Table 2.

Medical contraindications to VLCKD of ADI (Associazione Italiana di Dietetica e Nutrizione Clinica) and SIE (Società Italiana di Endocrinologia)

Contraindications
ADI	SIE
Pregnancy and lactation History of mental disorders and behavioral problems, abuse of alcohol and other substances Hepatic or renal failure Type 1 diabetes	Type 1 diabetes mellitus Latent autoimmune diabetes in adults β-Cell failure in type 2 diabetes mellitus Use of sodium/glucose cotransporter 2 (SGLT2) inhibitors (risk for euglycemic diabetic ketoacidosis) Pregnancy and breastfeeding Kidney failure and moderate-to-severe chronic kidney disease Liver failure Hearth failure (NYHA III–IV) Respiratory failure Unstable angina, recent stroke, or myocardial infarction (or myocardial infarction (or myocardial infarction (< 12 months) Cardiac arrhythmias Eating disorders and other severe mental illnesses, alcohol and substance abuse Active/severe infections Frail elderly patients 48 h prior to elective surgery or invasive procedures and perioperative period Rare disorders: porphyria, carnitine deficiency, carnitine palmitoyltransferase deficiency, carnitine-acylcarnitine translocase deficiency, mitochondrial fatty acid β-oxidation disorders, pyruvate carboxylase deficiency