Less Carbohydrate Intake Increases Serum Ketone Bodies in Low Carbohydrate Diet

Background: Discussion has continued for Calorie Restriction (CR) and low carbohydrate diet (LCD). We have investigated clinical research of LCD in various states for years. Case and results: The patient was 61 year-old female with HbA1c 10.5%, BMI 21.2 kg/m2 and normal vitals and physicals. Laboratory data were Hb 15.2 g/dl, Alb 5.0 g/dL, Triglyceride 43 mg/dL, HDL-C 89 mg/dL, LDL-C 152 mg/dL, immunoreactivity insulin (IRI) 2.9 μU/mL serum C-peptide reactivity (s-CPR) 1.0 ng/mL, total ketone bodies (T-KB) 3081 μmol/L (28-120), acetoacetic acid (AcAc) 300 μmol/L (14-68), 3-hydroxybutyric acid (3-OHBA) 2781 μmol/L (0-74) Autoantibodies were negative for Glutamate decarboxylase (GADA) or Islet cell (IA-2). She was diagnosed as type 2 diabetes mellitus (T2DM) and started super LCD formula meal with 12% of carbohydrate, and recorded carbohydrate amount about 20-40g per day. HbA1c value was 8.1% and 6.6% in 2 and 4 months, respectively. Significant relationship was shown between carbohydrate intake and hyperketonemia. AcAc/T-KB ratio was 15-20% and around 10%, when T-KB is less than 1000 μmol/L and more than 1000 μmol/L, respectively. Discussion and conclusion: Authors have proposed 3 types of LCD, which are petit, standard and super, with 40%, 26%, 12% of carbohydrate ratio. Continuing super- LCD usually brings elevated ketone bodies, which might have beneficial function for maintaining the health and anti-aging medicine. Currently obtained results would become the fundamental data and suppose future directions and recommendations for research of ketone bodies in low carbohydrate diet.