Low Carbohydrate Diets in Type 2 Diabetes—A Translational Study
- 1 Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
- 2 BakerIDI Heart and Diabetes Institute, 75 Commercial Rd Prahran, Melbourne, Australia
- 3 BakerIDI Heart and Diabetes Institute, 75 Commercial Rd Prahran, Melbourne, Australia
Abstract
Although intensive interventions with low carbohydrate diets compared with higher carbohydrate diets can reduce HbA1c in people with type 2 diabetes, it is not clear if simple advice to make modest reductions in carbohydrate is effective in clinical practice. Forty-three people with type 2 diabetes and poor control (HbA1c > 7.5%) were randomized to receive 2 short education sessions over 6 months with a non-dietitian researcher on how to reduce carbohydrate intake by about 25% or to 2 control sessions in which the Australian Guide to Healthy Eating was provided. Hba1c and fasting glucose and lipids were measured at baseline and 3 months and 6 months. 33 volunteers attended a baseline visit; 27 completed 3 months and 24 6 months. HbA1c was reduced by 0.6% - 0.7% in the low carbohydrate diet group compared with the control group (P = 0.1). Fasting glucose was reduced by 2.3 mmol/L compared with the control group at 3 months (P < 0.03) only. Changes in HbA1c at 6 months were related to baseline HbA1c in the intervention group only. Although we have obtained suggestive evidence that a low carbohydrate diet can be successfully implemented in normal practice without professional help, our results are limited by low participant numbers and further studies are required.
- Westman, E.C., Yancy Jr., W.S., Mavropoulos, J.C., Marquart, M. and McDuffie, J.R. (2008) The Effect of a Low-Carbohydrate, Ketogenic Diet versus a Low-Glycemic Index Diet on Glycemic Control in Type 2 Diabetes Mellitus. Nutrition and Metabolism (London), 5, 36. http://dx.doi.org/10.1186/1743-7075-5-36
- Mayer, S.B., Jeffreys, A.S., Olsen, M.K., McDuffie, J.R., Feinglos, M.N. and Yancy Jr., W.S. (2014) Two Diets with Different Haemoglobina 1C and Antiglycaemic Medication Effects despite Similar Weight Loss in Type 2 Diabetes. Diabetes, Obesity and Metabolism, 16, 90-93. http://dx.doi.org/10.1111/dom.12191
- Tay, J., Luscombe-Marsh, N.D., Thompson, C.H., Noakes, M., Buckley, J.D., Wittert, G.A., Yancy Jr., W.S. and Brinkworth, G.D. (2014) A Very Low-Carbohydrate, Low-Saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial. Diabetes Care, 37, 2909-2918. http://dx.doi.org/10.2337/dc14-0845
- Tay, J., Luscombe-Marsh, N.D., Thompson, C.H., Noakes, M., Buckley, J.D., Wittert, G.A., Yancy Jr., W.S. and Brinkworth, G.D. (2015) Comparison of Low- and High-Carbohydrate Diets for Type 2 Diabetes Management: A Randomized Trial. The American Journal of Clinical Nutrition, 102, 780-790. http://dx.doi.org/10.3945/ajcn.115.112581
- Gannon, M.C., Hoover, H. and Nuttall, F.Q. (2010) Further Decrease in Glycated Hemoglobin Following Ingestion of a LoBAG30 Diet for 10 Weeks Compared to 5 Weeks in People with Untreated Type 2 Diabetes. Nutrition and Metabolism (London), 7, 64. http://dx.doi.org/10.1186/1743-7075-7-64
- Feinman, R.D., Pogozelski, W.K., Astrup, A., Bernstein, R.K., Fine, E.J., Westman, E.C., Accurso, A., Frassetto, L., Gower, B.A., McFarlane, S.I., Nielsen, J.V., Krarup, T., Saslow, L., Roth, K.S., Vernon, M.C., Volek, J.S., Wilshire, G.B., Dahlqvist, A., Sundberg, R., Childers, A., Morrison, K., Manninen, A.H., Dashti, H.M., Wood, R.J., Wortman, J. and Worm, N. (2015) Dietary Carbohydrate Restriction as the First Approach in Diabetes Management: Critical Review and Evidence Base. Nutrition, 31, 1-13. http://dx.doi.org/10.1016/j.nut.2014.06.011
- Daly, M.E., Paisey, R., Paisey, R., Millward, B.A., Eccles, C., Williams, K., Hammersley, S., MacLeod, K.M. and Gale, T.J. (2006) Short-Term Effects of Severe Dietary Carbohydrate-Restriction Advice in Type 2 Diabetes: A Randomized Controlled Trial. Diabetic Medicine, 23, 15-20. http://dx.doi.org/10.1111/j.1464-5491.2005.01760.x
- Iqbal, N., Vetter, M.L., Moore, R.H., Chittams, J.L., Dalton-Bakes, C.V., Dowd, M., Williams-Smith, C., Cardillo, S. and Wadden, T.A. (2010) Effects of a Low-Intensity Intervention That Prescribed a Low-Carbohydrate vs. a Low-Fat Diet in Obese, Diabetic Participants. Obesity (Silver Spring), 18, 1733-1738. http://dx.doi.org/10.1038/oby.2009.460