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A ketone monoester drink reduces postprandial blood glucose concentrations in adults with type 2 diabetes: a randomised controlled trial – published online 14/03/2024

Monteyne graphical abstract

Alistair J. Monteyne, Kaja Falkenhain, Gráinne Whelehan, Helena Neudorf, Doaa R. Abdelrahman, Andrew J. Murton, Benjamin T. Wall, Francis B. Stephens, Jonathan P. Little

Recent studies have demonstrated the utility of ketone monoester supplements at inducing physiological ketosis and lowering blood glucose levels following a meal. In this issue, Monteyne et al (https://doi.org/10.1007/s00125–024–06122–7) address whether pre-meal ketone monoester ingestion reduces blood glucose in individuals with type 2 diabetes. The authors found that oral ingestion of the ketone monoester (R)-3-hydroxybutyl (R)-3-hydroxybutyrate rapidly induced ketosis and significantly reduced post-meal blood glucose levels compared with a non-caloric placebo. This was predominantly due to a decrease in the rate that glucose from the meal, measured directly using a dual-glucose stable isotope tracer approach, appeared in circulation. The reduction in blood glucose levels with the ketone monoester occurred in concert with reduced circulating NEFA levels, but with no difference in circulating insulin between conditions. The authors conclude that these findings highlight a novel approach to mitigate postprandial glucose excursions, and underscore the therapeutic potential of ketone monoester supplements in type 2 diabetes management.

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