Use of Remote Monitoring by E-mail for Long-Term Management of the Classic Ketogenic Diet

Nutrients. 2020 Jun 19;12(6):1833. doi: 10.3390/nu12061833.


The classic ketogenic diet (cKD) requires constant nutritional monitoring over time both to ensure its effectiveness and to reduce the likelihood of short- and long-term adverse effects. We retrospectively described the use of remote monitoring by e-mail during the first year of follow-up on cKD in 34 children (47% males; age range: 2-17 years) diagnosed with drug-resistant epilepsy (DRE; n = 14) or glucose transporter type 1 deficiency syndrome (GLUT1-DS; n = 20). All the e-mails were evaluated analyzing their frequency and content at 3, 6 and 12 months. Three families never sent e-mails. A median of 36.0 (IQR 23.0-64.0) e-mails per family were sent during the 12 follow-up months by the 31 patients. GLUT1-DS patients sent a greater number of e-mails than the DRE group (median 39.0 (IQR 25.5-56.5) vs. median 26.0 (IQR 19.0-65.0)). At the end of the follow-up period, a greater number of e-mails had been exchanged between the nutritional team and the families belonging to the group that increased its linear growth (median 83.5; IQR 48.0-102.0), compared to the other ones. Constant remote monitoring by e-mail could be a feasible and effective way for a better cKD management.

Keywords: children; drug-resistant epilepsy; e-mail; glucose transporter type 1 deficiency syndrome; home management; ketogenic diet; monitoring.

MeSH terms

  • Adolescent
  • Carbohydrate Metabolism, Inborn Errors / diet therapy*
  • Child
  • Child, Preschool
  • Diet, Ketogenic / methods*
  • Drug Resistant Epilepsy / diet therapy*
  • Electronic Mail*
  • Female
  • Humans
  • Male
  • Monosaccharide Transport Proteins / deficiency*
  • Retrospective Studies
  • Telemedicine / methods*
  • Time
  • Treatment Outcome


  • Monosaccharide Transport Proteins

Supplementary concepts

  • Glut1 Deficiency Syndrome