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Improvements in glucose metabolism and insulin sensitivity with a low-carbohydrate diet in obese patients with type 2 diabetes.
J Am Coll Nutr 2013; 32(1):11-7JA

Abstract

OBJECTIVE

The optimal diet for weight loss in type 2 diabetes remains controversial. This study examined a low-carbohydrate, high-fat diet with detailed physiological assessments of insulin sensitivity, glycemic control, and risk factors for cardiovascular disease.

METHODS

Fourteen obese patients (body mass index [BMI] 40.6 ± 4.9 kg/m(2)) with type 2 diabetes were recruited for an "Atkins"-type low-carbohydrate diet. Measurements were made at 0, 12, and 24 weeks of weight, insulin sensitivity, HbA1c, lipids, and blood pressure.

RESULTS

Twelve completers lost a mean of 9.7 ± 1.8 kg over 24 weeks attributable to a major reduction in carbohydrates and resultant reduction in total energy intake. Glycemic control significantly improved (HbA1c -1.1 ± 0.25%) with reductions in hypoglycemic medication. Fasting glucose, homeostasis model assessment (HOMA), and area under the curve (AUC) glucose (intravenous glucose tolerance test [IVGTT]) were significantly reduced by week 12 (p < 0.05). There were nonsignificant improvements in insulin sensitivity (SI) at week 12 (p = 0.19) and week 24 (p = 0.31). Systolic blood pressure was reduced (mean -10.0 mmHg between weeks 0 and 24, p = 0.13). Mean high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol all increased. The ratio of total: HDL cholesterol and triglycerides was reduced.

CONCLUSION

A low-carbohydrate diet was well tolerated and achieved weight loss over 24 weeks in subjects with diabetes. Glycemic control improved with a reduction in requirements for hypoglycemic agents.

Authors+Show Affiliations

Endocrine, Diabetes and Research Centre, Wellington Hospital, Wellington, New Zealand. Jeremy.krebs@ccdhb.org.nzNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24015695

Citation

Krebs, Jeremy D., et al. "Improvements in Glucose Metabolism and Insulin Sensitivity With a Low-carbohydrate Diet in Obese Patients With Type 2 Diabetes." Journal of the American College of Nutrition, vol. 32, no. 1, 2013, pp. 11-7.
Krebs JD, Bell D, Hall R, et al. Improvements in glucose metabolism and insulin sensitivity with a low-carbohydrate diet in obese patients with type 2 diabetes. J Am Coll Nutr. 2013;32(1):11-7.
Krebs, J. D., Bell, D., Hall, R., Parry-Strong, A., Docherty, P. D., Clarke, K., & Chase, J. G. (2013). Improvements in glucose metabolism and insulin sensitivity with a low-carbohydrate diet in obese patients with type 2 diabetes. Journal of the American College of Nutrition, 32(1), pp. 11-7. doi:10.1080/07315724.2013.767630.
Krebs JD, et al. Improvements in Glucose Metabolism and Insulin Sensitivity With a Low-carbohydrate Diet in Obese Patients With Type 2 Diabetes. J Am Coll Nutr. 2013;32(1):11-7. PubMed PMID: 24015695.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improvements in glucose metabolism and insulin sensitivity with a low-carbohydrate diet in obese patients with type 2 diabetes. AU - Krebs,Jeremy D, AU - Bell,Damon, AU - Hall,Rosemary, AU - Parry-Strong,Amber, AU - Docherty,Paul D, AU - Clarke,Kristen, AU - Chase,J Geoffry, PY - 2013/9/11/entrez PY - 2013/9/11/pubmed PY - 2014/2/4/medline SP - 11 EP - 7 JF - Journal of the American College of Nutrition JO - J Am Coll Nutr VL - 32 IS - 1 N2 - OBJECTIVE: The optimal diet for weight loss in type 2 diabetes remains controversial. This study examined a low-carbohydrate, high-fat diet with detailed physiological assessments of insulin sensitivity, glycemic control, and risk factors for cardiovascular disease. METHODS: Fourteen obese patients (body mass index [BMI] 40.6 ± 4.9 kg/m(2)) with type 2 diabetes were recruited for an "Atkins"-type low-carbohydrate diet. Measurements were made at 0, 12, and 24 weeks of weight, insulin sensitivity, HbA1c, lipids, and blood pressure. RESULTS: Twelve completers lost a mean of 9.7 ± 1.8 kg over 24 weeks attributable to a major reduction in carbohydrates and resultant reduction in total energy intake. Glycemic control significantly improved (HbA1c -1.1 ± 0.25%) with reductions in hypoglycemic medication. Fasting glucose, homeostasis model assessment (HOMA), and area under the curve (AUC) glucose (intravenous glucose tolerance test [IVGTT]) were significantly reduced by week 12 (p < 0.05). There were nonsignificant improvements in insulin sensitivity (SI) at week 12 (p = 0.19) and week 24 (p = 0.31). Systolic blood pressure was reduced (mean -10.0 mmHg between weeks 0 and 24, p = 0.13). Mean high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol all increased. The ratio of total: HDL cholesterol and triglycerides was reduced. CONCLUSION: A low-carbohydrate diet was well tolerated and achieved weight loss over 24 weeks in subjects with diabetes. Glycemic control improved with a reduction in requirements for hypoglycemic agents. SN - 1541-1087 UR - https://www.unboundmedicine.com/medline/citation/24015695/Improvements_in_glucose_metabolism_and_insulin_sensitivity_with_a_low_carbohydrate_diet_in_obese_patients_with_type_2_diabetes_ L2 - http://www.tandfonline.com/doi/full/10.1080/07315724.2013.767630 DB - PRIME DP - Unbound Medicine ER -