Table 3.

Studies of ketogenic diet in type 2 diabetes

Year and site of the study	Sample description	Intervention and duration	Study parameters	Results
Westman et al. 2008 USA	84 obese and type 2 diabetic community volunteers 18-65 years with BMI: 27-50 kg/m2	Randomly assigned LCKD and LGID Nutritional supplements and exercise recommended 24 weeks 49 (58.3%) completed study	HbA1c, fasting glucose, fasting insulin, weight loss, cholesterol	HbA1c, fasting glucose, fasting insulin, weight loss improved in both groups Significantly greater improvement among LCKD group in HbA1c (P=0.03) Body weight (P=0.008) HDL cholesterol (P<0.001) Reduced anti-diabetic drugs to 95.2% in LCKD group versus 62% in LGID group (P<0.01)
Dashti et al. 2007	64 healthy obese diabetic subjects	Study parameters determined before and at 8, 16, 24, 48 and 58 weeks after KD being administered	Body weight, BMI, blood glucose level, total cholesterol, LDL-cholesterol, triglycerides and urea	Significant reduction in body weight, BMI, blood glucose level, total cholesterol, LDL-cholesterol, triglycerides and urea from week 1-56 (P<0.0001) HDL-cholesterol increased significantly (P<0.0001) More significant results in subjects with hyperglycemia
Boden et al. 2005 University hospital	10 obese patients with type 2 DM	Inpatient comparison of 2 diets Usual diets for 7 days followed by KD for 14 days	Weight loss, 24-h blood glucose profiles, insulin sensitivity HbA1c, triglyceride and cholesterol levels	KD resulted in significant Spontaneous reduction in energy intake Weight loss Improved 24-h blood glucose profiles, insulin sensitivity, and HbA1c Decreased plasma triglyceride and cholesterol levels
Yancy et al. 2005 Durham VAMC clinic, USA	21 type 2 diabetic overweight participants 3 white, 8 African-American Mean±SD age 56.0±7.9 years BMI 42.2±5.8 kg/m2	LCKD counseling Medication adjustment 16 weeks	HbA1c, fasting serum triglyceride, drug dosage and waist measurement	HbA1c decreased by 16% Mean body weight decreased by 6.6% Fasting serum triglyceride decreased 42% Reduction in antihyperglycemic medications Positive effect on waist measurement
Gumbiner et al. 1996	13 obese patients with type 2 diabetes	7 patients treated with high-ketogenic VLED for 3 weeks 6 patients treated with low-ketogenic VLED for 3 weeks Patients crossed over and treated with alternate diet for another 3 weeks	Fasting and OGTT plasma insulin, C-peptide concentrations and HGO	Fasting and OGTT glycemia were lower during treatment with high-ketogenic VLED (P<0.05) Strong correlation between basal HGO and fasting plasma ketone bodies (P<0.05) No significant difference in weight loss, fasting and OGTT plasma insulin and C-peptide concentrations

VLED=Very low-energy diets, HGO=Hepatic glucose output, LCKD=Low carbohydrate ketogenic diet, KD=Ketogenic diet, LGID=Low-glycemic, reduced calorie diet, HDL=High-density lipoprotein, OGTT=Oral glucose tolerance test, VAMC=Veterans Affairs Medical Center, BMI=Body mass index, SD=Standard deviation, DM=Diabetes mellitus, LDL=Low-density lipoprotein, HbA1c=Glycosylated hemoglobin