Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis

Nutr Diabetes. 2020 Nov 30;10(1):38. doi: 10.1038/s41387-020-00142-z.

Abstract

Background: At present, the beneficial effect of the ketogenic diet (KD) on weight loss in obese patients is generally recognized. However, a systematic research on the role of KD in the improvement of glycemic and lipid metabolism of patients with diabetes is still found scarce.

Methods: This meta-study employed the meta-analysis model of random effects or of fixed effects to analyze the average difference before and after KD and the corresponding 95% CI, thereby evaluating the effect of KD on T2DM.

Results: After KD intervention, in terms of glycemic control, the level of fasting blood glucose decreased by 1.29 mmol/L (95% CI: -1.78 to -0.79) on average, and glycated hemoglobin A1c by 1.07 (95% CI: -1.37 to -0.78). As for lipid metabolism, triglyceride was decreased by 0.72 (95% CI: -1.01 to -0.43) on average, total cholesterol by 0.33 (95% CI: -0.66 to -0.01), and low-density lipoprotein by 0.05 (95% CI: -0.25 to -0.15); yet, high-density lipoprotein increased by 0.14 (95% CI: 0.03-0.25). In addition, patients' weight decreased by 8.66 (95% CI: -11.40 to -5.92), waist circumference by 9.17 (95% CI: -10.67 to -7.66), and BMI by 3.13 (95% CI: -3.31 to -2.95).

Conclusion: KD not only has a therapeutic effect on glycemic and lipid control among patients with T2DM but also significantly contributes to their weight loss.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / analysis
  • Body Mass Index
  • Cholesterol / blood
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diet, Ketogenic / methods*
  • Female
  • Glycated Hemoglobin / analysis
  • Glycemic Control*
  • Humans
  • Insulin Resistance*
  • Lipid Metabolism*
  • Lipids / blood
  • Male
  • Middle Aged
  • Triglycerides / blood
  • Waist Circumference
  • Weight Loss

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Lipids
  • Triglycerides
  • Cholesterol