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A hyperglycemic clamp was used to assess acute C-peptide response (ACP), and magnetic resonance imaging to assess hepatic fat fraction, at baseline and after 12 weeks of either a eucaloric KD (\u223c9% energy from carbohydrate, 65% energy from fat) or a eucaloric low-fat diet (LFD) (\u223c55% energy from carbohydrate, 20% energy from fat).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The KD led to decreases in pyruvate (\u221223%, P &amp;lt; .001) and palmitoleic acid, a marker of DNL (\u221232%, P &amp;lt; .01). Participants on the KD had higher fasting glucagon (25%, P &amp;lt; .05) and lower liver fat (28%, P &amp;lt; .05) at week 12 than those on the LFD. In all combined, the change in liver fat was positively associated with the change in pyruvate (r = 0.45, P = .05), and inversely associated with changes in glucagon (r = \u22120.34, P &amp;lt; .05), the glucagon to C-peptide ratio (r = \u22120.44, P &amp;lt; .01), and ACP (r = \u22120.34, P &amp;lt; .05). The change in ACP was inversely associated with the change in pyruvate in the KD group (r = \u22120.5, P &amp;lt; .05), but not in the LFD group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A shift in hepatic metabolism to favor fat oxidation over DNL may underlie the beneficial effects of carbohydrate restriction on hepatic steatosis and glucose-induced insulin secretion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf324","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T07:50:24Z","timestamp":1748591424000},"page":"e134-e141","source":"Crossref","is-referenced-by-count":6,"title":["Beneficial Effects of Carbohydrate Restriction in Type 2 Diabetes Can Be Traced to Changes in Hepatic 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