Impact of Ketogenic Diet and Low Carbohydrate on Type 2 Diabetes

This report presents a systematic review analyzing the impact of ketogenic and low-carbohydrate diets on the management of type 2 diabetes in adults, particularly focusing on young adults. The research explores the benefits of dietary management in improving health outcomes, including blood sugar control, insulin sensitivity, and potential reductions in medication dependency. The methodology involves a review of articles using Boolean operators and databases such as PubMed and Google Scholar. The report includes a flow diagram illustrating the selection process and presents key findings, discussing the differences between ketogenic and low-carb diets, and the rationale for their use. The study aims to educate patients about the benefits of ketogenic diets and to lower the risk of type 2 diabetes through nutritional management, ultimately aiming to improve the overall health and well-being of individuals affected by this condition. The report also acknowledges the potential side effects of ketogenic diets and emphasizes the importance of consulting healthcare professionals.

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
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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. 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. 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. 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 level can be maintained.
In this the patient will not face bad cholesterol level which is really necessary for patient to be
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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. 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).
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. 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
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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.
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.
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.
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. Mainly it can
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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.
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).
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. Whereas, in low carbohydrate
diet, less than 130 gram of carbohydrate is allowed to intake per day. So, from this variation in
ketogenic and low Carb diet it can be said that quantity of carbohydrate is the main difference.
PICO question
P: young adults with type 2 diabetes
I: ketogenic diet and low carbohydrate diet
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.
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PRESENTATION OF RESULTS/FINDINGS
Flow diagram including the data based search and number of articles selected
8

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 (Webster and et.al., 2019). 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
Aim
The aim of the
study was to
analyse impact of
ketogenic diet in
managing the
diabetes of type
Method
In this the method
used was
systematic review,
and also the expert
review was being
done in this type
The method of
data collection
was qualitative
in nature. It was
really easy and
reliable for
collecting the
data with this
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
9

Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
endocrinology &
metabolism, 13(5),
pp.263-272.
2 among adults of study. type of method. lowered down.
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
Method
The method which
was used included
meta-analysis. It
also included
randomized
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
10

Author / Year / Title Aim of study &
Design
Sampling Method
and size
Data Collection
method Data Analysis method
Main Findings
( related to your
question)
Practice. metabolic control
in patients
suffering from
type 2 diabetes.
controlled trial for
analyzing the
impact of
ketogenic diet.
enhancing the
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-
Aim
The aim of the
study was to
Method
In this systematic
review was been
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
11

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 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.
analyse the
impact of low
carbohydrate diet
in managing the
type 2 diabetes
among adults
used for the study.
The study has also
made use the
randomized
controlled trial.
the data. results. down the risk related
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,
The aim of the
study was to
analyse the
For the present
study 33
participants were
Exploratory
method was
being used for
Statistical analysis was
being used in the present
study. It assists in making
It assists the patients
in managing the diet
and keeping in
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