Cardiovascular Disease, Diabetes

Impact of very low carbohydrate ketogenic diets on cardiovascular risk factors among patients with type 2 diabetes; GRADE-assessed systematic review and meta-analysis of clinical trials

Type 2 diabetes is a chronic illness that affects millions of people and dramatically increases their risk of cardiovascular disease. The rising prevalence of type 2 diabetes has led to increased research on lifestyle and dietary interventions, such as very-low-carbohydrate ketogenic diets (VLCKDs), to reduce cardiovascular disease risk.

A recent systematic review and meta-analysis of 29 clinical trials analyzed the impact of a ketogenic diet on cardiovascular risk factors in people with type 2 diabetes. The trials included both ad libitum and calorie-restricted interventions.

Adherence to VLCKDs led to the following results:

→ Significant reductions in fasting blood glucose, HbA1C, HOMA-IR index, and insulin concentration overall, although results varied among studies

→ Significant reductions in triglyceride levels across all studies

→ Significant reductions in HDL levels overall, although results varied among studies

→ Significant reductions in systolic blood pressure across all studies and diastolic blood pressure in some studies

→ Non-significant increases in LDL cholesterol levels, although results varied among studies

This review found that adherence to a very low-carbohydrate ketogenic diet improves glycemic control and reduces cardiovascular risk factors in people with type 2 diabetes. These findings suggest ketogenic diets may offer cardioprotective benefits, although further research is needed to confirm their long-term effects and sustainability.