Wonder If: PKT Long-term Data And Personalized Precise Definition Of PKT Diet Rx Can Address These Issues

February 18, 2024




Brief Guide to the Post:

–  Black text in box = words from other authors
–  (Green bold text in parenthesis in box = our words)

Link to full Guide to Wonderments blog

PKT Long-Term Data And Personalized Precise Definition Of PKT Diet Rx Can Address These Issues

This paper published in 2023 by a group of authors from the United Kingdom is an evaluation of ketogenic therapy for treatment of diabetes and raised urgent questions that must be addressed to adequately evaluate ketogenic therapy for any disease.

Does A Ketogenic Diet Have a Place Within Diabetes Clinical Practice? Review of Current Evidence and Controversies  

C. H. Firman, D. D. Mellor, D. Unwin and A. Brown

Diabetes Ther 2023 Pages 1-21  

Accession Number: 37966583 DOI: 10.1007/s13300-023-01492-4


In the abstract, the authors emphasize the critical importance of defining the diet prescription provided during ketogenic therapy.

Carbohydrate restriction has gained increasing popularity as an adjunctive nutritional therapy for diabetes management. However, controversy remains regarding the long-term suitability, safety, efficacy and potential superiority of a very low carbohydrate, ketogenic diet compared to current recommended nutritional approaches for diabetes management. Recommendations with respect to a ketogenic diet in clinical practice are often hindered by the lack of established definition, which prevents its capacity to be most appropriately prescribed as a therapeutic option for diabetes. Furthermore, with conflicted evidence, this has led to uncertainty amongst clinicians on how best to support and advise their patients. This review will explore whether a ketogenic diet has a place within clinical practice by reviewing current evidence and controversies.

The authors list 5 key Summary Points of their paperThe following last 2 points are copied in the text box below. 

There is an urgent unmet need for long-term data of health outcomes comparing conventional and ketogenic diets.
There remains an absence of a univocal definition of a ketogenic diet which continues to hinder research and clinical implementation of ketogenic for diabetes management.


  • Wonder if PKT data for patients receiving PKT for 2 to 20 years can be used as “long-term data of health outcomes” during ketogenic therapy even with the lack of a prospective randomized parallel conventional diet group? 
  • Wonder if different types of ketogenic therapy are needed for a range of physiological / pathophysiological situations and thus there needs to be a corresponding range of ketogenic diet prescriptions?  
  • Wonder if the PKT Diet Rx approach can be the first steps for an “univocal (I would have used the word unequivocal) definition of a ketogenic diet” for patients using ketogenic therapy to treat and/or prevent seizures? 
Post by Paige Applegate