Trial reportThe Journal of clinical endocrinology and metabolism2025
Beneficial Effects of Carbohydrate Restriction in Type 2 Diabetes Can Be Traced to Changes in Hepatic Metabolism.
Trial report in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Ketogenic Diet in Obesity and Diabetes: A Narrative Review.Nutrients · 2026Review
- Greater reduction in the proinsulin-C-peptide ratio with a ketogenic vs control diet in patients with type 2 diabetes.Journal of the Endocrine Society · 2026Article
- Divergent Liver and Kidney Metabolic Responses to Ketogenic, High-Fat, and Sucrose-Enriched Diets in Mice.Nutrients · 2026Article
- Low-Carbohydrate (Ketogenic) Diet in Children with Obesity: Part 2-Hormonal Effects of the Ketogenic Diet.Children (Basel, Switzerland) · 2026Article
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5 authors.
Funding
Abstract
contextCarbohydrate restriction benefits metabolic health in patients with type 2 diabetes (T2D), possibly through changes in hepatic metabolism.
objectiveTo test the hypothesis that the ketogenic diet (KD) would decrease de novo lipogenesis (DNL) and liver fat, which would be associated with restored beta-cell function.
methodsParticipants were 57 adults with mild T2D. A hyperglycemic clamp was used to assess acute C-peptide response (ACP), and magnetic resonance imaging to assess hepatic fat fraction, at baseline and after 12 weeks of either a eucaloric KD (∼9% energy from carbohydrate, 65% energy from fat) or a eucaloric low-fat diet (LFD) (∼55% energy from carbohydrate, 20% energy from fat).
resultsThe KD led to decreases in pyruvate (-23%, P < .001) and palmitoleic acid, a marker of DNL (-32%, P < .01). Participants on the KD had higher fasting glucagon (25%, P < .05) and lower liver fat (28%, P < .05) at week 12 than those on the LFD. In all combined, the change in liver fat was positively associated with the change in pyruvate (r = 0.45, P = .05), and inversely associated with changes in glucagon (r = -0.34, P < .05), the glucagon to C-peptide ratio (r = -0.44, P < .01), and ACP (r = -0.34, P < .05). The change in ACP was inversely associated with the change in pyruvate in the KD group (r = -0.5, P < .05), but not in the LFD group.
conclusionA shift in hepatic metabolism to favor fat oxidation over DNL may underlie the beneficial effects of carbohydrate restriction on hepatic steatosis and glucose-induced insulin secretion.
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