The glucose ketone index calculator: a simple tool to monitor therapeutic efficacy for metabolic management of brain cancer

The use of glucose ketone index calculator to monitor therapeutic efficacy of brain cancer.


Written by Joshua J Meidenbauer, Purna Mukherjee, Thomas N Seyfried

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Metabolic therapy using ketogenic diets (KD) is emerging as an alternative or complementary approach to the current standard of care for brain cancer management. This therapeutic strategy targets the aerobic fermentation of glucose (Warburg effect), which is the common metabolic malady of most cancers including brain tumors. The KD targets tumor energy metabolism by lowering blood glucose and elevating blood ketones (β-hydroxybutyrate). Brain tumor cells, unlike normal brain cells, cannot use ketone bodies effectively for energy when glucose becomes limiting. Although plasma levels of glucose and ketone bodies have been used separately to predict the therapeutic success of metabolic therapy, daily glucose levels can fluctuate widely in brain cancer patients. This can create difficulty in linking changes in blood glucose and ketones to efficacy of metabolic therapy. A program was developed (Glucose Ketone Index Calculator, GKIC) that tracks the ratio of blood glucose to ketones as a single value. We have termed this ratio the Glucose Ketone Index (GKI). The GKIC was used to compute the GKI for data published on blood glucose and ketone levels in humans and mice with brain tumors. The results showed a clear relationship between the GKI and therapeutic efficacy using ketogenic diets and calorie restriction. The GKIC is a simple tool that can help monitor the efficacy of metabolic therapy in preclinical animal models and in clinical trials for malignant brain cancer and possibly other cancers that express aerobic fermentation.



It has not escaped our attention that the GKIC could have utility not only for managing brain cancer and possibly other cancers dependent on glucose and aerobic fermentation for survival, but also for managing other diseases or conditions where the ratio of glucose to ketone bodies could be therapeutic. Such diseases and conditions include Alzheimer’s disease, Parkinson’s disease, traumatic brain injury, chronic inflammatory disease, and epilepsy. For example, the ketogenic diet has long been recognized as an effective therapeutic strategy for managing refractory seizures in children. Therapeutic success in managing generalized idiopathic epilepsy in epileptic EL mice can also be seen when applying the GKI to the data presented on glucose and βOHB. Healthy individuals can utilize the GKIC to prevent diseases and disorder, and manage general wellness. Further studies will be needed to determine the utility of the GKIC for predicting therapeutic success in the metabolic management of disease.