The Ketogenic Diet and Low Carbohydrate in the Management of Diabetes in Adults with Type 2 Diabetes

This report discusses the benefits of ketogenic diet and low carbohydrate in managing type 2 diabetes in young adults. It highlights the importance of nutrition management and physical exercise in improving health outcomes. The study also explores the impact of ketogenic diet on blood sugar levels and insulin sensitivity. The research methodology used is systematic review.

The ketogenic diet and low
carbohydrate in the
management of diabetes in
adults with type 2 diabetes

ABSTRACT
Present report has discussed about the benefits of ketogenic diet, low carbohydrate and
nutrition management in lowering down the risk of type 2 diabetes in young adults. It has been
analysed that managing diet can assist young adults in overcoming issue of type of 2 diabetes. So
many of young adults in United Kingdom are being suffering from type 2 diabetes. In this the
patients have been engaged in changing their life style patterns. The patients’ needs to make sure
that adequate nutrition full diet is been consumed by them. They should also make sure that
proper physical exercise is been done by them and also they are not being engaged in consuming
alcohol. This has assisted in enhancing health outcome of patient and also their well-being is also
improved because of this. It has also been analysed from the research that ketogenic diet assists
in lowering down level of blood sugar. This has helped in reducing down the risk which is faced
by young adults in enhancing of type 2 diabetes. It lowers down the risk related to blood
pressure. It also assists in enhancing the insulin sensitivity. The methodology which has been
selected for research is systematic review. The articles have been reviewed based on subject
matter. It has also been analysed that for present report Boolean operator search strategy has
been used. This has assisted in getting relevant articles based on subject matter.

Contents
ABSTRACT.....................................................................................................................................2
INTRODUCTION TO REVIEW SUBJECT...................................................................................4
Aim and objectives......................................................................................................................5
Rationale for the present study ...................................................................................................5
METHODS......................................................................................................................................5
PRESENTATION OF RESULTS/FINDINGS...............................................................................7
DATA INTERPRETATION AND DISCUSSION ......................................................................19
CONCLUSION AND RECOMMENDATIONS..........................................................................21
REFERENCES..............................................................................................................................23
3

INTRODUCTION TO REVIEW SUBJECT
A ketogenic diet can assist patients with type 2 diabetes as it allows the body to maintain the
level of glucose at a low but at a healthy level (Webster and et.al., 2019). The lower intake of
carbohydrates in the diet can assist in eliminating the large chunk of blood sugar and lowering
down the need for insulin. This condition can be maintained by patient through consuming
healthy diet full of nutrition. A ketogenic diet is basically high fat, medium protein and low
carbohydrate diet which can assist in maintaining the blood sugar level inside patient’s body.
This assist in support level of blood sugar (Namazi, Larijani and Azadbakht, 2017). It has been
analysed that every person has different needs of diet. Health care professionals do not suggest
same diet to same individual as every person has different dietary needs. Evidence has provided
details that maintain adequate and proper diet can lower down risk related to diabetes in people
who do not have it yet. It also makes sure that glycaemic control can also be followed if the
patient is being engaged in following the proper diet (Chang, Borer and Lin, 2017). This diet can
assist people in improvising health and wellbeing. Body can be made slim when the patient with
type 2 diabetes is following this type of diet. It has also been analysed that ketogenic diet can
restrict down amount of carbohydrates. It assists in breaking down fats so that more and more
energy can be gained.
The procedure of making use of fat energy is basically known as ketosis. Studies has
provided evidence that ketogenic diet can assist in maintaining and controlling down the level of
HbA1c. It has been analysed that ketogenic diet can support in lowering down blood sugar level
and it can assist in reducing needs of taking medication for patients who are being suffering from
type 2 diabetes. Hypoglycaemia is a condition that appears when the blood sugar level lower
down to 70 milligrams (Sato and et.al., 2017). There are various signs and symptoms that can be
seen in patient who are being suffering from type 2 diabetes. This has lower down health
outcome of patient (Norwitz and Loh, 2020). The ketogenic diet also assists in lowering down
the body fat. It lowers down risk for those who are in stake of getting the type 2 diabetes. So this
diet needs to be maintained and followed by patients (Brouns, 2018). There are various benefits
of maintaining ketogenic diet. It lowers down the risk related to blood pressure. It also assists in
enhancing the insulin sensitivity. This type of diet also lower down the dependency on
medication which is really necessary so that health and well-being of patients can also be
enhanced and improved. Improvements in high-density lipoprotein (HDL) and good cholesterol
4

level can be maintained (Ebbeling and et.al., 2018). In this the patient will not face bad
cholesterol level which is really necessary for patient to be saved from type 2 diabetes.
Ketogenic diets are basically strict, but they provide patients with excessive nutrition. It has been
analysed that the carbohydrate diet ranges from 20gm-50gm. There are various side effects
which can be faced by maintaining the ketogenic diet. In this the person can be switched to
different type of energy, so short term side effects can be seen in the body. It can include keto-
flu, problems related to constipation, cramps in legs, mental fogginess, frequent urination. But
these side effects are temporary and it cannot be faced when maintained properly and adequately.
There are also long term side effects which can be faced by patients when they do not consult
their health care professionals for ketogenic diet. Patients can go through issue of kidney stones;
the low carb diet can also increase problem related to cardio-vascular disease (MEDICA, 2018).
A majority of health care professionals has prescribed ketogenic diet for lowering down effect of
diabetes. Management of nutrition can lower down this condition and also well-being can be
enhanced and improved by this. Several health full dietary patterns can assist in reducing the risk
related to and based on type 2 diabetes. In this the patient needs to be engaged in doing dietary
changes (Bando and et.al., 2017).
Ketogenic diet: A diet and all food products that consists low carbohydrate with high fat is
known as ketogenic diet and it is stated that it has similarities with low carbohydrate diet to some
extent. For this type of diet, people are asked about decreasing carbohydrate intake and replacing
it with fat (Burke, 2021).
As per the healthy and basic ketogenic guidelines, people need to consume food products
that have 75% fat, 10-30% protein and no more than 5% of Carbohydrate per day (Mawer,
2020). Mainly it can be said that it is all about having high fat of food products like meat, eggs,
dairy products and others.
Differences between a ketogenic and a low cho diet: In regard to low Carb diet it can
be said that it is the way of eating that restricts dietary carbohydrate that is being get from grains,
bread and sugar sweetened beverages. In low Carb diet, people can increase intake of protein,
healthy fat of products and vegetables for replacing Carbs (D’Abbondanza and et.al., 2020).
Ketogenic on the other hand is very low Carb with high fat diet. Overall it can be said that both
restricts carbs but to the varying. As compared to low Carb diet, Keto diet is more restrictive to
Carbs (Bolla and et.al., 2019).
5

Percentage of carbohydrate in Keto and low Carb diet: For ketogenic diet, 20-50
grams of Carbohydrate or less than 50 grams per day is allowed (Diet Review: Ketogenic Diet
for Weight Loss, 2021). Whereas, in low carbohydrate diet, less than 130 gram of carbohydrate
is allowed to intake per day (Kubala, 2020). So, from this variation in ketogenic and low Carb
diet it can be said that quantity of carbohydrate is the main difference.
Aim and objectives
The main aim and objective of the study is to analysing the impact of ketogenic diet in
adults and also to reduce the effect of type 2 diabetes through this. The objective of study is to
make adult patients aware about benefits of nutritional management and how their health
outcome can be improved by following this type of diet (Leow and et.al., 2018). The purpose
study is to lower down blood sugar level of adults so that no risk of type 2 diabetes is been faced
by them in future. The other goal is to educate patients about benefits of ketogenic diet.
Rationale for the present study
Type 2 diabetes is far more the most prevalent form of diabetes. In United Kingdom about
90% of people are suffering from type 2 diabetes and only 10% of them are suffering from type 1
(Bando and et.al., 2017). This type of diabetes is mainly seen in adults and also the most suffered
are young adults who are obese. It is necessary to make patients in UK aware and educate about
benefits of ketogenic diet. So that they can bring changes in their life style and risk of this type of
diabetes can be lower down (Masood, Annamaraju and Uppaluri, 2020). This will assist in
enhancing health outcome of patients.
METHODS
Search strategy used: The search strategy which is being used in present study is Boolean
operators. Boolean operators are the words "AND", "OR" and "NOT. In this all search terms are
being linked under one heading. It will assist researcher in finding out relevant data bases. This
strategy has assisted in finding out solution of adequate research problem. Better articles were
being able to be collected related and based on subject matter. It has assisted researcher in
gathering high quality of information which was really necessary (Norwitz and Loh, 2020). This
search strategy has assisted researcher in collecting the articles relevant to subject matter quickly.
In this initially 998 articles were being searched and from that relevant 7 articles have been
selected.
6

Data bases used: The data has been collected from PUBMED and Google scholar. In this
researcher has been able to collect high quality and relevant data which is required for systematic
review. In this the researcher has been able to collect high quality of biomedical literature.
Search terms used: There are various search terms which is being used for the present
research. It included nutritional diet, ketogenic diet, type 2 diabetes, nurses, health care
professionals, interventions, diabetes education, self-care, young adults, health outcome, well-
being, hospitals (Huntriss, Campbell and Bedwell, 2018).
Inclusion and exclusion criteria: For the present study there were also certain inclusion
criteria which were being followed. In this it included new articles, no older articles were being
selected for study. The articles based on English language were selected for study, no other
article was included. For more, young adults with type 2 diabetes were taken in order to make
them understand about Keto and low Carb diet. Quality appraisal is being also used for
systematically examining research and maintaining quality of the study. Helping out people
against resistance of insulin by body is the main aim of conducting and including all these.
Improved metabolism in young people with type 2 diabetes can be gain as outcomes.
In the exclusion criteria the articles which were published in other language were not
selected. Articles based on subject matter were only selected for study. Further articles published
in languages other than English were also excluded from the study. Another exclusion criterion
was based on the date of the published articles. The studies conducted before 2017 were
excluded from the study.
Inclusion criteria Exclusion criteria
Articles published in English language Articles published in languages other than
English
Studies published from 2017 onwards Studies published before 2017
Studies carried out on adults with type 2
diabetes
Studies conducted on adults with other
conditions
Studies conducted on adults Studies conducted on children
PICO question
P: young adults with type 2 diabetes
I: ketogenic diet and low carbohydrate diet
7

C: NA
O: Improved health outcome
The PICO question has provided details that young adults are suffering from type 2 diabetes an d
for improved health outcome, they need to follow ketogenic diet.
Data extraction and synthesis: In systematic review large amount of data is been extracted. The
data is being extracted from relevant studies and then the results are being compared (Klement,
2019).
Quality assessment: High quality of data is being collected so that better and adequate results
can be obtained.
8

PRESENTATION OF RESULTS/FINDINGS
Flow diagram including the data based search and number of articles selected
9

The above flow diagram has provided full details about the exclusion and inclusion criteria for literature search so that better and
adequate systematic review can be made. It is also being analysed from the above flow diagram that only 7 studies are been included
for review as it matches the subject matter selected for study. It is also being evaluated that initially 998 articles were being searched
on the subject matter. After that 650 articles were been removed for duplicate as they were not from the authentic and relevant
websites. After removing the duplicates and applying the assessors only 37 articles were selected for the study. From this the articles
which were excluded were 22. The eligible articles that were selected from the study was 15 and from it the 8 were being removed.
The studies that included were only 7. The articles were taken from authentic and relevant data bases. The articles selected were of
high quality and relevant. Also high quality of biomedical literature was being selected for the study. It was also being evaluated that
the inclusion and exclusion criteria was been followed throughout the review. It has assisted in analysing the articles.
Summary of each study
Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
Westman, E.C., Tondt,
J., Maguire, E. and
Yancy Jr, W.S., 2018.
Implementing a low-
carbohydrate, ketogenic
diet to manage type 2
diabetes mellitus.
Expert review of
endocrinology &
Aim
The aim of the
study was to
analyse impact of
ketogenic diet in
managing the
diabetes of type
2 among adults
Method
In this the method
used was
systematic review,
and also the expert
review was being
done in this type
of study.
The method of
data collection
was qualitative
in nature. It was
really easy and
reliable for
collecting the
data with this
type of method.
In this thematic analysis
was used for the study.
The main findings
were Ketogenic diet
has helped the obese
adults in lowering
down their weight
and also because of
this the risk of type
2 diabetes has been
lowered down.
10

Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
metabolism, 13(5),
pp.263-272.
Design
Descriptive
design is being
used in the
present study.
Size
In this study 25
obese adult was
included, who are
were in tightly
controlled diet.
Dashti, H.M., Mathew,
T.C. and Al-Zaid, N.S.,
2020. Efficacy of low
carbohydrate ketogenic
diet in the treatment of
Type 2 Diabetes.
Medical Principles and
Aim
The aim of this
meta-analysis
was to explore
the efficacy of a
low carbohydrate
ketogenic diet in
metabolic control
Method
The method which
was used included
meta-analysis. It
also included
randomized
controlled trial for
In this the data
was collected by
making use of
primary sources.
14 studies were included
in the present meta-
analysis. Through this
reliable and high quality of
data related to subject
matter was been collected.
The main findings
were that ketogenic
diet related to
substantial reduction
of weight. It has
assisted in
improvising and
enhancing the
11

Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
Practice. in patients
suffering from
type 2 diabetes.
analyzing the
impact of
ketogenic diet.
metabolic
dysfunction of obese
adults. The
metabolic
parameters have
been improved
because of ketogenic
and low
carbohydrate diet.
Design
Exploratory
design was being
used for the
present study.
Size
14 studies were
included and also
the patients with
diabetes were
being included in
the study.
Huntriss, R., Campbell,
M. and Bedwell, C.,
2018. The interpretation
and effect of a low-
carbohydrate diet in the
Aim
The aim of the
study was to
analyse the
Method
In this systematic
review was been
used for the study.
Primary as well
as secondary
sources were
used to collect
The analysis was done by
making use of meta-
analysis method. It assists
in getting the better end
The findings was in
taking better and
adequate diet has
assisted in lowering
down the risk related
12

Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
management of type 2
diabetes: a systematic
review and meta-
analysis of randomised
controlled trials.
European journal of
clinical nutrition, 72(3),
pp.311-325.
impact of low
carbohydrate diet
in managing the
type 2 diabetes
among adults
The study has also
made use the
randomized
controlled trial.
the data. results. to type 2 diabetes.
Design:
descriptive
design was being
used for the
present study
Size
Several studies
was included in
the present
analysis.
Sato, J., Kanazawa, A.,
Makita, S., Hatae, C.,
Komiya, K., Shimizu,
T., Ikeda, F., Tamura,
The aim of the
study was to
analyse the
impact of
For the present
study 33
participants were
selected for the
Exploratory
method was
being used for
the present
Statistical analysis was
being used in the present
study. It assists in making
sure that reliable and valid
It assists the patients
in managing the diet
and keeping in
control the type 2
13

Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
Y., Ogihara, T., Mita, T.
and Goto, H., 2017. A
randomized controlled
trial of 130 g/day low-
carbohydrate diet in
type 2 diabetes with
poor glycaemic
control. Clinical
nutrition, 36(4), pp.992-
1000.
carbohydrate diet
type 2 diabetes
with poor
glycaemic
controll.
study. research and
study.
data is been collected,
analysed and evaluated.
diabetes. This type
of diet has assisted
in improvising the
health and well-
being of patients
suffering from type
2 diabetes.
Design
Descriptive
design was being
used for the
study. It was
used to explain
the causal
relationship.
Size
comparative study
included 66
T2DM patients
with HbA1c
>7.5% even after
receiving repeated
education
programs on CRD.
Bando, H., Muneta, T.,
Bando, M. and Yonei,
Y., 2017. Effect of low
Aim
The aim is to
analyse the
Method
Randomized
controlled trial
Primary method
of data
collection is
The analysis is being done
by making use the
descriptive analysis, it has
In this the low
carbohydrate dietary
therapy was been
14

Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
carbohydrate diet on
type 2 diabetic patients
and usefulness of M-
value. Diabetes
Research: Open
Journal, 3(1), pp.9-16.
impact of low
carbohydrate diet
on managing the
patients who are
suffering and
going through
type 2 diabetes.
was used for the
present study, so
that cause and
effect relationship
can be established
effectively.
been used for
the study
assisted researcher in
knowing about the impact
of LCD.
given to patients
who were suffering
from type 2 diabetes.
It was being given
so that the diabetes
can be in controlled.
This assisted in
managing and
Design
In this present
research
exploratory
design is been
used so that the
end results can
be obtained.
Size
26 patients
suffering from
type 2 diabetes
were motivated to
take low
carbohydrate diet
for managing the
type 2 diabetes.
15

Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
Namazi, N., Larijani, B.
and Azadbakht, L.,
2017. Low-
carbohydrate-diet score
and its association with
the risk of diabetes: a
systematic review and
meta-analysis of cohort
studies. Hormone and
Metabolic Research,
49(08), pp.565-571.
Aim
The aim of the
study is to
analyse the
impact of low
carbohydrate diet
and lowering
down the risk of
type 2 diabetes.
Design:
Descriptive
design is being
used for the
present study.
Method
The method which
is used systematic
review and also
meta-analysis is
been used for the
present research. It
is the systematic
review for cohort
study.
Size: Several
studies were being
included in this
type of study.
The data is
being collected
from the
secondary
sources.
Meta-analysis method is
being used for the present
study.
The study has
provided the details
that LCD is useful in
lowering down the
risk related to
diabetes.
16

Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
Author/Year/Title Aim of the study
& design
Sampling method
and size
Data collection
method
Data analysis method Main findings
Webster, C.C., Murphy,
T.E., Larmuth, K.M.,
Noakes, T.D. and
Smith, J.A., 2019. Diet,
diabetes status, and
personal experiences of
individuals with type 2
diabetes who self-
selected and followed a
low carbohydrate high
fat diet. Diabetes,
metabolic syndrome
and obesity: targets and
therapy, 12, p.2567
The aim of the
study is to
control the status
of diabetes and
to increase the
personal
experience of
people who are
suffering from
type 2 diabetes.
The study took
place for a period
of six months and
several studies
were included in
the present study.
The sample size
taken for the
present study was
36. 10 randomized
trial and the 10
other systematic
review was being
done in the present
research and
study.
Primary data
was being
collected for the
present study. In
this the
systematic
review was also
been added on.
Thematic analysis was
being used for the present
study. In this the themes
were made for analyzing
the data.
The main findings
provided that the
personal experience
of people with type
2 diabetes has been
improved.
17

Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
Design: multi-
method descriptive
design study was
being used for the
study.
18

Presentation of the results and findings
Article 1: Westman, E.C., Tondt, J., Maguire, E. and Yancy Jr, W.S., 2018. Implementing a
low-carbohydrate, ketogenic diet to manage type 2 diabetes mellitus. Expert review of
endocrinology & metabolism, 13(5), pp.263-272. Accessed through : <
https://pubmed.ncbi.nlm.nih.gov/30289048/>
The aim of the article was to implement a low-carbohydrate and ketogenic diet so that the
type 2 diabetes can be managed. In the present article expert review was been done. It has been
analysed that the type 2 diabetes has reached out the epidemic proportions in the modern society.
For individuals who are been suffering from type 2 diabetes, it is really necessary for them to
follow the low carbohydrate ketogenic diet so that their well-being and health outcome can be
improved. It has been analysed that lowering down the intake of carbohydrate into a certain level
approximately upto 50g a day can assist in lowering down the risk related to diabetes mellitus.
The main findings were to make use of low-carbohydrate and ketogenic diet for lowering down
the weight and also to reduce down the risk of type 2 diabetes. It assists in improvising the
underlying resistance of insulin. The study provided that higher ketogenic diet and low-
carbohydrate can assist in managing T2DM.
Article 2: Dashti, H.M., Mathew, T.C. and Al-Zaid, N.S., 2020. Efficacy of low
carbohydrate ketogenic diet in the treatment of Type 2 Diabetes. Medical Principles and
Practice. Accessed through : < https://www.karger.com/Article/FullText/512142>
The above study has provided the details that low carbohydrate and ketogenic diet is useful
in treatment the type 2 diabetes. It is really essential to provide people at the risk of type 2
diabetes to give nutritional therapy. This review has laid emphasis on therapeutic effectiveness of
various diets and its impact on the managing risk related to the type 2 diabetes. It has also been
analysed that ketogenic diet related to substantial reduction of weight. It has assisted in
improvising and enhancing the metabolic dysfunction of obese adults. The metabolic parameters
have been improved because of consuming the low carbohydrate and ketogenic diet. The
introduction to the low carbohydrate diet has assisted in improvising the quality of life. The
efficacy related to low carbohydrate diet is high. This is because of the reason that it has assisted
in lowering down the risk related to diabetes. There are various types of food that were avoided
by participants so that their diet remains better and maintained (Hall and Chung, 2018).
19

Article 3: Huntriss, R., Campbell, M. and Bedwell, C., 2018. The interpretation and effect
of a low-carbohydrate diet in the management of type 2 diabetes: a systematic review and
meta-analysis of randomised controlled trials. European journal of clinical nutrition, 72(3),
pp.311-325. Accessed through : <https://pubmed.ncbi.nlm.nih.gov/29269890/>
In the present study a low carbohydrate diet was been followed so that wellbeing can be
enhanced. In this present article the method which was selected was randomized controlled trial.
Low carbohydrate diet is useful in management of the type 2 diabetes. It has been analysed that
the low carbohydrate diet can vary from person to person. It has also been evaluated that the
patients with type 2 diabetes are advised to put carbs in their diet so that their health well-being
and quality of life can be enhanced. The method which has been used is systematic review
randomized controlled trial. It has also been evaluated that for the present article the data bases
that are been used for collecting the data are MEDLINE, EMBASE, CINAHL. Reducing the
carbs in diet helps in making sure that risk related to type 2 diabetes is been lowered down. This
assists in making sure that patients well-being is been improved and also it helps in improvising
quality of life which is mandatory to be done.
Article 4: Sato, J., Kanazawa, A., Makita, S., Hatae, C., Komiya, K., Shimizu, T., Ikeda, F.,
Tamura, Y., Ogihara, T., Mita, T. and Goto, H., 2017. A randomized controlled trial of 130
g/day low-carbohydrate diet in type 2 diabetes with poor glycemic control. Clinical
nutrition, 36(4), pp.992-1000. Accessed through :
<https://pubmed.ncbi.nlm.nih.gov/27472929/>
In the present article randomized controlled trial is being done. The article has provided details
randomized controlled trial related to 130g/day of low carbs diet in management of type 2
diabetes with poor glycemic control is been done. In this the special emphasis is laid upon
improvising the poor glycemic control. It has also been analysed that personal nutritional
education is being given to patients so that they can be involved in maintaining the low carbs
diet. It has also been evaluated that it is also effective to given nutritional therapy for patients
suffering from type 2 diabetes.
Article 5: Bando, H., Muneta, T., Bando, M. and Yonei, Y., 2017. Effect of low
carbohydrate diet on type 2 diabetic patients and usefulness of M-value. Diabetes Research:
Open Journal, 3(1), pp.9-16 Accessed through : <
20

https://openventio.org/Volume3-Issue1/Effect-of-Low-Carbohydrate-Diet-on-Type-2-
Diabetic-Patients-and-Usefulness-of-M-Value-DROJ-3-130.pdf>
The low carbohydrate diet is being followed for several years, it has been analysed that this type
of diet is really useful in managing the type 2 diabetes and also it is useful for lowering down the
risk related to cardio-vascular disease. It has also been analysed that in the present article the low
carbohydrate dietary is been given to those individuals who is been suffering from type 2
diabetes. It was being provided so that the diabetes can be in controlled. This assisted in
managing and controlling the type 2 diabetes. It has also been analysed that so many hospital
care setting is being engaged in making use of this type of diet. The method which was been
used included M-value. It was an effective method for analysis of impact of type 2 diabetic
patients. The 12-day diet can assist in improvising the profile of blood glucose and this has
helped in keeping in control the diabetes of patients. It has also been analysed that patients who
are been suffering from diabetes (Chang, Borer and Lin, 2017). For analyzing the effectiveness,
the urine and blood sample from patient has been taken. The level of blood glucose was based on
M value. Ethical considerations were also being followed in present study which was been
necessary to be done. Research has given details that patients with type 2 diabetes is also been
able to slim together and also their blood sugar level can be lower down with the help of this.
Article 6: Namazi, N., Larijani, B. and Azadbakht, L., 2017. Low-carbohydrate-diet score
and its association with the risk of diabetes: a systematic review and meta-analysis of
cohort studies. Hormone and Metabolic Research, 49(08), pp.565-571. Accessed through : <
https://pubmed.ncbi.nlm.nih.gov/28679144/>
Association between the low carbohydrate diet and lowering down the risk of diabetes is being
analysed in this present systematic review. It has also been analysed that patients who are been
suffering from the diabetes type 2 is been engaged in following ketogenic diet in which there are
low carbs presented. This has assisted in enhancing quality of life and also well-being has been
enhanced. It has also been analysed that risk of diabetes has been lower by following the low
carb diet. It has also been analysed that the method which were been used for analysing was
meta-analysis.
Article 7: Webster, C.C., Murphy, T.E., Larmuth, K.M., Noakes, T.D. and Smith, J.A.,
2019. Diet, diabetes status, and personal experiences of individuals with type 2 diabetes
who self-selected and followed a low carbohydrate high fat diet. Diabetes, metabolic
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syndrome and obesity: targets and therapy, 12, p.2567 Accessed through : <
https://www.dovepress.com/diet-diabetes-status-and-personal-experiences-of-individuals-
with-type-peer-reviewed-article-DMSO>
In this present article the personal experience was been measured for the individuals who are
been suffering from the type 2 diabetes. In this the individual patient has been provided with low
carb diet so that the type 2 diabetes can be enhanced. It has also been analysed that this has
assisted in reducing down the low carbohydrate and high fat diet. It has assisted in supporting
patients with obesity.
DATA INTERPRETATION AND DISCUSSION
Summary of key findings
It is being summarised that lowering down the crab’s level such as 50g per day has
assisted in increasing the ketogenic so that the adequate fuel for the body is ben given. It has
been evaluated that low carbohydrate and ketogenic diet has led to making the patients slim and
is really useful in managing the diabetes. The ketogenic diet is really useful in lowering down the
glycaemic response. Evidence suggests that a better treatment can be taken for type 2 diabetes
and also the higher amount of carbohydrate must be included. The ketogenic diet can also assist
in lowering down the glycaemic response that comes up from dietary carbohydrate and also the
underlying insulin resistance gets improved (Westman and et.al., 2018).
It is also being summarised from the articles that the LCKD that is low carbohydrate
ketogenic diet is been used for treating the type 2 diabetes in adults and also it is useful in
lowering down the fat level of people. It has been found out that the diet has better impact in
lowering down body weight, level of glucose in body and is also useful in overcoming of
neurological disorders. This type of diet is being useful in lowering down the consumption level
of antidiabetic drugs and also the use of insulin for the type 2 diabetes patients can be lowered
down.
The role of low carbohydrate diet in management of diabetes is important as it assists in
reducing down the use of medications and also there can be seen clinical improvements in
patient health and wellbeing (Dashti, Mathew and Al-Zaid, 2020). It has also been evaluated that
the patients with type 2 diabetes are advised to put carbs in their diet so that their health well-
being and quality of life can be enhanced.
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It is also being found out that a low carb diet can lower down the risk of developing the
type 2 diabetes even if the patient does not manage to lose any kind of weight. Ketogenic and
low carbohydrate diet is also useful in lowering down the risk from getting a stroke and any type
of cardio vascular disease. It is also being evaluated and research has provided the details that
adults who are suffering from metabolic syndrome and type 2 diabetes shows improved results
by consuming the low carbs diet. By eating the low carbs diet patients are seen with improved
health measures.
The researchers have provided the evidence that the burning of fat efficiency increases
after consumption of low carb diet. It has shown the improvement in level of blood sugar. The
insulin resistance has been improved by consuming and in taking nutritious diet (Tay and et.al.,
2018). The blood sugar level of the people going through type 2 diabetes has been improved by
making their diet with low carbs and also making use of ketogenic diet. This has also assisted in
improvising health measures and well-being of patients suffering from type 2 diabetes. Research
has recommended to make use of ketogenic and low carbohydrate diet.
Interpretation of results
The popularity of low carbohydrate diet is being increasing among young patients who are
been suffering from type 2 diabetes. The results that were got after the conducting of this study
provided that participants were seen with reduced hunger and cravings which was one of the
most important thing for maintaining a better diet. Some of the participants which were included
also provided that they felt unsupported by their health care professionals. The result has
provided details that young adults were eager and had interest in managing ketogenic and low
carbohydrate diet. It is also being analysed that by maintain this type of diet they were able to
control eating and also it was easy to sustain. It was analysed that after the LCD there were
changes in energy level and negative acquaintances got lower down (Namazi, Larijani and
Azadbakht, 2017). These results were being interpreted from articles which were provided. It
was also being analysed that after consuming the ketogenic diet there were increased energy
level and the use of drugs and medication lower down.
Result is being taken from this systematic review that the people with type 2 diabetes are
seen with long term level of improvements which assists in managing the level of blood sugar.
The carbs which is been taken in the diet of young patients was 150g. It was being analysed that
there have been only 20% calories the carb intake. low carbohydrate dietary therapy was being
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given to patients who were suffering from type 2 diabetes. LCD is useful in lowering down the
risk related to diabetes. There are various types of food that were avoided by participants so that
their diet remains better and maintained. It has also been analysed that there is various type of
nutritional intake which was been taken by the participants, it has assisted them in lowering
down the risk related to heart stroke and any other kind of cardiovascular disease. There is also
various type of side effects which has been caused because of the ketogenic diet. The low carb
diet also has certain type of side effects. There are also long term side effects which can be faced
by patients when they do not consult their health care professionals for ketogenic diet. But the
impact of these side effects are not major. These diet has assisted in enhancing wellbeing and
health outcome of young adults.
Strengths: The greater type 2 diabetes strengths were being related to resilient outcomes. These
outcomes are beyond risk factors. The management of type 2 diabetes is difficult and also if
there is an inefficiency in management the quality of life can be lower down (Greene and et.al.,
2018).
Limitations: There were no potential conflicts of interest which were based on the articles
selected. There were also limitations related to type 2 diabetes pharmacotherapy. These were the
limitations.
CONCLUSION AND RECOMMENDATIONS
Conclusion: From the above study it has been summarised that ketogenic and low
carbohydrate diet is useful for managing the type two diabetes. The type 2 diabetic food plan
included strict meal plan such as brown rice, whole wheat, quinoa, oats, fruits and vegetables.
Patients are suggested to avoid the food such as sugar, pasta potatoes. It has been analysed that
the type 2 diabetes is been faced by people when there are issues in getting an adequate amount
of sugar. In this the body gets problems for having an adequate amount of sugar. This issue has
been clearly solved by consuming ketogenic and carbohydrate diet. It has been evaluated from
the research that the ketogenic diet has assisted the patients in maintain their glucose level. This
has improvised their well-being and enhance health outcome. Evidence has provided details that
patients with type 2 diabetes is also been able to slim together and also their blood sugar level
can be lower down with the help of this. Research has provided the details about the side effects
which can be faced because of following ketogenic and low carbohydrate diet for a long duration
of time. It has also been analysed from the research that ketogenic diet assists in lowering down
24

level of blood sugar. A majority of health care professionals has prescribed ketogenic diet for
lowering down effect of diabetes. Management of nutrition can lower down this condition and
also well-being can be enhanced and improved health outcome. It has also been analysed that
maintain the low carb diet also assists in lowering down the risk for heart disease. A low carb
diets assists in making sure that excessive carbs form diet is been removed and only healthy
ingredients are being consumed.
Recommendations: It is being suggested that in future the researcher can make use of
various other data bases such as MEDLINE, CINAHL for searching of relevant literature.
Instead of a systematic review, randomised controlled trial can also be used for the future
research. It is also recommended to make use of multi-institutional collaborations. Research
which will be conducted in future needs to be well funded so that the aim and objective related to
research can be achieved adequately (Carmen and et.al., 2020). Multi-disciplinary solutions must
be used for the present issue and problem. These recommendations will assist in making the
present research better. It is also being suggested to do the key planning and scientific evaluation
of disease so that better solution of problem can be brought up by them. The work must be
collaborated with multi-disciplinary focus on the sites of disease. It is also being suggested to
make use of more efficient and timely methods so that the research can be completed on time in
future. The case reports must be developed and should met the desired criteria. The consent form
of the patients’ needs to be shortened with the well described summary in it. It is mandatory to
do so for achieving objectives.
25

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