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Diabetes Mellitus Type 2 (DM2)/Adult Onset Diabetes
Published in Charles Theisler, Adjuvant Medical Care, 2023
Ketogenic Diet: Low-carbohydrate nutritional programs including ketosis reduce insulin resistance. A ketogenic diet was used to treat individuals with diabetes before the advent of insulin. The American Diabetes Association has updated its guidelines to include low-carbohydrate eating patterns for type 2 diabetes treatment. Results from several studies have shown positive outcomes.39 Additionally, preliminary results from the Indiana Type 2 Diabetes Reversal Trial involving 465 patients demonstrated reduced Alc levels, lower insulin resistance, lower insulin use or elimination, reduced need for medication across the board. Reversal of diabetes was achieved for 55% of patients who completed the low-carbohydrate diet patterns.39 Lowering a patient’s insulin resistance through a ketogenic diet may also help prevent or treat diabetic skin disease.40
Introduction and Method
Published in Christopher Cumo, Ancestral Diets and Nutrition, 2020
Chapter 10 indicates that aversion to fat is not universal. The Atkins and keto diets cause the body to metabolize fats, a process known as ketosis, by restricting carbohydrates. Ketosis produces ketones, which have the formula (CH2)#O, where # is a positive integer. Although ketones harm the body in excess, such diets remain trendy. “I’m going to rescue you from a lifetime of trying to avoid eating fat and cholesterol and prove how these delicious ingredients preserve the highest functioning of your brain,” wrote American neurologist David Perlmutter (b. 1954) in 2018.42 He asserted without evidence that evolution shaped humans to derive 75 percent of calories from fat—a claim scrutinized in Chapter 10—and that cravings for it prove its worth.43 Readers might test this logic by noting that cravings for nicotine do not demonstrate that tobacco benefits smokers. Chapter 10 examines claims for and against fatty foods.
Ketogenic Diets
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Douglas R. Nordli, Dorcas Koenigsberger, Joanne Schroeder, Darryl C. de Vivo
In plain terms a ketogenic diet is a high-fat, low-carbohydrate diet that produces ketosis. It has been used to treat refractory seizures for nearly 70 years, and it still enjoys widespread use in certain circumstances. This chapter is intended to serve as a practical guide to its use. As such, basic mechanisms underlying the efficacy of the diet will not be stressed, but instead, our attention will focus on the indications, administration, and practical tips that may be found helpful. It is the hope that this chapter will provide the readers with sufficient information that will allow them to confidently administer and monitor the ketogenic diet.
Evaluation of the point-of-care devices KetoSureTM and StatStrip Express® blood ketone tests using β-hydroxybutyrate spiked samples
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2022
Lise Nørkjær Bjerg, Henrik Holm Thomsen, Jeppe Buur Madsen, Birgitte Sandfeld-Paulsen
Diabetic ketoacidosis (DKA) is a serious acute complication to mainly type-1 diabetes that can be lethal if left untreated. DKA is characterized by insulinopenic hyperglycemia, metabolic acidosis and ketosis why precise and reliable monitoring of these parameters is key for optimal treatment of this condition [1,2]. Ketosis is characterized by elevated levels of the ketone bodies acetoacetate, acetone and β-hydroxybutyrate (BHB) in the blood [3]. Also, scientific interest in the application of exogenous ketoses as a therapeutic measure have gained traction in recent years underlining the importance of accurate quantification of BHB concentration [4]. Previously, ketosis was assessed by the nitroprusside test of acetoacetate in urine as a semiquantitative reflection of the average blood ketone concentration since last void. The collection of urine is cumbersome and, more importantly, only acetoacetate is estimated which substantially underestimates the degree of ketosis in DKA where ketosis is dominated by BHB over acetoacetate and the vaporizable acetone [3]. With the introduction of measuring BHB in the blood, the diagnostic certainty and quality of treatment improved owed to more timely and accurate measurements [5–10]. Hence, the use of BHB measured in the blood is now recommended as standard for DKA diagnosis and monitoring [11,12].
Considering safety and patient tolerance in the use of ketogenic diet in the management of refractory and super-refractory status epilepticus: a systematic review
Published in Expert Review of Neurotherapeutics, 2021
Blandine Dozières-Puyravel, Sophie Höhn, Stéphane Auvin
The second prospective study was conducted in children with refractory SE. The primary endpoint was the KD efficacy which was represented by the proportion of patients with electrographic seizure resolution within 7 days after the initiation of the KD [5]. This study was based on a cohort of 239 patients with RSE, including 14 patients treated by KD with a median age of 4.7 years. An enteral administration was used in 11/14 patients, while 3 patients had a parenteral administration at KD onset. The KD was started after a median of 13 days (IQR 12.5). Ketosis was achieved within a median of 2 days (IQR 2 days) using a 4:1 ratio at initiation in 8/14 patients. The final maximum KD ratio was 4:1 in 11/14 patients. The efficacy primary endpoint (seizure resolution observed on EEG) was reached in 10/14 patients within 7 days of KD initiation. Half of the patients (7/14) also received another treatment for RSE management. The KD was maintained after intensive care unit discharge in 8/14 patients concomitantly to anti-seizure medications (median of 5 (IQR 2)). Adverse events were reported in 3/14 patients and consisted in gastrointestinal events and hyperlipidemia.
Effect of a Free-Living Ketogenic Diet on Feasibility, Satiety, Body Composition, and Metabolic Health in Women: The Grading Level of Optimal Carbohydrate for Women (GLOW) Study
Published in Journal of the American College of Nutrition, 2021
Catherine Saenz, Stephanie Hooper, Terrance Orange, Ashlyn Knight, Martin Barragan, Tarah Lynch, Abigail Remenapp, Kevin Coyle, Carena Winters, Heather Hausenblas
Carbohydrate restriction is linked with a wide range of health improvements, with recent evidence highlighting its impact on metabolic health (13). Research related to carbohydrate restriction demonstrates consistent and uniform improvements in body composition and metabolic health factors including fasting blood glucose, blood pressure, triglycerides, and high-density lipoprotein (HDL) (14–16). Habitually consuming a ketogenic diet, or a high fat, moderate protein, very low carbohydrate diet, encourages individuals to reach nutritional ketosis. Nutritional ketosis is a natural, systemic phenomenon that occurs when dietary carbohydrate levels are reduced and the body turns to fat as its primary fuel source. The increased rates of fat oxidation produce higher levels of ketones, which are water-soluble byproducts of lipid metabolism. Growing research suggests reaching a state of nutritional ketosis, defined as 0.5–5.0 mmol/L leads to improvements related to metabolic health (17,18) and reduces the risk of developing downstream metabolic disorders such as cardiovascular disease, diabetes mellitus, and strokes (19).