Research

Hormonal

Sustained nutritional ketosis achieved through a continuous remote care intervention (CCI) involving carbohydrate restriction (<30g/day initially) leads to significant improvements in glycemic control, weight loss, and diabetes remission in Type 2 Diabetes patients over 2 years, while reducing medication dependence without adverse effects on bone health.

To manage Type 2 Diabetes long-term, consider a continuous care approach that includes nutritional ketosis. Start with less than 30g of carbs per day, aiming for a blood ketone level of 0.5-3.0 mmol/L. Work with a healthcare team to monitor your progress and adjust medications as needed. This approach has been shown to improve blood sugar, reduce weight, and even reverse diabetes in many cases over 2 years, without harming bone health.

ModerateSupportsMEDIUM confidence
The CCI group sustained long-term beneficial effects on multiple clinical markers of diabetes and cardiometabolic health at 2 years while utilizing less medication. The intervention was also effective in the resolution of diabetes and visceral obesity with no adverse effect on bone health.
Shaminie J. Athinarayanan et al. · Frontiers in Endocrinology · 2019

Why this rating

The study is a non-randomized, open-label, controlled trial with a relatively large sample size (262 CCI vs 87 UC) and long duration (2 years), but lacks randomization and blinding.

Source

Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial

Shaminie J. Athinarayanan et al. · Frontiers in Endocrinology · 2019

DOI 10.3389/fendo.2019.00348

cohort · n=349Cited 318×
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DOI resolved against Crossref · corpus check 2026-06-10

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