) HDL↑TRIGL ↓ + + [67]
2 months 25 – 30% of fat 5 – 10% of CHO (≤ 25g/day) No data + + [68]
4 months 65% of fat <10% of CHO No data + + [69]
3 weeks 60 – 70% of fat 5 – 10% of CHO (≤40 g/day) HDL↑TRIGL ↓ + + [26]
12 months Protein 1.5 g/unit of body weight Individualized carbohydrate HDL↑TRIGL ↓ + + [70]
and by pleasure to fat restriction, resulting in a blood level
of 0.5 – 3.0 mM/L of βHOB.
12 months 28% protein, 58% fat CHO 14%, No data + + [71]
4 months 600 – 800 kcal/day, Protein: 0.8 – 1.2 g/kg of ideal body HDL↑TRIGL ↓ + + [72]
CHO <50 g weight; fat: 10 g of olive oil each day
12 months Hypocaloric. CHO 14% (50 g/d) Protein 28%, fat 58% (10% saturated HDL↑TRIGL ↓ + No data [73]
fat)
6 months Protein 1.5 g/unit of body weight CHO 20 g/day, total energy HDL↑TRIGL ↓ + + [18]
and by pleasure to fat 2200 kcal/day
Notes: ↑: Increase; ↓: Decrease; +: Positive impact; CHO: Carbohydrate; HbA1c: Glycohemoglobin; HDL: High density lipoprotein; TRIGL: Triglycerides.

Volume 2 Issue 4 (2023) 8 https://doi.org/10.36922/gtm.1361