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Despite the low rates of acute diabetes-related complications in some studies in this review, Buehler et al.’s study reiterates the potential serious risks of unmonitored ketosis in patients particularly with T1D and suggests that a continuous glucose monitor (CGM) may be used to prevent any hypoglycaemic or DKA episodes when embarking on a ketogenic diet. Despite a lack of data specifically on ketogenic diets, it is well established in Mendelian randomisation studies which reveal not only that dietary saturated fat increases LDL cholesterol (LDLc) but also the subsequent deleterious impact of LDLc as a risk factor of coronary disease. Studies using dual-energy x-ray absorptiometry scans [63, 65] reveal ketogenic diets lead to greater reductions in fat mass and visceral adipose tissue, which may provide additional metabolic advantages compared to non-ketogenic diets. 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