The potential application of a ketogenic diet in type 1 diabetes mellitus and multiple sclerosis

Ketogenic diets, which are characterized by high fat, moderate protein, and very low carbohydrate intake, have attracted increasing interest because of their potential functional relevance to metabolic and neuroimmune regulation. Available evidence suggests that ketogenic diets may modulate inflammatory and immune-related pathways and alter the composition of the gut microbiota. In individuals with type 1 diabetes mellitus, ketogenic dietary approaches have been associated with glycaemic stability, body weight regulation, and potential effects on mood- and cognition-related outcomes. In patients with multiple sclerosis, ketogenic diets may be associated with changes in sleep quality, gut microbial fermentation, muscle-related outcomes, and neuroprotective processes. Evidence from small and observational studies suggests potential associations between ketogenic dietary approaches and quality-of-life– related outcomes in patients with type 1 diabetes mellitus and multiple sclerosis; however, the current findings remain preliminary and are insufficient to establish efficacy and safety. • Ketogenic diets are explored as adjunctive nutritional strategies in T1DM and MS. • The potential intervention of KD in T1DM and MS by modulating the immune response. • Human evidence for ketogenic diets in T1DM and MS remains limited and exploratory.