A small 12-week study found that a very low-carbohydrate diet improved a marker of pancreatic beta-cell stress more than a low-fat diet, although larger and longer trials are needed.
A small clinical study suggests that a ketogenic diet may ease stress on the pancreas in some people with type 2 diabetes, offering a possible explanation for benefits that go beyond weight loss alone. Researchers at the University of Alabama at Birmingham and their collaborators reported in the Journal of the Endocrine Society that, over roughly three months, people on a very low-carbohydrate, high-fat diet showed a bigger improvement in a marker of beta-cell strain than those assigned to a low-fat diet. Beta cells are the insulin-producing cells in the pancreas that can struggle in type 2 diabetes.
The key measure was the ratio of proinsulin to C-peptide. Proinsulin is the precursor to insulin, and C-peptide is released when insulin is made. When that ratio is high, it can signal that beta cells are under pressure and are not processing insulin efficiently. In this study, the ketogenic group had a larger fall in that ratio, and the improvement tracked with better signs of insulin secretion, suggesting the cells may have been working more effectively.
The findings are modest but important because they point to a possible biological effect of carbohydrate restriction on pancreatic function, not just on body weight. The participants were 51 adults with relatively early type 2 diabetes, and the trial lasted only about 12 weeks. Both groups were meant to maintain weight, yet both lost some weight on average, which makes it harder to separate the effect of the diet itself from the effect of weight change. The researchers therefore said longer and larger studies are needed to see whether the same pattern holds over time and whether it translates into lower medication needs or remission.
The new report also fits into a broader body of evidence suggesting that very low-carbohydrate diets can improve blood sugar control in type 2 diabetes, although experts continue to stress that the long-term safety and sustainability of such diets still need more study. A separate systematic review in Diabetes, Obesity and Metabolism found that ketogenic eating patterns were linked with improvements in glycaemic control and body weight, but it also highlighted the need for further research on durability and safety. The latest study does not show that a ketogenic diet cures diabetes; rather, it adds to evidence that changing macronutrient balance may influence how hard the pancreas has to work.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
