A ketone monoester drink reduces postprandial blood glucose concentrations in adults with type 2 diabetes: a randomised controlled trial
dc.contributor.author | Monteyne, AJ | |
dc.contributor.author | Falkenhain, K | |
dc.contributor.author | Whelehan, G | |
dc.contributor.author | Neudorf, H | |
dc.contributor.author | Abdelrahman, DR | |
dc.contributor.author | Murton, AJ | |
dc.contributor.author | Wall, BT | |
dc.contributor.author | Stephens, FB | |
dc.contributor.author | Little, JP | |
dc.date.accessioned | 2024-05-21T13:16:08Z | |
dc.date.issued | 2024-03-14 | |
dc.date.updated | 2024-05-21T10:25:52Z | |
dc.description.abstract | AIMS/HYPOTHESIS: The aim of the present study was to conduct a randomised, placebo-controlled, double-blind, crossover trial to determine whether pre-meal ketone monoester ingestion reduces postprandial glucose concentrations in individuals with type 2 diabetes. METHODS: In this double-blind, placebo-controlled, crossover design study, ten participants with type 2 diabetes (age 59±1.7 years, 50% female, BMI 32±1 kg/m2, HbA1c 54±2 mmol/mol [7.1±0.2%]) were randomised using computer-generated random numbers. The study took place at the Nutritional Physiology Research Unit, University of Exeter, Exeter, UK. Using a dual-glucose tracer approach, we assessed glucose kinetics after the ingestion of a 0.5 g/kg body mass ketone monoester (KME) or a taste-matched non-caloric placebo before a mixed-meal tolerance test. The primary outcome measure was endogenous glucose production. Secondary outcome measures were total glucose appearance rate and exogenous glucose appearance rate, glucose disappearance rate, blood glucose, serum insulin, β-OHB and NEFA levels, and energy expenditure. RESULTS: Data for all ten participants were analysed. KME ingestion increased mean ± SEM plasma beta-hydroxybutyrate from 0.3±0.03 mmol/l to a peak of 4.3±1.2 mmol/l while reducing 2 h postprandial glucose concentrations by ~18% and 4 h postprandial glucose concentrations by ~12%, predominately as a result of a 28% decrease in the 2 h rate of glucose appearance following meal ingestion (all p<0.05). The reduction in blood glucose concentrations was associated with suppressed plasma NEFA concentrations after KME ingestion, with no difference in plasma insulin concentrations between the control and KME conditions. Postprandial endogenous glucose production was unaffected by KME ingestion (mean ± SEM 0.76±0.15 and 0.88±0.10 mg kg-1 min-1 for the control and KME, respectively). No adverse effects of KME ingestion were observed. CONCLUSIONS/INTERPRETATION: KME ingestion appears to delay glucose absorption in adults with type 2 diabetes, thereby reducing postprandial glucose concentrations. Future work to explore the therapeutic potential of KME supplementation in type 2 diabetes is warranted. TRIAL REGISTRATION: ClinicalTrials.gov NCT05518448. FUNDING: This project was supported by a Canadian Institutes of Health Research (CIHR) Project Grant (PJT-169116) and a Natural Sciences and Engineering Research Council (NSERC) Discovery Grant (RGPIN-2019-05204) awarded to JPL and an Exeter-UBCO Sports Health Science Fund Project Grant awarded to FBS and JPL. | en_GB |
dc.description.sponsorship | Canadian Institutes of Health Research (CIHR) | en_GB |
dc.description.sponsorship | Natural Sciences and Engineering Research Council (NSERC) | en_GB |
dc.description.sponsorship | Exeter–UBCO Sports Health Science Fund | en_GB |
dc.format.extent | 1107-1113 | |
dc.format.medium | Print-Electronic | |
dc.identifier.citation | Vol. 67(6), pp. 1107-1113 | en_GB |
dc.identifier.doi | https://doi.org/10.1007/s00125-024-06122-7 | |
dc.identifier.grantnumber | PJT-169116 | en_GB |
dc.identifier.grantnumber | RGPIN-2019-05204 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/135996 | |
dc.identifier | ORCID: 0000-0002-6019-6709 (Wall, Benjamin T) | |
dc.identifier | ORCID: 0000-0001-6312-5351 (Stephens, Francis B) | |
dc.identifier | ScopusID: 12779890700 (Stephens, Francis B) | |
dc.language.iso | en | en_GB |
dc.publisher | Springer | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/38483543 | en_GB |
dc.rights | © The Author(s) 2024. Open access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. | en_GB |
dc.subject | Carbohydrate metabolism | en_GB |
dc.subject | Clinical science | en_GB |
dc.subject | Human | en_GB |
dc.subject | Insulin resistance | en_GB |
dc.subject | Insulin sensitivity | en_GB |
dc.subject | Metabolic physiology in vivo | en_GB |
dc.subject | Nutrition and diet | en_GB |
dc.subject | Oral pharmacological agents | en_GB |
dc.title | A ketone monoester drink reduces postprandial blood glucose concentrations in adults with type 2 diabetes: a randomised controlled trial | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2024-05-21T13:16:08Z | |
dc.identifier.issn | 0012-186X | |
exeter.place-of-publication | Germany | |
dc.description | This is the final version. Available on open access from Springer via the DOI in this record | en_GB |
dc.description | Data availability: Data that support the findings of this study are available from the corresponding author on reasonable request. | en_GB |
dc.identifier.eissn | 1432-0428 | |
dc.identifier.journal | Diabetologia | en_GB |
dc.relation.ispartof | Diabetologia, 67(6) | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2024-02-01 | |
dc.rights.license | CC BY | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2024-03-14 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2024-05-21T13:11:02Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2024-05-21T13:16:53Z | |
refterms.panel | A | en_GB |
refterms.dateFirstOnline | 2024-03-14 |
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