In obese adults with type 2 diabetes, an 8-week low-carbohydrate, intermittent fasting regimen is associated with a 63% reduction in the triglyceride-to-HDL cholesterol ratio and a 77% decrease in HOMA-IR.

When carbohydrates are severely restricted and eating is limited to a short daily window, the body runs out of stored sugar and starts breaking down fat for energy. This produces ketone bodies, which replace glucose as the main fuel. With less glucose and insulin in the blood, the liver stops making new fat and starts burning existing fat. This lowers triglycerides in the blood and improves the quality of HDL cholesterol. At the same time, reduced insulin levels allow the liver and muscles to respond better to insulin again, fixing insulin resistance. The drop in inflammation from ketones further helps restore normal metabolic function.