08 Jan Could a Ketone Drink Help Keep Blood Sugar Under Control?

MedicalResearch.com Interview with:

Dr. Little

Jonathan P. Little PhD
Associate Professor Canadian Institutes of Health Research New Investigator
Michael Smith Foundation for Health Research Scholar
Faculty of Health and Social Development
School of Health and Exercise Sciences
The University of British Columbia Syilx Okanagan Nation Territory
Kelowna, BC  Canada

MedicalResearch.com: What is the background for this study?

Response: Ketones are energy-yielding molecules that are bodies naturally produce during periods of starvation or when we restrict carbohydrate intake. Recently, scientists from Oxford and the NIH have created exogenous ketone supplements, which now enable us to be able to drink ketones. This puts our body into a unique state – we can consume a drink that raises blood levels of ketones without having to starve or restrict carbohydrate intake. Some are even touting ketone supplements as a “fourth macronutrient”.

Ketone supplements are primarily marketed for athletes to provide an alternative fuel for improving endurance exercise performance. We were actually studying how ketone supplements impacted exercise performance when we noticed that they consistently lowered blood glucose after participants consumed them. We went to the literature and found some classic papers where it was shown that infusing ketones did in fact lower glucose and the mechanism seemed to involve reducing liver glucose output. This was very exciting to us because we also study type 2 diabetes, a condition where blood sugars are too high and elevated liver glucose output is one of the major reasons. So we came up with the hypothesis that ketone supplements might be a unique strategy to help with blood glucose control.

In the recent study, we tested this out in a randomized crossover experiment in 15 participants with overweight/obesity who were at risk for type 2 diabetes. Participants drank the ketone monoester supplement or a placebo and 30 minutes later they consumed an oral glucose tolerance test drink containing 75 grams of sugar. Blood samples were collected for 2 hours after the glucose test drink.

MedicalResearch.com: What are the main findings?

Response: We saw that the ketone supplement raised blood ketones very quickly. Within 15 minutes the blood ketone levels were similar to those you would find if you fasted for ~5 days – so the ketone monoester was very efficient at raising ketones. In line with our hypothesis, blood glucose levels were reduced 30 minutes after consuming the ketone supplement and then remained lower compared to placebo throughout the entire 2 hours after the glucose tolerance test. This occurred while insulin levels were similar in both ketone and placebo conditions, suggesting that the lowered glucose was not the result of increased insulin secretion and likely due to a direct effect of the ketones themselves. 

MedicalResearch.com: What should readers take away from your report?

Response: Because ketone supplements are so new, research is in its infancy on this topic. The fact that you can raise your blood ketones by consuming a drink is intriguing but it is a unique situation for our bodies. We don’t know what the long-term effects of this are, although published studies show that there are no seemingly negative effects of consuming them consistently for up to 28 days. I think the concept of ketone supplements, and our results, are intriguing but they should be taken in context. This was a small study that only looked at glucose levels for 2 hours after consuming a sugar drink so we don’t know what might happen over the longer term. The study was also done in people who were at risk for type 2 diabetes but they did not have clinically elevated blood sugar, so the findings may not extrapolate to people with diabetes. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We are currently working on longer term studies and research in people with type 2 diabetes in the lab. These are needed before we could ever recommend taking ketone supplements to help control blood sugar. Other potentially exciting research regarding ketone supplements is being done in the areas of Alzheimer’s disease/dementia, hunger/appetite, reducing inflammation, and improving exercise performance.

MedicalResearch.com: Is there anything else you would like to add?

Response:     Ketone supplements are relatively new and anecdotes greatly outweigh research evidence right now. It is intriguing to think that we can raise ketones by consuming a drink but we need more research to understand how these compounds impact our physiology.

Citation:

Étienne Myette-Côté, Hannah G Caldwell, Philip N Ainslie, Kieran Clarke, Jonathan P Little. A ketone monoester drink reduces the glycemic response to an oral glucose challenge in individuals with obesity: a randomized trial. The American Journal of Clinical Nutrition, 2019; 110 (6): 1491 DOI: 10.1093/ajcn/nqz232

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Last Updated on January 8, 2020 by Marie Benz MD FAAD