Ketogenic diet may show more promising results than Mediterranean diets in short-term type 2 diabetes management

In a recent article published in Metabolites, researchers evaluated the short-term impact of the very-low-calorie ketogenic diet (VLCKD) and Mediterranean diet (MD) on the gut microbiota (GM) of obese patients with new-onset type II diabetes (T2DM).

Study: Dynamics of Gut Microbiota and Clinical Variables after Ketogenic and Mediterranean Diets in Drug-Naïve Patients with Type 2 Diabetes Mellitus and Obesity. Image Credit: Foxys Forest Manufacture/Shutterstock


T2DM leads to increased mortality, especially from cardiovascular diseases (CVD),  with the main symptom being hyperglycemia. While genetic susceptibility predisposes people to develop T2DM, sedentary behavior, high-caloric, and poor eating habits also manifest as the loss of glycemic homeostasis, subsequently, obesity.

The presence of visceral and ectopic fat, assessed by body mass index (BMI) value, is associated with insulin resistance (IR), the basis of the T2DM pathophysiology. An increased release of leptin from excess fat promotes the loss of hypothalamic control over energy intake and expenditure and carbohydrate metabolism, with consequent alterations in endocrine-metabolic regulation and nutrient partitioning (NI). Most importantly, obesity increases Firmicutes/Bacteroidetes ratio and reduces the diversity of the GM, the bacterial community residing in the intestine, which has a link with the pathogenesis of IR and T2DM besides other disease states.

T2DM management requires a patient-centered approach, mainly focused on improving the quality of diets and the macronutrient source, together with physical activity and drug treatment. In recent years, scientific associations have developed various guidelines concerning the nutritional treatment of T2DM. Notably, the MD, which favors unprocessed vegetable foods and a reduction in red meats and industrial foods, without excluding any food category, is usually recommended. Recently, scientific societies have also begun to promote VLCKD that limits carbohydrates and then gradually re-introduces them, with a favorable outcome on body weight and metabolic parameters.

Studies have also linked GM modifications to obesity…

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