▄ Animal test
The effect of the ketogenic diet on blood sugar is controversial. Domestic research has long believed that it is beneficial to glycemic control in diabetic patients. Chen Hao gave mice a ketogenic diet 4 days after monitoring their blood glucose changes
The blood glucose of mice after KD feeding was significantly lower than that of the control group (normal diet group). In a foreign country, a recent study analyzed the effects of KD on exercise rats and sedentary mice. Compared with other diets (standard feed), after 6 weeks, insulin levels were reduced by 80%, blood sugar was reduced by 50%, triglycerides were reduced by 55%, and cholesterol was reduced by 20%.
The activity did not bring benefits. However, animal experiments have shown that the mice have decreased glucose tolerance after 22 weeks of feeding KD. KD does not prevent beta-cell function decline, nor does it improve insulin secretion.
▄ Clinical observation
Studies have shown that limiting carbohydrate intake in patients with type 2 diabetes and metabolic syndrome can improve glycemic control, reduce insulin fluctuations, and its efficacy is at least comparable to that of low-fat diets, and fat-substituted carbohydrates are beneficial for cardiovascular disease. There is no significant correlation between weight loss from a low-carbohydrate diet. Limiting carbohydrate intake improves all characteristics of metabolic syndrome. We know that Asians consume more carbohydrates, so Asians' data on low-carb diets are more convincing. A total of 27,799 men and 36,875 women participated in a prospective study at the Japan Public Health Center. Five years later, the results showed that a low-carbohydrate diet was significantly associated with a lower risk of developing type 2 diabetes in women, while a high-fat, high-protein diet was Japanese women have protective factors for diabetes. Similarly, it is worth noting that during the obesity and diabetes epidemic, the proportion of saturated fat in men's diets fell by 14%. However, Delahant's data led to the opposite conclusion. In patients with type 1 diabetes, people who were independent of exercise and body mass index, high-fat, low-carbohydrate dietary intake, had higher glycated hemoglobin and poorer glycemic control.
A major feature of insulin resistance is the ability of the body to slow the liver's glucose output and the ability of muscle cells to withstand circulating glucose. Therefore, the fundamental problem with insulin resistance individuals is that a greater proportion of carbohydrates in the diet are converted to fat in the liver without being oxidized by the skeletal muscle into energy. Elements of lipid metabolism can promote cellular localization of glucose transporters, which can also alleviate certain inflammatory processes by blocking specific cytokines.
Some scholars believe that the physiological response to the strict control of the same diet has a wide heterogeneity. Inferred from mouse study data, genetic heterogeneity may be the basis for heterogeneity of dietary responses, and the health effects of dietary patterns depend on the genetic background. In addition, glucose cotransporter 2 (SGLT2) inhibitors also exhibit mild ketogenic effects by switching the regulation of glycolipid metabolism, and it is not recommended to receive KD at the same time.
Therefore, clinically, the dietary choices of diabetic patients should be more considering individual differences and treatment.
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