Feb 1, 2025

Feb 1, 2025

Feb 1, 2025

Effect of Acute Hyperketonemia on the Cerebral Uptake of Ketone Bodies in Nondiabetic Subjects and IDDM Patients

Effect of Acute Hyperketonemia on the Cerebral Uptake of Ketone Bodies in Nondiabetic Subjects and IDDM Patients

Effect of Acute Hyperketonemia on the Cerebral Uptake of Ketone Bodies in Nondiabetic Subjects and IDDM Patients

This PET imaging study demonstrates that both healthy individuals and insulin-dependent diabetics (IDDM) rapidly absorb ketone bodies into the brain during acute hyperketonemia. As blood ketone levels rose to 1.5–2.0 mM via infusion, cerebral uptake of ketones increased significantly, confirming that the brain can swiftly shift to using ketones for energy—regardless of insulin status. These findings highlight the potential of exogenous ketones to bypass impaired glucose metabolism and support brain function in diabetic or metabolic-compromised states.

This PET imaging study demonstrates that both healthy individuals and insulin-dependent diabetics (IDDM) rapidly absorb ketone bodies into the brain during acute hyperketonemia. As blood ketone levels rose to 1.5–2.0 mM via infusion, cerebral uptake of ketones increased significantly, confirming that the brain can swiftly shift to using ketones for energy—regardless of insulin status. These findings highlight the potential of exogenous ketones to bypass impaired glucose metabolism and support brain function in diabetic or metabolic-compromised states.

Summary of

Effect of Acute Hyperketonemia on the Cerebral Uptake of Ketone Bodies in Nondiabetic Subjects and IDDM Patients

By

Pawel L. Muzik

Pawel L. Muzik

, et al.

, et al.

Purpose

To investigate whether acute elevation of blood ketones increases cerebral uptake of ketone bodies in both healthy individuals and insulin-dependent diabetics (IDDM).

Methods

Six nondiabetic controls and five IDDM patients received infusions of labeled acetoacetate and β-hydroxybutyrate, elevating blood ketones to ~1.7 mM. Cerebral uptake was measured using positron emission tomography (PET) to determine ketone transport and metabolism across the blood-brain barrier.

Results

In both groups, cerebral uptake of ketones increased linearly with plasma levels. IDDM subjects showed ketone utilization similar to controls, indicating insulin is not required for cerebral ketone transport. Uptake was most prominent in brain regions with high metabolic demand, such as the cortex and thalamus.

Conclusion

Acute hyperketonemia enables rapid brain uptake of ketones in both diabetic and non-diabetic individuals, offering an alternative energy substrate for cognitive and metabolic support—particularly in glucose-impaired conditions.

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