The classical ketogenic diet (cKD) is a normocaloric, high-fat, very low-carbohydrate diet that induces ketosis, mimicking starvation state. The ketone bodies are alternative body fuel and they pass into the brain, replacing glucose as an energy source; for these reasons, it’s used as a recognised treatment for drug-resistant epilepsy (DRE), GLUT1 Deficiency Syndrome (GLUT1DS) and PDH deficiency, and it’s currently assessed for obesity, metabolic syndrome and type 2 diabetes. Glucose profile on patients treated with a long- term cKD has poorly investigated, so we evaluated the effect of a 12-months cKD on glucose metabolism of 29 children affected by DRE and GLUT1DS (mean age: 8.0 y, range: 0.5- 16.6 y; 17 females; 22 GLUT1DS), to determine fasting HOmeostatic Model Assessment- Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Index (QUICKI). BMI- zscore (-0.22±1.87 vs -0.38±1.39, P=0.453) and percentage of body fat (22.7±7.8 vs 22.2±1.3, P=0.488) didn’t change during the treatment. Children showed a not significant reduction in fasting blood glucose (84.9±1.6 mg/dl vs 80.8±1.6 mg/dl; P=0.085). However, fasting insulin significantly decreased (9.2±1.0 μU/mL vs 5.5±1.0 μU/mL; P=0.013), and both HOMA-IR and QUICKI indexes were significantly changed (2.0±0.2 vs 1.2±0.2; P=0.018; 0.51±0.00 vs 0.52±0.00; P=0.041, respectively). After 12 months of cKD, fasting blood glucose doesn’t change, but a significant improvement is observed in HOMA-IR and QUICKI indexes, corroborating our previously published data of short-term effect of cKD on glucose metabolism. These results suggest potential interesting implications of the KD in insulin metabolism alterations; however, long-term studies on adult patients are needed to confirm these adaptive metabolic changes during cKD.

Long-term effect of a classical ketogenic diet on glucose metabolism: A 12-months longitudinal study / R. De Amicis, A. Leone, A. Foppiani, C. Lessa, S. Ravella, A. Battezzati, S. Bertoli. - In: ACTA PHYSIOLOGICA. - ISSN 1748-1716. - 227:Suppl. 718(2019 Sep), pp. OP.102.44-OP.102.45. ((Intervento presentato al convegno Joint Meeting of the Federation of European Physiological Societies (FEPS) and the Italian Physiological Society (SIF) : September, 10th – 13th tenutosi a Bologna nel 2019.

Long-term effect of a classical ketogenic diet on glucose metabolism: A 12-months longitudinal study

R. De Amicis
;
A. Leone
Secondo
;
A. Foppiani;C. Lessa;A. Battezzati
Penultimo
;
S. Bertoli
Ultimo
2019

Abstract

The classical ketogenic diet (cKD) is a normocaloric, high-fat, very low-carbohydrate diet that induces ketosis, mimicking starvation state. The ketone bodies are alternative body fuel and they pass into the brain, replacing glucose as an energy source; for these reasons, it’s used as a recognised treatment for drug-resistant epilepsy (DRE), GLUT1 Deficiency Syndrome (GLUT1DS) and PDH deficiency, and it’s currently assessed for obesity, metabolic syndrome and type 2 diabetes. Glucose profile on patients treated with a long- term cKD has poorly investigated, so we evaluated the effect of a 12-months cKD on glucose metabolism of 29 children affected by DRE and GLUT1DS (mean age: 8.0 y, range: 0.5- 16.6 y; 17 females; 22 GLUT1DS), to determine fasting HOmeostatic Model Assessment- Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Index (QUICKI). BMI- zscore (-0.22±1.87 vs -0.38±1.39, P=0.453) and percentage of body fat (22.7±7.8 vs 22.2±1.3, P=0.488) didn’t change during the treatment. Children showed a not significant reduction in fasting blood glucose (84.9±1.6 mg/dl vs 80.8±1.6 mg/dl; P=0.085). However, fasting insulin significantly decreased (9.2±1.0 μU/mL vs 5.5±1.0 μU/mL; P=0.013), and both HOMA-IR and QUICKI indexes were significantly changed (2.0±0.2 vs 1.2±0.2; P=0.018; 0.51±0.00 vs 0.52±0.00; P=0.041, respectively). After 12 months of cKD, fasting blood glucose doesn’t change, but a significant improvement is observed in HOMA-IR and QUICKI indexes, corroborating our previously published data of short-term effect of cKD on glucose metabolism. These results suggest potential interesting implications of the KD in insulin metabolism alterations; however, long-term studies on adult patients are needed to confirm these adaptive metabolic changes during cKD.
Settore MED/49 - Scienze Tecniche Dietetiche Applicate
Settore BIO/09 - Fisiologia
https://onlinelibrary.wiley.com/doi/epdf/10.1111/apha.13366
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/676224
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