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The Cardiac and Hemodynamic Effects of Ketone Bodies Are Abnormal in Patients With Type 1 Diabetes: A Randomized

Kristoffer Berg-Hansen1,2, Maj Bangshaab2,3, Nigopan Gopalasingam1,2

  • 1Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

Diabetes
|June 17, 2025
PubMed

Insights

Type 1 diabetes impairs the heart's ability to use ketones for energy. This study found a significantly blunted cardiac response to ketone infusion in individuals with type 1 diabetes.

Area of Science:

  • Cardiology
  • Metabolic Disorders
  • Endocrinology

Background:

  • Diabetic hearts exhibit reduced ketone utilization due to impaired ketolytic enzyme activity.
  • Ketone bodies are an important energy substrate for the heart.

Purpose of the Study:

  • To investigate the cardiac response to 3-hydroxybutyrate infusion in type 1 diabetes.
  • To determine if impaired cardiac ketone metabolism contributes to diabetic cardiomyopathy.

Main Methods:

  • Randomized controlled crossover trial.
  • Infusion of 3-hydroxybutyrate (a ketone body).
  • Assessment of cardiac output, systolic function, and left ventricular work efficiency.

Main Results:

  • Cardiac output response to 3-hydroxybutyrate infusion was blunted by 80% in type 1 diabetes.
  • No improvement in systolic function was observed.
  • Left ventricular work efficiency was reduced in type 1 diabetes.

Conclusions:

  • Cardiac ketone metabolism is impaired in type 1 diabetes.
  • Impaired ketone utilization may contribute to the development of diabetic cardiomyopathy.
Abstract

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