# Consequences of Glucose Enriched Diet on Oncologic Patients
### Role of Sugar in Cancer Metabolism
#### 1.2.4 Targeting the Warburg Effect for Cancer Treatment: Ketogenic Diets for Management of Glioma  
The Warburg effect, named after the German scientist [PERSON] who originally identified it in the 1950s, is the metabolic reprogramming of cancer cells, which happens when they make energy through glycolysis rather than mitochondrial oxidative phosphorylation [67]. He stated that an increase in glycolysis causes cancer cells to secrete a lot of lactate. Glucose transporters can enter cancer cells during the glycolysis process. As a result, a number of glucose metabolites are generated, some of which are connected to specific metabolic pathways such as the serine/glycine metabolic pathway and PPP [15].  
Thanks to the Warburg effect, dietary glucose plays the role of the principal metabolic fuel for various cancers. This finding led to the original exploration of the ketogenic diet as a cancer treatment, and it is considered that the principal mechanism by which the ketogenic diet may delay tumor progression is by carbohydrate restriction-induced glucose  
\begin{table}
\begin{tabular}{c c c c} \hline
**Patient** & **Diagnosis** & **Diet** & **After Treatment** \\ \hline \hline \multirow{8}{*}{1 patient, 65 years old} & & & The patient’s body mass reduced by roughly 20\% after two months of administration of the diet and the presence of brain cancer cells was not observed. For six months, the stringent diet was continued. Relapse of the disease was identified by magnetic resonance imaging two months following the course of the same [65]. \\ \cline{2-3}  & & Ketogenic diet (60 g of carbohydrates daily) that comprised, among other things, vegetable oils and fermented milk drinks (500 mL). \\ \hline \hline \multirow{8}{*}{20 patients} & & Ketogenic diet (60 g of carbohydrates daily) that comprised, among other things, vegetable oils and fermented milk drinks (500 mL). \\ \cline{2-3}  & & Ketogenic diet for 28 days & The ketogenic diet may function in part by blocking insulin signaling in tumors [64]. \\ \cline{1-1} \cline{2-3}  
deptivation. It is well-known that hyperglycemia accelerates the rate of tumor growth in people and animals. Therefore, ketogenic diet is believed to function mostly by lowering the availability of glucose to the tumor. As indicated, ketogenic diet has been demonstrated to limit glucose uptake by the malignancies in people [68; 69].  
The ketogenic diet reduces pancreatic insulin production by reducing carbohydrate consumption. Additionally, it has been found to improve the sensitivity of healthy tissues to insulin, which reduces the quantity of circulating insulin in the blood. Indeed, a conversion from a regular diet to a low-carb diet resulted in reduced total insulin levels in clinical testing by 41% in type 1 diabetes and 50% in healthy participants, while boosting sensitivity to insulin up to 75% in type 2 diabetics [69].  
In a small human experiment with 10 patients, end-stage cancer patients who received a ketogenic diet for 28 days demonstrated a considerable decline in blood insulin. The degree of relative ketosis, which was favorably correlated with the therapeutic response, and this drop in insulin were both inversely related. Thus, the ketogenic diet may function in part by blocking insulin signaling in tumors [69].