Researchers tested whether combining a ketogenic diet (very low in carbs) with a diabetes medication called dulaglutide could help people with type 2 diabetes better than the medication alone. They studied 104 people with diabetes, splitting them into two groups: one taking just the medication, and another taking the medication plus following a ketogenic diet. After six months, the group combining both approaches had better blood sugar control, healthier cholesterol levels, and reported feeling better overall with improved sleep quality. This suggests that using diet and medication together might be more effective than relying on medication alone.

The Quick Take

  • What they studied: Whether adding a ketogenic diet (eating very few carbohydrates) to a diabetes medication helps people with type 2 diabetes control their blood sugar and cholesterol better than just taking the medication alone.
  • Who participated: 104 adults with type 2 diabetes were randomly assigned to two equal groups. One group took the medication dulaglutide alone, while the other group took the same medication but also followed a ketogenic diet.
  • Key finding: People who combined the ketogenic diet with their medication had significantly lower blood sugar levels, better cholesterol numbers, and improved how their bodies used insulin compared to those taking medication alone. They also slept better and reported better quality of life.
  • What it means for you: If you have type 2 diabetes, combining a low-carb diet with your current medication might help you manage your condition more effectively. However, you should always talk to your doctor before making major diet changes or starting any new treatment plan.

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of research studies. Researchers took 104 people with type 2 diabetes and randomly divided them into two groups to ensure fairness. One group (the control group) continued taking dulaglutide, a medication that helps control blood sugar. The other group (the study group) took the same medication but also followed a ketogenic diet, which means eating very few carbohydrates and more fats and proteins instead.

The study lasted six months, and researchers measured several important health markers at the beginning and end. They checked blood sugar levels, cholesterol and fat levels in the blood, how well the body’s insulin was working, sleep quality, and overall quality of life. By comparing the two groups, researchers could see whether the diet made a real difference when added to the medication.

This type of study design is valuable because randomly assigning people to groups helps reduce bias and makes it easier to determine whether the diet actually caused the improvements, rather than other factors.

Using a randomized controlled trial design is important because it helps prove cause-and-effect relationships. By comparing two similar groups where only one variable (the diet) is different, researchers can be more confident that any improvements in the diet group are actually due to the diet itself, not just chance or other factors. This type of evidence is what doctors rely on when deciding what treatments to recommend.

This study has several strengths: it used random assignment to create fair comparison groups, it had a reasonable sample size of 104 participants, and it measured multiple important health outcomes. However, the study was published in a regional journal rather than a major international journal, which may mean it received less rigorous peer review. The study duration of six months is moderate—longer studies would provide more confidence about lasting effects. The study doesn’t mention whether participants knew which group they were in, which could potentially influence results if they changed their behavior based on expectations.

What the Results Show

The main finding was that people combining the ketogenic diet with dulaglutide medication had significantly better blood sugar control than those taking medication alone. Their blood glucose levels were measurably lower after the six-month treatment period. Additionally, their cholesterol and fat levels in the blood improved more than the medication-only group.

Another important finding involved insulin, a hormone that helps the body use sugar. The combination group showed improved insulin sensitivity, meaning their bodies used insulin more efficiently. They also had lower insulin resistance, which is a key problem in type 2 diabetes. These improvements suggest the diet and medication work together to help the body handle blood sugar more naturally.

Beyond blood work, participants in the combination group reported better sleep quality and higher overall quality of life scores. This is significant because people with diabetes often struggle with sleep problems, and better sleep can improve overall health and help with weight management.

The study measured sleep quality using a standard assessment tool called the Pittsburgh Sleep Quality Index. The combination group had notably lower scores on this index, which means better sleep. This finding is particularly valuable because sleep quality directly affects how well the body manages blood sugar and maintains a healthy weight. The improved quality of life scores suggest that people felt better overall—not just in their medical numbers, but in how they felt day-to-day.

Previous research has shown that ketogenic diets can help with weight loss and blood sugar control in people with diabetes. Other studies have demonstrated that dulaglutide is an effective medication for managing type 2 diabetes. This research builds on that knowledge by testing whether combining these two approaches produces better results than either one alone. The findings align with the growing scientific understanding that combining lifestyle changes with medication often works better than relying on just one approach.

Several limitations should be considered when interpreting these results. First, the study only lasted six months, so we don’t know if these benefits continue long-term or if people can stick with the ketogenic diet over many years. Second, the study doesn’t clearly explain whether participants and researchers knew which group people were in, which could influence results. Third, the study was conducted in one location with a specific population, so results might differ in other groups or countries. Fourth, the study doesn’t provide detailed information about how strictly people followed the diet or whether some people dropped out. Finally, the journal’s impact factor wasn’t provided, suggesting it may not be a top-tier publication, which means the findings should be considered preliminary until confirmed by larger, more widely-recognized studies.

The Bottom Line

If you have type 2 diabetes, discuss with your doctor whether combining a ketogenic diet with your current medication might be appropriate for you. This research suggests moderate confidence that the combination approach may improve blood sugar control and overall health markers better than medication alone. However, ketogenic diets are restrictive and not suitable for everyone, so medical supervision is essential. Start any new diet only under your doctor’s guidance, especially if you take diabetes medications, as your medication doses may need adjustment.

This research is most relevant for adults with type 2 diabetes who are looking for ways to improve their blood sugar control beyond medication alone. It may be particularly interesting for people who struggle with sleep quality or have high cholesterol alongside their diabetes. However, this approach is NOT recommended for people with type 1 diabetes, pregnant women, people with a history of eating disorders, or those with certain liver or kidney conditions without medical supervision. Always consult your healthcare provider before making significant dietary changes.

Based on this study, you might expect to see improvements in blood sugar levels and cholesterol within a few weeks of starting the combination approach, with more noticeable changes by 3-6 months. Sleep quality improvements may appear within 2-4 weeks. However, individual results vary significantly, and some people may see benefits faster or slower than others. Sustainable weight loss and long-term health improvements typically take several months to become apparent.

Want to Apply This Research?

  • Track daily carbohydrate intake (aim for under 50 grams per day on a ketogenic diet) and record fasting blood sugar readings 2-3 times per week. Log sleep quality each morning using a simple 1-10 scale. This creates measurable data to show whether the combination approach is working for you.
  • Use the app to plan and log meals that fit the ketogenic diet guidelines (high fat, moderate protein, very low carbs). Set reminders to take your medication at the same time daily. Create a simple sleep tracking habit by logging bedtime, wake time, and sleep quality each morning to monitor improvements.
  • Establish a weekly review routine where you check trends in blood sugar readings, carb intake, and sleep quality. Share monthly summaries with your healthcare provider to ensure the approach is working safely for you. If blood sugar drops too low or medication side effects appear, alert your doctor immediately as medication adjustments may be needed.

This research summary is for educational purposes only and should not replace professional medical advice. Before starting a ketogenic diet or making changes to diabetes treatment, consult with your doctor or registered dietitian. Ketogenic diets can affect medication effectiveness, particularly diabetes medications, and may cause side effects in some people. This study is preliminary research with a moderate sample size and six-month duration; larger, longer-term studies are needed to confirm these findings. Individual results vary significantly based on genetics, lifestyle, and other health factors. Never adjust diabetes medications without medical supervision, as improper dosing can be dangerous.