In a short 24-week study, HbA1c levels
improved and cholesterol levels were reduced to the point of reduced
need for statins. Type 2 diabetes patients are normally advised by
dietitians to make dietary decisions that are high in carbohydrates
and low in fat and protein. This increase in carbohydrates leads to
high postprandial blood glucose levels. Because of this, there is
more interest in food plans low in carbohydrates with higher amounts
of fat and protein for type 2 diabetes management. Past studies have
been done with food plans that are low in both carbohydrates and fat.
Both have proved successful in lowering body weight, blood pressure,
and insulin concentrations. Most of these prior studies have ignored
the role of physical activity and glycemic variability.
This new study was designed to compare
the use of a high carbohydrate, low fat diet (53% carbohydrate, 17%
protein, and 30% fat) to a very low carbohydrate, high unsaturated
fat diet (14% carbohydrate, 28% protein, and 58% fat). This would be
used with measurements taken at baseline and end of trail to see what
their impact was on glycemic control and risk factors associated with
cardiovascular disease in type 2 diabetes patients.
A total of 115 obese type diabetes
patients were randomly assigned to one of the two diet groups. In
addition, they both participated in a supervised exercise program.
The primary outcome was a change in HbA1c. Secondary outcomes
included effects on glycemic variability, and changes in
anti-glycemic medications, lipid profile, and blood pressure
readings.
Those in the low carbohydrate diet
group showed a larger decrease in HbA1c when compared to the high
carbohydrate diet group and changes in anti-glycemic medications were
also more likely in this group as seen by the changes in the
medication effects score. Differences in the diets were not seen in
weight loss, and no diet effect was observed in the fasting blood
glucose, LDL reduction, or blood pressure.
The results of this study show the
impact that diet selection can have on managing type 2 diabetes.
While both of the diets studied in this trial showed some positive
results, the very low carbohydrate diet was more effective in
lowering HbA1c, reducing anti-glycemic medication requirements, and
improving HDL cholesterol. And of course, they made the statement
that larger trials with a similar design can be used to determine if
a low carbohydrate, high unsaturated fat diet continues to have an
impact on managing diabetes beyond a 24-week timeframe.
For this short of a trial or study, the
few conclusions show that people with type 2 diabetes need to make
lifestyle changes in both diet and exercise. While both diets showed
improvements in weight, a very low carbohydrate, high unsaturated fat
diet showed more beneficial in lowering HbA1c, anti-glycemic
medication requirements and increasing HDL cholesterol.
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