The Islet De-stress Hypothesis: A potential explanation for the gluco metabolic effects of ketogenic diet

Ketogenic diet (KD) is an established therapy with indications which span multiple disciplines. Initial skepticism about the role of KD in diabetes and obesity has been replaced by interest in its mechanism of action. We propose that KD works by de-stressing the islet of Langerhans, and reducing its workload. This de-stress occurs at both beta and alpha cell, and suggests that the islet should be considered a single anatomic-functional unit. The Islet De-stress Hypothesis, as we term it, is based upon the Law of Endocrine Parsimony. Simply put, this states that minimal burden should be placed on any gland, including the islet of Langerhans, while managing endocrine disease.