Trial reportDiabetologia2026

Ketone supplementation dose-dependently lowers postprandial blood glucose, lipid and ghrelin levels in individuals with type 2 diabetes: a randomised crossover study.

Maj Bangshaab, Mads B Bengtsen, Stine Smedegaard, Esben Søndergaard, Niels Møller, Mads V Svart, Nikolaj Rittig

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Diabetologia, 2026. The graph read 1 number from its abstract, feeding 1 cell of the map: it supports the treatment in 1. It is linked to 2 registered trials, which are not on this map. Not yet cited in PubMed.

1number the graph read from it
1cell of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
-57.00 · no effect
Glycemic controlfavours the treatment · against placebo · t2d, dyslipidemiafeeds one cell of the map
decrease -36.0-57.0 to -14.0
RESULTS: We found that the iAUC for glucose decreased by 36% (95% CI 14, 57) with KE and 22% (95% CI 1, 44) with KS compared with placebo.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Metformin×glycemic control

SupportsOpen on the map →What to test next →

40 readable studies in this cell: 41 favour the treatment, 12 find no difference, 8 favour the comparator.

Belief with this paper
0.84replicated · 32 families support, 6 contradict · against placebo
Without it
0.84This paper does not move the number.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 2026
decrease -36.0-57.0 to -14.0
NCT017190031,413 enrolled · 2012
Adjusted mean -0.72-0.95 to -0.48
NCT018093271,186 enrolled · 2013
Δ -0.40-0.59 to -0.21
NCT022730501,136 enrolled · 2014
Δ -0.89-1.08 to -0.69
NCT008598981,093 enrolled · 2009
Δ -0.53-0.74 to -0.32
Δ -0.85-43.8 to 26.7
NCT00643851994 enrolled · 2008
Δ -0.86-1.11 to -0.62
NCT01708902876 enrolled · 2012
Δ -1.00-1.23 to -0.78
NCT00676338820 enrolled · 2008
Δ -0.05-0.26 to 0.17
NCT01126580807 enrolled · 2010
Δ -0.22-0.36 to -0.08
NCT01023581784 enrolled · 2009
Δ -0.67-0.96 to -0.37
NCT01076088744 enrolled · 2010
Δ -0.84-1.15 to -0.52
NCT00386100688 enrolled · 2006
Δ -0.49-0.67 to -0.30
4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05263401 nacompletednot on this map

3-hydroxybutyrate as a Meal Primer in Patients With Type 2 Diabetes

TypeinterventionalSponsorUniversity of AarhusRan2022 to 2022Enrolled14ConditionsType 2 Diabetes, Ketoses, MetabolicArms3-hydroxybutyrate
NCT05581043 nacompletednot on this map

Pre-meals of 3-hydroxybutyrate for People With Type 2 Diabetes

TypeinterventionalSponsorUniversity of AarhusRan2023 to 2024Enrolled10ConditionsKetosis, Postprandial Hyperglycemia, Glucose Metabolism Disorders (Including Diabetes Mellitus)Arms3-hydroxybutyrate (3-OHB)
5 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

7 authors.

Maj Bangshaab *Medical/Steno Aarhus Research Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.ORCID http://orcid.org/0000-0001-6265-2854
Mads B Bengtsen *Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.ORCID http://orcid.org/0000-0001-8985-8385
Stine SmedegaardMedical/Steno Aarhus Research Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.ORCID http://orcid.org/0000-0003-0225-8809
Esben SøndergaardMedical/Steno Aarhus Research Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.ORCID http://orcid.org/0000-0001-8041-6994
Niels MøllerMedical/Steno Aarhus Research Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.ORCID http://orcid.org/0000-0001-5627-7322
Mads V SvartSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.ORCID http://orcid.org/0000-0002-9574-0612
Nikolaj RittigMedical/Steno Aarhus Research Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. Nikolaj.rittig@clin.au.dk.ORCID http://orcid.org/0000-0001-9938-2181

Funding

Aase og Ejnar Danielsens Fond Jr. No. 23-10-0145Novo Nordisk Fonden NNF19OC0058872Novo Nordisk Fonden NNF22OC0081911
8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

aims/hypothesisPostprandial hyperglycaemia and hyperlipidaemia are independent risk factors for CVD in individuals with type 2 diabetes. We aimed to test whether a ketone monoester (KE) and ketone salts (KS) reduce postprandial glucose and lipid excursions in individuals with type 2 diabetes.

methodsIn two randomised, participant-blind crossover studies we investigated individuals with type 2 diabetes treated with either metformin monotherapy or a lifestyle intervention alone. In study 1, 14 participants received 30 g of KE, KS or placebo 30 min before a mixed meal test on three separate occasions. The primary outcome was the incremental AUC (iAUC) for glucose. In study 2, ten participants were investigated on six separate occasions, consuming various doses (0 g, 10 g, 20 g and 40 g) of KE 30 min, 60 min or immediately before an OGTT. Both studies were conducted at Aarhus University Hospital, Denmark, with the primary investigator randomly assigning the intervention order.

resultsWe found that the iAUC for glucose decreased by 36% (95% CI 14, 57) with KE and 22% (95% CI 1, 44) with KS compared with placebo. Both ketone supplements lowered postprandial NEFA and ghrelin concentrations, and KE reduced triglycerides (n=14). Furthermore, KE dose-dependently lowered the iAUC of glucose, with the strongest effect when ingested 30 min or 60 min before the OGTT (n=10). No serious adverse events occurred; however, transient mild gastrointestinal symptoms, including nausea and diarrhoea, were reported. CONCLUSIONS/

interpretationPre-meal ketone supplementation reduced postprandial glucose, lipid and ghrelin concentrations. These findings support the therapeutic potential of KE supplementation in the management of type 2 diabetes.

trial registrationClinicalTrials.gov NCT05263401 and NCT05581043

fundingNovo Nordisk Foundation (NNF19OC0058872 and NNF22OC0081911), the Health Research Foundation of Central Denmark Region and the Aase Einar Danielsen Foundation (Jr. No. 23-10-0145).

Indexed as

Blood GlucoseDiabetes Mellitus, Type 2GhrelinKetonesLipidsAdultAgedCross-Over StudiesDietary SupplementsFemaleHumansMaleMetforminMiddle AgedPostprandial PeriodBlood GlucoseGhrelinKetonesLipidsMetforminKetonesMetabolismPostprandial hyperglycaemiaPostprandial hyperlipidaemiaType 2 diabetesβ-Hydroxybutyrate

Identifiers

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.