Cited by 115Diet and metabolism studiesDiabetes Management and ResearchDietary Effects on Health

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The glycaemic benefits of a very‐low‐carbohydrate ketogenic diet in adults with Type 1 diabetes mellitus may be opposed by increased hypoglycaemia risk and dyslipidaemia

Leow, Z. Z. X., Guelfi, K. J., Davis, E. A., Jones, T. W., Fournier, P. A.·2018·Diabetic Medicine

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Abstract

Aims: To investigate whether very‐low‐carbohydrate high‐fat diets, typical of ketogenic diets, can improve glycaemic control without causing any ill health effects in adults with Type 1 diabetes. Methods: In this observational study, 11 adults with Type 1 diabetes (seven men, four women, mean ± sd age 36.1± 6.8 years, mean ± sd duration of diabetes 12.8 ± 10.3 years), who followed a ketogenic diet (< 55 g carbohydrate per day) for a mean ± sd of 2.6 ± 3.3 years (β‐hydroxybutyrate 1.6 ± 1.3 mmol/l), underwent sampling and analysis of fasting blood, and were fitted with a blinded continuous glucose monitor for 7 days to measure glycaemic variability. Results: The mean ± sd HbA 1c levels were 35±4 mmol/mol (5.3±0.4%), and participants spent 74±20 and 3±8% of their time in the euglycaemic (4–8 mmol/l) and hyperglycaemic (>10 mmol/l) ranges, respectively, with little daily glycaemic variability (sd 1.5±0.7 mmol/l; coefficient of variation 26±8%). Blood glucose levels were <3.0 mmol/l for 3.6% of the time, and participants experienced a median (range) of 0.9 (0.0–2.0) daily episodes of hypoglycaemia. Total cholesterol, LDL cholesterol, total cholesterol/HDL cholesterol ratio, and triglycerides were above the recommended range in 82%, 82%, 64% and 27% of participants, respectively; however, HDL cholesterol levels were within the recommended range for all participants. Participants displayed no or little evidence of hepatic or renal dysfunction. Conclusion: This study provides the first evidence that, ketogenic diets in adults with Type 1 diabetes are associated with excellent HbA 1c levels and little glycaemic variability, but may also be associated with dyslipidaemia and a high number of hypoglycaemic episodes.

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Authors: Leow, Z. Z. X., Guelfi, K. J., Davis, E. A., Jones, T. W., & Fournier, P. A.
Affiliations: The University of Western Australia (AU)
The Kids Research Institute Australia (AU)
Corresponding author: Leow, Z. Z. X.
ORCID: Leow, Z. Z. X.
Guelfi, K. J.
Davis, E. A.
Jones, T. W.
Fournier, P. A.
Venue: Diabetic Medicine
Publisher: Wiley
Published: 2018-05-23
Volume: 35
Issue: 9
Pages: 1258-1263
ISSN: 0742-3071 (ISSN-L)
1464-5491
DOI: 10.1111/dme.13663
OpenAlex: W2799506931
Cited by: 115
References: 14
Citations by year: 2026: 9 · 2025: 12 · 2024: 18 · 2023: 13 · 2022: 15 · 2021: 13 · 2020: 17 · 2019: 14 · 2018: 4
FWCI: 8.23
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Diabetic Medicine (publishedVersion)
PubMed (publishedVersion)
UWA Profiles and Research Repository (UWA) (submittedVersion)
Funders: University of Western Australia
Topics: Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
Keywords: ketogenic diet, very low carbohydrate diet, type 1 diabetes, glycemic control, glycemic variability, hypoglycemia, dyslipidemia, lipid profile, continuous glucose monitoring, beta-hydroxybutyrate, liver and kidney function

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The glycaemic benefits of a very‐low‐carbohydrate ketogenic diet in adults with Type 1 diabetes mellitus may be opposed by increased hypoglycaemia risk and dyslipidaemia

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