Search Strategy


Should a ketogenic diet (<50 g/day carbohydrate) be recommended for adults with type 2 diabetes?


MeSH Terms

Diet, ketogenic
Diet, carbohydrate-restricted
Diet, high-protein low-carbohydrate
Body weight
Weight loss
Diabetes Mellitus, Type 2
Glycated hemoglobin A


Text Words

Ketogenic diet
type 2 diabetes
low carbohydrate

DATABASES and Grey Literature Sources (e.g. international guidelines) Searched

PubMed, TRIP

Reasons for excluding reviews or studies identified using a hierarchical literature search

McArdle PD, Greenfield SM, Rilstone SK, Narendran P, Haque MS, Gill PS. Carbohydrate restriction for glycaemic control in Type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2019 Mar;36(3):335-348. doi: 10.1111/dme.13862. Epub 2019 Jan 3. Abstract available from:

This review did a subgroup analysis examining effects of a very low carbohydrate diet (20-50 g/day), but had limited patient important outcomes (i.e. reported only A1C and body weight).  

van Zuuren EJ, Fedorowicz Z, Kuijpers T, Pijl H. Effects of low-carbohydrate- compared with low-fat-diet interventions on metabolic control in people with type 2 diabetes: a systematic review including GRADE assessments. Am J Clin Nutr. 2018 Aug 1;108(2):300-331. doi: 10.1093/ajcn/nqy096. Abstract available from:
This review did not examine separately the effects of a very low carbohydrate diet.

Sainsbury E, Kizirian NV, Partridge SR, Gill T, Colagiuri S, Gibson AA. Effect of dietary carbohydrate restriction on glycemic control in adults with diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2018 May;139:239-252. doi: 10.1016/j.diabres.2018.02.026. Epub 2018 Mar 6. Abstract available from:
This review did not focus on ketogenic diet: it included only three of the trials in the ketogenic diet arm and did not give reasons for excluding the other trials reported in the included review.

DATE of Search

Date Search Completed: June 2019

Search Limits (e.g. date, language): English language, 2005+