The effect of the ketogenic diet on HbA1c levels in type 2 diabetes mellitus patients and its correlation with dental caries

Background: Diabetes mellitus (DM) is currently a significant global health concern and a leading cause of illness and death. The prevalence of diabetes in adults is estimated to have exceeded three hundred million and is projected to increase by 55% by 2035. The ketogenic diet has been confirmed to increase insulin sensitivity in type 2 diabetes mellitus (T2DM) sufferers. 

Purpose: To explain the effect of a ketogenic diet on HbA1c levels in patients with T2DM and provide an overview of its correlation with dental caries. 

Discussion: Carbohydrate restriction in the ketogenic diet triggers the mechanism of gluconeogenesis and ketogenesis in the liver and changes the pattern of energy supply to be based on ketone bodies. There is a significant relationship between the risk of dental caries and fasting blood glucose levels as well as HbA1c and salivary glucose. One study showed that T2DM sufferers who had HbA1c ≥ 8.0% had more dental caries than those who had HbA1c 7.0%–7.9%. 

Conclusion: A reduction in HbA1c levels resulting from a ketogenic diet intervention may be linked to a lower risk of dental caries in patients with T2DM. However, additional studies are necessary to explore the direct impact of the ketogenic diet on the risk of dental caries in these patients.