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Exogenous ketosis in patients with type 2 diabetes : safety and effect on glycaemic control
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Soto-Mota, Adrian, Norwitz, Nicholas G., Evans, Rhys, Clarke, Kieran and Barber, Thomas M. (2021) Exogenous ketosis in patients with type 2 diabetes : safety and effect on glycaemic control. Endocrinology, Diabetes & Metabolism, 4 (3). e00264. doi:10.1002/edm2.264 ISSN 2398-9238.
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WRAP-Exogenous-ketosis-patients-type-2-diabetes-glycaemic-control-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (525Kb) | Preview |
Official URL: https://doi.org/10.1002/edm2.264
Abstract
Introduction
Ketogenic diets have shown to improve glycaemic control in patients with type 2 diabetes. This study investigated the safety, tolerability, and effects on glycaemic control in patients with type 2 diabetes of an exogenous ketone monoester (KE) capable of inducing fasting-like elevations in serum β-hydroxybutyrate (βHB) without the need for caloric or carbohydrate restriction.
Methods
Twenty one participants (14 men and 7 women, aged 45 ± 11 years) with insulin-independent type 2 diabetes, and unchanged hypoglycaemic medication for the previous 6 months, were recruited for this non-randomised interventional study. Participants wore intermittent scanning glucose monitors (IS-GM) for a total of 6 weeks and were given 25 ml of KE 3 times daily for 4 weeks. Serum electrolytes, acid-base status, and βHB concentrations were measured weekly and cardiovascular risk markers were measured before and after the intervention. The primary endpoints were safety and tolerability, with the secondary endpoint being glycaemic control.
Results
The 21 participants consumed a total of 1,588 drinks (39.7 litres) of KE over the course of the intervention. Adverse reactions were mild and infrequent, including mild nausea, headache, and gastric discomfort following fewer than 0.5% of the drinks. Serum electrolyte concentrations, acid-base status, and renal function remained normal throughout the study. Compared to baseline, exogenous ketosis induced a significant decrease in all glycaemic control markers, including fructosamine (335 ± 60 μmol/L to 290 ± 49 μmol/L, p < .01), HbA1c (61 ± 10 mmol/mol to 55 ± 9 mmol/mol [7.7 ± 0.9% to 7.2 ± 0.9%], p < .01), mean daily glucose (7.8 ± 1.4 mM to 7.4 ± 1.3 mM [140 ± 23 mg/dl to 133 ± 25 mg/dl], p < .01) and time in range (67 ± 11% to 69 ± 10%, p < .01).
Conclusions
Constant ketone monoester consumption over 1 month was safe, well tolerated, and improved glycaemic control in patients with type 2 diabetes.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Diabetes -- Diet therapy, Acetonemia , Non-insulin-dependent diabetes | ||||||||
Journal or Publication Title: | Endocrinology, Diabetes & Metabolism | ||||||||
Publisher: | John Wiley & Sons | ||||||||
ISSN: | 2398-9238 | ||||||||
Official Date: | July 2021 | ||||||||
Dates: |
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Volume: | 4 | ||||||||
Number: | 3 | ||||||||
Article Number: | e00264 | ||||||||
DOI: | 10.1002/edm2.264 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 21 May 2021 | ||||||||
Date of first compliant Open Access: | 21 May 2021 | ||||||||
RIOXX Funder/Project Grant: |
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