Italian Ketogenic Mediterranean Diet in Overweight and Obese Patients with Prediabetes or Type 2 Diabetes

obesity is a multifactorial disease strongly associated with insulin resistance and/or type 2 diabetes mellitus. correct nutrition represents a valid strategy to fight these dysmetabolic pathologies responsible for numerous diseases, including inflammatory and cardiovascular ones. medical nutrition therapy, including a mediterranean diet (MD) and a very low-calorie ketogenic diet (VLKCD), is the first-line treatment for prediabetes/diabetes and overweight/obesity. eighty patients (forty women and forty men) affected by overweight/obesity and type 2 diabetes mellitus or impaired glucose tolerance or impaired fasting glucose (51 (ys) +/- 1.75; BMI (kg/m(2)) 33.08 +/- 1.93; HA1c (%): 6.8% +/- 0.25) were enrolled at the University service of diet therapy, diabetology and metabolic diseases, policlinico riuniti Hospital of foggia, and subjected to a very-low-calorie mediterranean diet and a very-low-calorie ketogenic mediterranean diet for thirty days. both diets result in a marked decrease in body weight (kg) and BMI (kg/m(2)). at the same time, only the very-low-calories ketogenic mediterranean diet reduced waist and hip circumferences. both diets helped reduce fat mass, but a major loss was achieved in a very low-calorie ketogenic mediterranean diet. among gluco-metabolic parameters, only the very-low-calorie ketogenic mediterranean diet group showed a significant decrease in fasting blood glucose and HbA1c, insulin, C-peptide total cholesterol, LDL, and triglycerides. the results of our study seem to show that the very-low-calorie ketogenic mediterranean diet is a good strategy to improve rapidly metabolic, anthropometric, and body composition parameters in patients with prediabetes or diabetes and overweight/obesity.