Agree. This first study was small scale and did indeed do a load of tetst that I do not thinke were used in subsequentltrils. They did full c-peptide tests, insulin clamps tests, OGTT, hepatic glucose with intravenous measurements of plasma blood levels etc. But only on 11 subjects (we do not know which group the dropouts occurred in) It looks like these tests were done in weeks 1,2, and 8 but not sure if this was the frequency for the ketone measurements too, since they could occur more frequently being less invasive. They also did the MRI scans in this trial.
Again, unlikely to have this level of scrutiny in a larger study population,
But it does seem that ketosis was intended and checked in this initial study. Interesting that the control group were not given these tests except at week 8. In fact there is very little said about the control group. I have always suspected that even a borderline VLCD close to trigger will give periods of ketosis during the activities of a normal day, so is similar to IF in this respect. Its just that they cannot admit it.
The conclusion does not involve the control group, except to say:
"Although pancreatic fat content was 30% higher in the diabetic group, the study was powered to demonstrate responses to the dietary intervention rather than to test differences from weight-matched non-diabetic individuals. No correlation was observed between pancreatic fat and BMI within the restricted range of BMI examined in this study."
One interesting point I picked up on this re-visit, and that was the comments that the IR response improvement was independant of changes to the peripheral IR in the muscles, but was solely due to hepatic fat reduction. Also noted the comment that bariatric banding does not produce remission, but the bypass surgery does.