Purpose of review 

To summarize the underlying biochemical basis for low-carbohydrate and ketogenic diets (LC/KD) and provide mechanisms to account for demonstrated effectiveness.

Recent findings 

LC/KD continue to have success, to outperform other diets as well as most drugs for weight loss and diabetes treatment. In many cases, LC/KD can effect remission (absence of drugs) or reversal (only metformin or nondiabetes drugs) of type 2 diabetes and can provide a significant adjunct to pharmacology in type 1. Medication is reduced or eliminated in most cases. The results are consistent with the biochemical rationale which stresses the global effects of the glucose–insulin axis.

Summary 

Evidence for the superior effectiveness of LC/KD for metabolic disease is now overwhelming. At the same time, the approach has received only limited support, and in many cases, persistence of the traditional opposition. Clinical practice or research must confront this crisis in order to bring practice in line with current science and to avoid continued harm to medicine and ultimately, the patient.

中文翻译：

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低碳水化合物和生酮饮食的生物化学

审查目的 

总结低碳水化合物和生酮饮食（LC / KD）的潜在生化基础，并提供机制说明已证明的有效性。

最近的发现 

LC / KD继续取得成功，优于其他饮食以及大多数减肥和糖尿病治疗药物。在许多情况下，LC / KD可以缓解2型糖尿病的缓解（无药物）或逆转（仅二甲双胍或非糖尿病药物），并且可以为1型药理学提供重要的辅助手段，在大多数情况下减少或消除药物治疗。结果符合生化原理，后者强调了葡萄糖-胰岛素轴的整体作用。

概要 

现在，有关LC / KD对代谢性疾病的卓越疗效的证据不胜枚举。同时，该方法仅获得了有限的支持，在许多情况下，还得到了传统反对派的坚持。临床实践或研究必须面对这一危机，以便使实践与当前科学保持一致，并避免对医学乃至最终对患者的持续伤害。