Application of the diet
(J. Klepper, Aschaffenburg; updated 01.2007)
The application of the ketogenic diet follows these steps:
- Starting the diet
Before initiating a ketogenic diet, a careful history needs to be taken and clinical examination performed. Contraindications of the ketogenic diet such as defects of fat metabolism or ketone production must be excluded. The compliance of the child and the caretakers is essential to make the diet work.
2. Starting the diet
For the initiation of the ketogenic diet the patient should be hospitalized for roughly 5 days.
Patients are fasted initially and metabolic parameters such as blood glucose are monitored closely. Water or sugar-free beverages are allowed. When ketosis is achieved, the ketogenic diet is initiated. After establishing the maintenance of the diet and the dietary education the patient can be discharged once he and his caretakers feel confident to prepare and monitor the diet at home.
After discharge the patient needs to be followed up closely at outpatient clinics. Frequent phonecalls and initial appointments at weekly intervals can gradually be extended to regular follow-up appointments every 3-6 months.