VLCK diets have been shown to have beneficial effects on weight loss, insulin sensitivity and HbA1c in most studies.13, 30 A study in which 84 patients with obesity and T2DM were randomized to either a low-carbohydrate, ketogenic diet or a low-glycemic, reduced-calorie diet over a 24-week period in patients with obesity and T2DM, showed diet lower in carbohydrate led to greater improvements in glycemic control (hemoglobin A1c, fasting glucose, fasting insulin) and weight loss, and more frequent medication reduction/ elimination than the low glycemic index diet.31 The gene discussed is INS; the disease is obesity due to melanocortin 4 receptor deficiency.