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Evidence for KD in refractory epilepsy or status epilepticus in adults is limited, with only one RCT

30 Among the pathways activated by IR and IGF-1R signaling are the RASRAFMEK1/2extracellular signal-regulated kinase (ERK)-1/2 pathway 34 and the phosphatidylinositol-3-kinase (PI3K)AKTmammalian target of rapamycin (mTOR) pathway, two fundamental pathways for tumor cell proliferation and survival (Figure 2)

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The mean study age was 58.4 7.4 years, mean was 32.1 5.1 kg/m 2 , HbA1c 8.66 0.92% [43]