Yuan · Nutrition & diabetes 2020 · systematic review and meta-analysis · n=?

Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis.

Cited 256 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of clinical intervention studies.

PubMed 33257645 · doi:10.1038/s41387-020-00142-z · record verified 2026-08-29

What was done

A systematic review and meta-analysis using fixed-effects or random-effects models evaluated the average difference in glycemic, lipid, and weight outcomes before and after ketogenic diet intervention in patients with type 2 diabetes mellitus.

What was found

After the ketogenic diet, fasting blood glucose decreased by 1.29 mmol/L (95% CI: -1.78 to -0.79) and HbA1c decreased by 1.07 (95% CI: -1.37 to -0.78). For lipids, triglycerides decreased by 0.72 (95% CI: -1.01 to -0.43), total cholesterol decreased by 0.33 (95% CI: -0.66 to -0.01), low-density lipoprotein decreased by 0.05 (95% CI: -0.25 to -0.15), and high-density lipoprotein increased by 0.14 (95% CI: 0.03 to 0.25). In addition, body weight decreased by 8.66 (95% CI: -11.40 to -5.92), waist circumference decreased by 9.17 (95% CI: -10.67 to -7.66), and BMI decreased by 3.13 (95% CI: -3.31 to -2.95).

Why it matters

This review synthesizes quantitative evidence indicating that a ketogenic diet can improve glycemic control, lipid markers, and anthropometric measures in patients with type 2 diabetes.

Limits

The abstract does not report the number of included studies, total participant count, study designs, or duration of dietary intervention. The meta-analysis assessed pre-versus-post differences rather than controlled comparisons against standard diets. Units for several lipid and anthropometric measures were omitted from the abstract, and adverse events or long-term adherence were not reported.

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