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Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM.

Abstract

Previous studies indicate that diets rich in digestible carbohydrates improve glucose tolerance in nondiabetic individuals, but may worsen glycemic control in NIDDM patients with moderately severe hyperglycemia. The effects of such high-carbohydrate diets on glucose metabolism in patients with mild NIDDM have not been studied adequately. This study compares responses to an isocaloric high-carbohydrate diet (60% of total energy from carbohydrates) and a low-carbohydrate diet (35% of total energy from carbohydrates) in 8 men with mild NIDDM. Both diets were low in saturated fatty acids, whereas the low-carbohydrate diet was rich in monounsaturated fatty acids. The two diets were matched for dietary fiber content (25 g/day). All patients were randomly assigned to receive first one and then the other diet, each for a period of 21 days, in a metabolic ward. Compared with the low-carbohydrate diet, the high-carbohydrate diet caused a 27.5% increase in plasma triglycerides and a similar increase in VLDL-cholesterol levels; it also reduced levels of HDL cholesterol by 11%. Plasma glucose and insulin responses to identical standard breakfast meals were studied on days 4 and 21 of each period, and these did not differ significantly between the two diets. At the end of each period, a euglycemic hyperinsulinemic glucose clamp study with simultaneous infusion of [3-3H]glucose revealed no significant changes in hepatic insulin sensitivity; and peripheral insulin-mediated glucose disposal remained unchanged (14.7 +/- 1.4 vs. 16.5 +/- 2.3 microM.kg-1.min-1 on the high-carbohydrate and low-carbohydrate diets, respectively).(

ABSTRACT

TRUNCATED AT 250 WORDS)

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  • Authors+Show Affiliations

    ,

    Veterans Affairs Medical Center, University of Texas Southwestern Medical Center, Dallas 75235-9052.

    ,

    Source

    Diabetes 41:10 1992 Oct pg 1278-85

    MeSH

    Analysis of Variance
    Blood Glucose
    Cholesterol
    Diabetes Mellitus, Type 2
    Dietary Carbohydrates
    Energy Intake
    Glucose Clamp Technique
    Glycated Hemoglobin A
    Glycosuria
    Humans
    Insulin
    Insulin Infusion Systems
    Lipoproteins
    Male
    Middle Aged
    Time Factors
    Triglycerides

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    1397701

    Citation

    Garg, A, et al. "Comparison of Effects of High and Low Carbohydrate Diets On Plasma Lipoproteins and Insulin Sensitivity in Patients With Mild NIDDM." Diabetes, vol. 41, no. 10, 1992, pp. 1278-85.
    Garg A, Grundy SM, Unger RH. Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM. Diabetes. 1992;41(10):1278-85.
    Garg, A., Grundy, S. M., & Unger, R. H. (1992). Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM. Diabetes, 41(10), pp. 1278-85.
    Garg A, Grundy SM, Unger RH. Comparison of Effects of High and Low Carbohydrate Diets On Plasma Lipoproteins and Insulin Sensitivity in Patients With Mild NIDDM. Diabetes. 1992;41(10):1278-85. PubMed PMID: 1397701.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM. AU - Garg,A, AU - Grundy,S M, AU - Unger,R H, PY - 1992/10/1/pubmed PY - 1992/10/1/medline PY - 1992/10/1/entrez SP - 1278 EP - 85 JF - Diabetes JO - Diabetes VL - 41 IS - 10 N2 - Previous studies indicate that diets rich in digestible carbohydrates improve glucose tolerance in nondiabetic individuals, but may worsen glycemic control in NIDDM patients with moderately severe hyperglycemia. The effects of such high-carbohydrate diets on glucose metabolism in patients with mild NIDDM have not been studied adequately. This study compares responses to an isocaloric high-carbohydrate diet (60% of total energy from carbohydrates) and a low-carbohydrate diet (35% of total energy from carbohydrates) in 8 men with mild NIDDM. Both diets were low in saturated fatty acids, whereas the low-carbohydrate diet was rich in monounsaturated fatty acids. The two diets were matched for dietary fiber content (25 g/day). All patients were randomly assigned to receive first one and then the other diet, each for a period of 21 days, in a metabolic ward. Compared with the low-carbohydrate diet, the high-carbohydrate diet caused a 27.5% increase in plasma triglycerides and a similar increase in VLDL-cholesterol levels; it also reduced levels of HDL cholesterol by 11%. Plasma glucose and insulin responses to identical standard breakfast meals were studied on days 4 and 21 of each period, and these did not differ significantly between the two diets. At the end of each period, a euglycemic hyperinsulinemic glucose clamp study with simultaneous infusion of [3-3H]glucose revealed no significant changes in hepatic insulin sensitivity; and peripheral insulin-mediated glucose disposal remained unchanged (14.7 +/- 1.4 vs. 16.5 +/- 2.3 microM.kg-1.min-1 on the high-carbohydrate and low-carbohydrate diets, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0012-1797 UR - https://www.unboundmedicine.com/medline/citation/1397701/Comparison_of_effects_of_high_and_low_carbohydrate_diets_on_plasma_lipoproteins_and_insulin_sensitivity_in_patients_with_mild_NIDDM_ L2 - http://diabetes.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=1397701 DB - PRIME DP - Unbound Medicine ER -