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Study design

The randomized diet study assigned 16 people with type 1 diabetes and recurrent hypoglycemia to MCT (n=8) or an isocaloric control diet (n=8) for four weeks, including a two-week run-in. MCT oil supplied 20% of energy and was titrated from 14 to about 56 g/day. A separate magnetic-resonance spectroscopy experiment studied 11 people (5 with diabetes, 6 healthy controls) during a glucose clamp.

Findings

During hypoglycemia, beta-hydroxybutyrate contributed more to brain metabolism in the diabetes group. In the diet trial, working-memory accuracy was 8% higher with MCT on the S6D task (p=0.03); reaction time did not differ significantly (p=0.33). The authors also reported greater regional brain activation during the challenge.

Limits and disclosures

This small study tested performance during experimentally induced hypoglycemia, not everyday cognition or dementia prevention; the distinctive oil taste also meant diet assignment was not blinded. It cannot establish long-term benefit. The study was registered as NCT01315171, funded by NIH Clinical and Translational Science Award support, and reported no potential conflicts of interest.

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