Type 2 diabetes remission with very low-energy ketogenic treatment: a retrospective real-world study

Q2 Medicine
Daniela Sofra , Maitane Nuñez-Garcia , Ignacio Sajoux , Massimiliano Caprio , Francesca Amati
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引用次数: 0

Abstract

Aims

The role of Very Low-Energy Ketogenic Treatment (VLEKT) in managing type 2 diabetes mellitus (T2DM) remains underexplored. This retrospective, single-center study evaluated the effectiveness of a structured VLEKT protocol in achieving diabetes remission or improving glycemic control (reversal) in overweight and obese T2DM patients in a real-world setting.

Methods

Thirty-eight patients underwent a three-phase VLEKT intervention. The initial phase included three consecutive very low-energy ketogenic stages with calibrated meal replacements, aimed at reducing endogenous insulin secretion, stimulating lipolysis, and promoting fat loss. The second phase involved transitioning to a low-calorie diet and increased physical activity, followed by a maintenance phase to sustain metabolic benefits. Anthropometric data, HbA1c, and medication use were recorded at each visit.

Results

VLEKT significantly improved weight and glycemic control. After 6 months, 47.4 % of patients achieved diabetes remission, with 28.9 % maintaining remission at 2 years. Nearly half of the patients showed a trend toward remission within 3 months, based on early medication discontinuation and normalized glucose values, but this did not meet the formal criteria for remission. Shorter diabetes duration and fewer baseline glucose-lowering drugs predicted remission. The intervention also enabled sustained weight loss and reduced medication reliance over 18 months. Limitations include the retrospective design, small sample size, single-center scope, and potential selection bias due to self-funded participation.

Conclusion

VLEKT is a feasible, safe, and effective non-pharmacological approach to induce T2DM remission in routine clinical practice. These findings support integrating ketogenic nutritional protocols into multidisciplinary diabetes care, offering clinicians valuable alternatives to conventional drug therapies.

Abstract Image

低能量生酮治疗缓解2型糖尿病:一项真实世界的回顾性研究
极低能量生酮治疗(VLEKT)在2型糖尿病(T2DM)治疗中的作用仍未得到充分研究。本回顾性单中心研究评估了结构化VLEKT方案在现实世界中实现超重和肥胖T2DM患者糖尿病缓解或改善血糖控制(逆转)的有效性。方法38例患者接受三阶段VLEKT干预。初始阶段包括三个连续的低能量生酮阶段和校准的代餐,旨在减少内源性胰岛素分泌,刺激脂肪分解,促进脂肪减少。第二阶段包括过渡到低热量饮食和增加体力活动,随后是维持代谢益处的维持阶段。每次就诊时记录人体测量数据、糖化血红蛋白和药物使用情况。结果vlekt能显著改善体重和血糖控制。6个月后,47.4%的患者达到糖尿病缓解,28.9%的患者在2年内保持缓解。根据早期停药和正常血糖值,近一半的患者在3个月内出现缓解趋势,但这并不符合缓解的正式标准。较短的糖尿病病程和较少的基线降糖药物预测缓解。在18个月的时间里,干预还使体重持续下降,减少了对药物的依赖。局限性包括回顾性设计、小样本量、单中心范围和自费参与的潜在选择偏倚。结论在常规临床实践中,vlekt是一种可行、安全、有效的非药物诱导T2DM缓解方法。这些发现支持将生酮营养方案整合到多学科糖尿病治疗中,为临床医生提供了替代传统药物治疗的宝贵选择。
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来源期刊
Obesity Medicine
Obesity Medicine Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.50
自引率
0.00%
发文量
74
审稿时长
40 days
期刊介绍: The official journal of the Shanghai Diabetes Institute Obesity is a disease of increasing global prevalence with serious effects on both the individual and society. Obesity Medicine focusses on health and disease, relating to the very broad spectrum of research in and impacting on humans. It is an interdisciplinary journal that addresses mechanisms of disease, epidemiology and co-morbidities. Obesity Medicine encompasses medical, societal, socioeconomic as well as preventive aspects of obesity and is aimed at researchers, practitioners and educators alike.
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