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Sources of energy
hvmn.com/ketone-ester/science
Effect of exogenous ketones in prediabetes: A randomised controlled - - PowerPoint PPT Presentation
Effect of exogenous ketones in prediabetes: A randomised controlled - - PowerPoint PPT Presentation
Effect of exogenous ketones in prediabetes: A randomised controlled trial Sakina H Bharmal PhD candidate Sources of energy hvmn.com/ketone-ester/science Metabolism of ketone bodies Newman, J. C., & Verdin, E. (2014). Trends in
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Metabolism of ketone bodies
Newman, J. C., & Verdin, E. (2014). Trends in Endocrinology & Metabolism, 25(1), 42-52
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Ketosis
hvmn.com/ketone-ester/science
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Ketogenic diet Pros
Aids in glucose allostasis, weight loss, and neurological conditions
Cons
Increased levels of lipids Long adaption period Poor tolerance
Endogenous ketosis
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Exogenous ketones
hvmn.com/ketone-ester
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To investigate the effect of exogenous ketones on metabolic markers (such as pancreatic hormones, incretins, lipids) in adults with prediabetes
Project goals
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Cross-over randomisEd Trial of β-hydroxybUtyrate in prediabeteS (CETUS)
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Exclusion criteria
1)
Individuals with diabetes
2)
On insulin treatment
3)
On a ketogenic diet or consuming nutritional ketone supplements
4)
Involved in extensive endurance training or competitive athletics
5)
Pregnancy
6)
Malignant tumours Inclusion criteria
1)
Over 18 years
2)
Glycated haemoglobin 39-47 mmol/mol and/or fasting plasma glucose between 5.6-6.9 mmol/L
Participants
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Baseline characteristics
Characteristics Mean ± SD/ frequency Age (years) 55 ± 14 Sex Men 12 Women 6 BMI (kg/m2) 28.4 ± 5.9 Waist circumference (cm) 98.6 ± 15.8 Hip circumference (cm) 106 ± 13 Systolic blood pressure (mmHg) 135 ± 27 Diastolic blood pressure (mmHg) 88.1 ± 12.8 Glycated haemoglobin (mmol/L) 39 ± 0.3
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Clinical visit protocol
Participants (n=18) Baseline Blood samples at 30 minutes interval up to 150 minutes First clinical visit Second clinical visit Baseline bloods Ketone ester supplement/ Placebo Baseline bloods Baseline Ketone ester supplement/ Placebo Blood samples at 30 minutes interval up to 150 minutes Wash out period 7-10 days No exercise No alcohol No exercise No alcohol
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Primary aim: To investigate the effect of a single drink of ketone ester supplement on glucose levels in adults with prediabetes Secondary aim: To investigate its impact on pancreatic hormones and incretins
Study aims
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Area under the curve for the primary (i.e., glucose) and secondary (i.e., pancreatic hormones and incretins) endpoints
Paired t tests and Cohen’s effect size were calculated to difference in means of the endpoints after ketone supplement versus placebo
Repeated measures ANOVA was conducted to determine the change in endpoints over time and to measure the interaction between the drinks and time
Statistical methods
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Ketone levels
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Glucose levels
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AUC of pancreatic hormones and incretins
Hormones Placebo (n=18) KEβHB (n=18) p d Insulin (pmol/L) 28035 ± 6154 35189 ± 8732 0.02 0.61 C-peptide (nmol/L) 74 ± 8 100 ± 15 <0.01 0.89 Amylin (ng/L) 16859 ± 4203 17416 ± 4500 0.84 0.15 Glucagon (ng/L) 22994 ± 4890 22983 ± 4678 0.98 0.04 GIP (pmol/L) 1479 ± 146 1965 ± 242 <0.01 0.77 GLP-1 (pmol/L) 9643 ± 968 9679 ± 899 0.91 0.02
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Pancreatic hormones and incretins
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A single drink of ketone supplement lowers glucose levels by 14.5% in prediabetes
A statistically significant interaction effect (drink x time) was observed for insulin, C-peptide, and GIP
Summary
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