Abstract The prevalence of type two diabetes (T2D) has been increasing sharply worldwide. Many recent studies have been done to determine the efectve strategies for beter management of type two diabetes. One of these strategies was the Ketogenic Diet, which when performed on rats and human showed very impressive results. The benefts of having some ketone bodies circulatng in the body have numerous benefts such as weight loss, improvement of HbA1c levels, reversal of nephropathy, cardiac benefts and treatment for dyslipidemia. Keywords: Ketogenic diet; Diabetes; Cardiology; Nephrology Introducton According to the latest data by the World Health Organizaton, approximately 366 million people will have diabetes by the year 2030 [1]. Several studies have shown a strong associaton between being overweight and the risk of developing diabetes. In fact, according to the US center for Disease control and Preventon, 85% of the diabetc patents are overweight and 55% are obese [2]. For weight loss, it became well known that the energy intake should be decreased and the energy expenditure should be increased. Several interventons have been proposed for decreasing energy intake such as bariatric surgeries, pharmacological usage, and decreasing caloric intake while enhancing energy expenditure to achieve weight loss [3]. Yet, recent studies showed that most of the obesity interventons tend to fail in the long term, especially those that have previously focused on reducing dietary fat [4]. However, recently, several studies have showed the benefts of ketogenic diet in overweight diabetc populaton [2-14]. This review will discuss the physiological foundaton of ketogenic diet and their efects on patents with type 2 diabetes. Discussion Physiological aspect of ketogenic diet Ketogenic diet is a diet that is very low in carbohydrates which results in high circulaton of ketone bodies in the body. Usually afer 3 days of fastng, or having a dietary intake of carbohydrates less than 20 grams per day, fat oxidaton through Krebs cycles will be stopped due to the lack of producton of oxaloacetate since glucose is needed with pyruvate carboxylase for the carboxylaton of pyruvic acid through ATP to produce oxaloacetate [4]. Moreover, the central nervous system requires glucose as an energy source and thus following a ketogenic diet will cause the need for an alternatve energy source which is derived from the overproducton of acetyl-CoA namely ketone bodies. Ketone bodies are made up of acetoacetate, B-hydroxybutric acid and acetone. This whole process occurs in the matrix of liver and is called ketogenesis. Under normal diet, the concentraton of ketones bodies is less than 0.3 mmol/l and ketone bodies will not be used as an energy source by the central nervous system untl this concentraton reaches 4 mmol/l, similar to the glucose concentraton. At that point, ketone bodies are then used as a source of energy by the all tssues. Specifcally, B-hydroxybutric acid is transformed into acetoacetyl-coA which is then transformed into two molecules of actely-coA which are used in Krebs cycle. The maximum ketone bodies concentraton in individuals following the ketogenic diet will reach to 8 mmol/l [4]. However, it is important to note that glucose is also formed from two sources: glycogenic amino acids and glycerol. In fact, afer few days of complete fastng, glycerol can produce around 60% of the body glucose [4]. Benefts of ketogenic diet with type 2 diabetes Several studies have shown the benefts of ketogenic diet for patents with type two diabetes, such as weight loss, reducing hbaA1c, reversing nephrology, cardiac benefts, improvement of lipid profle and even have potental efect on reversing diabetc neuropathy and retnopathy [5]. review iMedPub Journals http://www.imedpub.com/ . Sami T Azar * , Hanadi M Beydoun and Marwa R Albadri Department of Internal Medicine, Division of Endocrinology and Metabolism, American University of Beirut Medical Center, Lebanon * Corresponding author: Sami T Azar, Department of Internal Medicine, Division of Endocrinology and Metabolism, American University of Beirut Medical Center, Lebanon, Tel: 03534250; E-mail: sazar@aub.edu.lb Received date: March 01, 2021; Accepted date: March 14, 2021; Published date:March 22, 2021 Citation: Azar ST (2021) of Type 2 Diabetes Mellitus. J Obes Eat Disord 7: 2. Copyright: © 2021 Azar ST, et al. This is an open-access artcle distributed under the terms of the Creatve Commons Atributon License, which permits unrestricted use, distributon, and reproducton in any medium, provided the original author and source are credited. Obesity & Eating Disorders ISSN 2471-8203 Vol.7 No.2:4 2021 © Under License of Creative Commons Attribution 3.0 License | This article is available from: 10.4172/2471-8203.100022 1 Ketogenic Diet Role in Management of Type 2 Diabetes Mellitus Ketogenic Diet Role in Management