Walton · Journal of diabetes research 2019 · single-arm pre-post intervention · n=11

Improvement in Glycemic and Lipid Profiles in Type 2 Diabetics with a 90-Day Ketogenic Diet.

Cited 52 times in the scientific literature.

Level 4 - case-series / case-control

Uncontrolled single-arm case series evaluating pre-post dietary changes.

PubMed 31485454 · doi:10.1155/2019/8681959 · record verified 2026-08-29

What was done

Eleven women aged 18–45 with recently diagnosed type 2 diabetes (baseline mean BMI 36.3 kg/m² and baseline HbA1c 8.9%) volunteered for a 90-day dietary intervention restricting carbohydrate intake to under 30 grams daily. The primary outcome was the change in HbA1c; secondary outcomes were body weight, blood pressure, blood lipids, and liver enzymes (AST and ALT).

What was found

Over 90 days, participants lost weight (85.7 ± 3.2 kg to 76.7 ± 2.8 kg) and lowered systolic (134.0 ± 1.6 to 123.3 ± 1.1 mmHg) and diastolic (89.9 ± 1.3 to 82.6 ± 1.0 mmHg) blood pressure. Mean HbA1c dropped to 5.6%. HDL cholesterol increased from 43.1 ± 4.4 to 52.3 ± 3.3 mg/dl, triglycerides decreased from 177.0 ± 19.8 to 92.1 ± 8.7 mg/dl, and the TG:HDL ratio decreased from 4.7 ± 0.8 to 1.9 ± 0.2. LDL cholesterol showed no significant difference. AST and ALT (reported in 8 patients) showed no significant changes.

Why it matters

This paper demonstrates that a short-term, very-low-carbohydrate ketogenic diet can lower HbA1c below the diagnostic threshold for diabetes in newly diagnosed individuals alongside improvements in blood pressure and lipid profiles.

Limits

The study is an uncontrolled case series with a very small sample size (n = 11) restricted to adult females aged 18–45. Without a control group or dietary comparator, it is impossible to distinguish the specific effects of carbohydrate restriction from total caloric restriction, weight loss, or study participation effects. Long-term sustainability and outcomes beyond 90 days were not evaluated.

Cited by