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Ocular Very common (10% or more): Diabetic retinopathy (up to 20.1%) Common (1% to 10%): Retinal disorders, diabetic retinopathy complications Uncommon (0.1% to 1%): Nonproliferative retinopathy Very rare (less than 0.01%): Nonarteritic anterior ischemic optic neuropathy (NAION) Diabetic retinopathy complications included need for retinal photocoagulation, need for treatment with intravitreal agents, vitreous hemorrhage, and onset of diabetes-related blindness

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The ketone ester extended the time participants were able to maintain an 80 rpm cadence by 24 9% ( p = 0.027)