The effect of acute and 14-day exogenous ketone supplementation on glycaemic control in adults with type 2 diabetes: two randomized controlled trials

Am J Physiol Endocrinol Metab. 2023 Nov 22. doi: 10.1152/ajpendo.00332.2023. Online ahead of print.ABSTRACTAcute ingestion of the exogenous ketone monoester supplement [(R)-3-hydroxybutyl-(R)-3-hydroxybutyrate] lowers blood glucose, suggesting therapeutic potential in individuals with impaired glucose metabolism. However, it is unknown how acute or repeated ingestion of exogenous ketones affect blood glucose control in individuals with type 2 diabetes (T2D). We conducted two randomized, counter-balanced, double-blind, placebo-controlled crossover trials to determine if (1) acute exogenous ketone monoester (0.3 g/kg body mass; N=18), or (2) 14-day thrice daily pre-meal exogenous ketone monoester (15 g; N=15) supplementation could lower blood glucose in individuals living with T2D. A single dose of the ketone monoester supplement elevated blood ß-OHB to ~2 mM. There were no differences in the primary outcomes of plasma glucose concentration (acutely) or serum fructosamine (glycaemic control across 14 days) between conditions. Ketone monoester ingestion acutely increased insulin and lowered non-esterified fatty acid concentrations; plasma metabolomics confirmed a reduction in multiple free fatty acids species and select gluconeogenic amino acids. In contrast, no changes were observed in fasting metabolic outcomes following 14 days of supplementation. In the context of these randomized controlled trials, acute or repeated ketone monoester ingestion in adults with T2D did not low...
Source: American Journal of Physiology. Endocrinology and Metabolism - Category: Physiology Authors: Source Type: research