Examining the Effect of Exogenous Ketone Supplementation on Glucose Control in Type 2 Diabetes

Effect of 14 Days of Exogenous Ketone Supplementation on Glycemic Control in Type 2 Diabetes: a Randomized Placebo-controlled Crossover Trial

Ketone bodies are a fuel source and signaling molecule that are produced by the body during prolonged fasting or if an individuals consistently eats a low-carbohydrate "keto" diet. Blood ketones can be used as a source of energy by the body, but they may also act as signals that impact the functioning of different cells in the body. Recently, the availability of ketone supplements that can be taken orally allows for raising blood ketones without having to fast or eat a "keto" diet. The investigators' studies and those of other researchers have shown that ketone supplementation can lower blood sugar without having to make any other dietary changes. Oral ingestion of ketones may therefore be an effective strategy to improve blood sugar control and influence how cells function.

The main objective of this study is to determine if consuming a ketone supplement 3 times per day (before meals) for 14 days lowers blood sugar and impacts how the body's cells function. The results of this study will be used to guide future recommendations on the utility of ketone supplements for improving health in individuals with, or at elevated risk of, type 2 diabetes.

Inclusion Criteria:

• Have a type 2 diabetes diagnosis from a physician
• Have stable use of glucose-lowering medications for at least 3 months

Exclusion Criteria:

• Are a competitively trained endurance athlete
• Are actively attempting to gain or lose weight
• Have a history of mental illness or existing neurological disease(s), cardiovascular events (i.e., heart attack, stroke) in the last 2 years
• Have hypoglycemia, irritable bowel syndrome or inflammatory bowel disease
• Are currently using insulin or SGLT2 inhibitors
• Are using more than 2 classes of glucose-lowering medication
• Are currently following a ketogenic diet or taking ketone supplements
• Are unable to commit for a 29-day trial
• Are unable to follow a controlled diet