Evidence map›Paper›PMID 40448689›Full record

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.

Barbara A Gower, Marian L Yurchishin, Amy M Goss, John Knight, William T Garvey

Abstract readRandomized Controlled Trial
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Barbara A GowerDepartment of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA.ORCID 0000-0001-8461-4613
Marian L YurchishinDepartment of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA.ORCID 0000-0003-1544-6841
Amy M GossDepartment of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA.ORCID 0000-0001-8772-2935
John KnightDepartment of Urology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA.ORCID 0000-0002-9683-8064
William T GarveyDepartment of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA.ORCID 0000-0003-0822-0860

Funding

Why is the prevalence of obesity so high in U.S. Southern States? Regional predictors of BMI and obesity treatment response.P30DK056336 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI James O Hill · 2000 to 2026
$31.9M
University of Alabama at Birmingham's Diabetes Research CenterP30DK079626 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Stuart J Frank · 2013 to 2026
$19.5M
UAB Pre-Doctoral Training Program in Obesity-Related ResearchT32HL105349 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI BARBARA A GOWER · 2010 to 2026
$5.7M
Depletion of pancreatic lipid improves beta-cell function in early type 2 diabetesR01DK116726 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GARVEY, W TIMOTHY, GOWER, BARBARA A · 2018 to 2022
$2.7M
Oxalate formation from ascorbic acidR01DK126774 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI KNIGHT, JOHN · 2021 to 2024
$2.5M
NHLBI NIH HHS T32 HL105349NIDDK NIH HHS P30 DK056336NIDDK NIH HHS P30 DK079626NIDDK NIH HHS R01 DK116726NIDDK NIH HHS R01 DK126774NIH HHS R01DK116726NIH HHS T32HL105349UAB Diabetes Research Center P30DK079626UAB Nutrition Obesity Research Center P30DK56336
6 · The paper itself

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.

Indexed as

Diabetes Mellitus, Type 2Diet, Carbohydrate-RestrictedDiet, KetogenicLiverAdultAgedC-PeptideDiet, Fat-RestrictedFemaleGlucagonGlucose Clamp TechniqueHumansLipogenesisMagnetic Resonance ImagingMaleMiddle AgedC-PeptideGlucagonbeta-cellde novo lipogenesisketogenic dietliver fatpyruvatetype 2 diabetes

Identifiers

PMID40448689
PMCPMC12712994

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.