Ketone supplementation dose‑dependently lowers postprandial blood glucose, lipid and ghrelin levels in individuals with type 2 diabetes: a randomised crossover study – Published online 28/11/2025

Maj Bangshaab, Mads B. Bengtsen, Stine Smedegaard, Esben Søndergaard, Niels Møller, Mads V. Svart, Nikolaj Rittig

Beyond their traditional association with insulin deficiency and prolonged fasting, ketones are increasingly recognised for their potential to improve metabolic control, suppress appetite, enhance cognitive performance and support cardiac function. In this issue, Bangshaab and Bengtsen et al (https://doi.org/10.1007/s00125-025-06614-0) demonstrate that ketone supplementation with β-hydroxybutyrate significantly attenuates postprandial blood glucose and lowers circulating NEFA and ghrelin concentrations in individuals with type 2 diabetes. These findings position ketone bodies as active regulators of postprandial substrate handling rather than passive by-products of altered fuel utilisation. The authors propose that, from a clinical perspective, ketone supplementation may represent a novel, insulin-independent strategy to attenuate postprandial hyperglycaemia—an unmet need particularly relevant for individuals with impaired endogenous insulin secretion. Improving hyperglycaemia and dyslipidaemia without increasing insulin exposure may potentially reduce hypoglycaemia risk, support weight management and improve cardiovascular risk.

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