Examining the Feasibility of Prolonged Beta-Hydroxybutyrate-Containing Supplement Drink Consumption in Adults with Type 2 Diabetes: A Randomized Controlled Pilot Trial

This double-blind, remote, randomized, placebo-controlled pilot trial assigned 40 adults with type 2 diabetes to 90 days of a thrice-daily ketone supplement (5 g of R-beta-hydroxybutyric acid with 5 g of R-1,3-butanediol per serving) or a taste-matched calorie-free placebo. Most feasibility criteria were met, but drop-out was higher in the ketone group (8 participants, 40 percent) than in the placebo group (2 participants, 10 percent), mostly because of gastrointestinal symptoms and unpleasant taste. Compliance was similar, at 17 +/- 4 and 18 +/- 4 drinks per week out of a possible 21 in the ketone and placebo groups. Continuous glucose monitoring metrics suggested acute and chronic glucose-lowering effects in the ketone group.