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

Le résumé fourni par la source

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 the patients showed a trend toward remission within 3 months, based on early medication discontinuation and normalized glucose values, but does 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.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.