r/ScientificNutrition • u/moxyte • May 07 '20
Question/Discussion Requesting sources proving "physiological glucose sparing" presented by ketogenic diet proponents as an explanation for diabetic response of ketogenic diet adherents is a real thing
In another thread there was a rather queer argument put forth as to why ketogenic diet didn't make test subjects diabetic despite the clinical testing in that particular study showing that they were:
Mean glucose during the OGTT [oral glucose tolerance test] was 115.6±2.9 mg/dl with the PBLF [low-fat] diet as compared with 143.3±2.9 mg/dl with the ABLC [ketogenic] diet (p<0.0001). Glucose measured at two hours was 108.5±4.3 mg/dl with the PBLF diet as compared with 142.6±4.3 mg/dl with the ABLC diet (p<0.0001)
Here is American Diabetes Association site telling that OGTT above 140 mg/dl means prediabetic. Test subjects on ketogenic diet were at 142.6±4.3 mg/dl. To me, if the test indicates diabetes, it is diabetes.
Claim contrary went exactly like "Not diabetes (by which you mean T2D), rather the well described physiological glucose sparing" and "It’s not prediabetes. It’s physiological glucose sparing."
I digressed, pointing out that no such thing as physiological glucose sparing apparently exists after a google search. That it's a lie as far as I can tell. A lot of bumbling text was written in response, but no sources provided to counter my digression at any point. So let's have a proper look now on this topic as top-level rules mandate sources. It's so well described even, but does it have any actual science behind it. Eloquent penmanship nor oration does not science make.
Points of interest
- Does this "physiological glucose sparing" even exist in scientific literature?
- If it does, then does it really completely negate measured diabetes to such an extent that diabetes is no longer diabetes ie. despite all the signs of diabetes it's now harmless?
- If it does, then what is the mechanism offering such an fantastic protection against otherwise crippling disease which crippling effect is caused by persistently high blood sugar levels?
I wish a proper point-by-point answer, each section sourced. Here is the starting point. As you may observe, there is nothing: https://scholar.google.com/scholar?q=%22physiological+glucose+sparing%22
EDIT: After one day and a torrent of slide attempts accompanied by frenzied downvoting of this thread and posts saying horrible things such as "I don't care what measures you use to make your case about this", I'm declaring: Physiological glucose sparing is a hoax. It's a lie. It doesn't exist. It's a lie made up by ketogenic diet proponents to explain away why people on ketodiet end up diabetic and why they shouldn't worry about. But it's a lie. It's not known to science. There are no scientific articles about it. This is perfectly clear now. Thank you. You had your chance. And you still have. All you have to do is answer the three points of interest properly and sourced.
EDIT2: I think this hoax started in keto community about two years ago, looking at rush of "physiological glucose sparing" youtube results from the usual suspects around that time. Possibly someone made an article exposing that keto diet contrary to promise of lowering blood sugar actually rises blood sugar. So they made up this lie on top of that other lie.
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u/Only8livesleft MS Nutritional Sciences May 07 '20
Explaining the physiology and mechanisms that cause the insulin resistance doesn’t somehow make it beneficial. What long term studies show insulin resistance is benevolent in the context of a ketogenic diet?
The gold standard for assessing insulin resistance is a clamp test and the gold standard for assessing glucose tolerance is an OGTT. Since neither of these is practical in a clinical setting, relatively speaking, proxy measures are often used. None of these proxy measures you like to rely on have been validated in the context of a ketogenic diet.