Interconnected ketone and glucose molecules symbolize their relationship in post-pancreatitis prediabetes.

Ketone Bodies and Blood Sugar: What's the Link in Post-Pancreatitis Prediabetes?

Nico Varela in Health & Wellness December 2025 • 4 min read.

"Uncover the surprising connection between ketone levels and glucose control in individuals with post-pancreatitis prediabetes, and how it could change diabetes management."

The intricate dance between ketone bodies and glucose metabolism has long been a subject of scientific inquiry, particularly in the context of diabetes. Ketone bodies, produced during periods of fasting or low carbohydrate intake, serve as an alternative energy source for the body. However, their role becomes particularly interesting in individuals with metabolic disorders, such as diabetes and prediabetes.

A recent study published in the Archives of Physiology and Biochemistry sheds new light on this relationship, specifically focusing on individuals with post-pancreatitis prediabetes (PPP). This condition, arising after acute pancreatitis, often leads to impaired glucose metabolism, making it crucial to understand the underlying mechanisms.

This article breaks down the key findings of this research, exploring how ketone bodies, particularly β-hydroxybutyrate (BHB), interact with fasting plasma glucose in individuals with PPP. We'll delve into the potential implications of these findings for managing blood sugar and improving overall metabolic health.

The Ketone-Glucose Connection: What the Research Reveals

Interconnected ketone and glucose molecules symbolize their relationship in post-pancreatitis prediabetes.

The study, led by Sakina H. Bharmal and colleagues, investigated the associations between ketone bodies (acetoacetate and BHB) and fasting plasma glucose (FPG) in individuals with PPP compared to those with normoglycemia after pancreatitis (NAP). The researchers analyzed fasting blood samples from 27 individuals with PPP and 52 with NAP, taken at a median of 26 months after an acute pancreatitis event.

The key finding was a significant inverse association between BHB and FPG in the PPP group. This means that higher levels of BHB were associated with lower levels of fasting plasma glucose. Specifically, the study found that for every 1 mmol/L increase in BHB, FPG decreased by a significant amount. This relationship was not observed in the NAP group.

BHB and Fasting Glucose: A clear link in post-pancreatitis prediabetes.
Acetoacetate's Role: No significant impact on fasting plasma glucose.
Insulin Sensitivity: Higher BHB linked to better insulin sensitivity markers.
Inflammation: Key inflammatory markers influenced ketone body levels.

These findings suggest that altered ketosis, especially involving BHB, plays a crucial role in the pathophysiology of PPP. While acetoacetate, another ketone body, did not show a significant association with FPG, BHB's inverse relationship highlights its potential importance in glucose regulation within this specific population.

Implications and Future Directions

This research opens new avenues for understanding and managing post-pancreatitis prediabetes. The finding that higher BHB levels are associated with lower fasting glucose suggests that interventions aimed at promoting mild ketosis could be beneficial for individuals with PPP. Future studies should investigate the potential of ketomimetics (substances that stimulate endogenous ketogenesis) to normalize blood glucose and improve metabolic health in this vulnerable population.

About this Article -

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Everything You Need To Know

What are ketone bodies and how do they relate to blood sugar?

Ketone bodies, specifically β-hydroxybutyrate (BHB) and acetoacetate, are produced by the body during periods of fasting or low carbohydrate intake. These serve as an alternative energy source. In the context of post-pancreatitis prediabetes (PPP), research has shown an inverse association between BHB levels and fasting plasma glucose (FPG). This means that higher BHB levels are linked to lower FPG. Acetoacetate, another ketone body, did not show this significant association with FPG in the study. This relationship suggests that BHB plays a crucial role in glucose regulation within the PPP population.

What is post-pancreatitis prediabetes (PPP), and how does it differ from normoglycemia after pancreatitis (NAP)?

Post-pancreatitis prediabetes (PPP) is a condition that arises after acute pancreatitis, leading to impaired glucose metabolism. Individuals with PPP experience challenges in regulating blood sugar levels. This is in contrast to normoglycemia after pancreatitis (NAP), where individuals have normal blood sugar levels following pancreatitis. The study highlighted that the inverse association between BHB and fasting plasma glucose (FPG) was observed only in the PPP group, not in the NAP group, indicating that the relationship between ketone bodies and glucose regulation is unique to the PPP population.

What specific findings did the study reveal about ketone bodies and fasting plasma glucose?

The study found a significant inverse association between BHB and fasting plasma glucose (FPG) in individuals with post-pancreatitis prediabetes (PPP). For every 1 mmol/L increase in BHB, FPG decreased significantly. However, acetoacetate, another ketone body, did not show a significant impact on FPG. The researchers analyzed fasting blood samples from 27 individuals with PPP and 52 with normoglycemia after pancreatitis (NAP). The findings underscore the potential of BHB in glucose regulation within the PPP population.

How could the research findings on ketone bodies influence the management of post-pancreatitis prediabetes (PPP)?

The research suggests that interventions aimed at promoting mild ketosis could be beneficial for individuals with post-pancreatitis prediabetes (PPP). The inverse association between BHB and fasting plasma glucose (FPG) implies that increasing BHB levels might help in normalizing blood glucose. Future studies should investigate the potential of ketomimetics (substances that stimulate endogenous ketogenesis) to improve metabolic health in this vulnerable population. This includes a potential positive impact on insulin sensitivity and a possible influence on inflammatory markers, as these also play a role in the pathophysiology of PPP.

What are ketomimetics, and how could they be used in managing post-pancreatitis prediabetes?

Ketomimetics are substances that stimulate endogenous ketogenesis, the process by which the body produces ketone bodies. In the context of post-pancreatitis prediabetes (PPP), the research suggests that these could be a valuable tool. Because higher levels of β-hydroxybutyrate (BHB) were associated with lower fasting plasma glucose (FPG), ketomimetics could potentially increase BHB levels, thereby helping to normalize blood glucose in individuals with PPP. Future studies should explore the use of ketomimetics to improve metabolic health by potentially impacting insulin sensitivity and influencing key inflammatory markers.