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Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus.
JAMA 1994; 271(18):1421-8JAMA

Abstract

OBJECTIVE

To study effects of variation in carbohydrate content of diet on glycemia and plasma lipoproteins in patients with non-insulin-dependent diabetes mellitus (NIDDM).

DESIGN

A four-center randomized crossover trial.

SETTING

Outpatient and inpatient evaluation in metabolic units.

PATIENTS

Forty-two NIDDM patients receiving glipizide therapy.

INTERVENTIONS

A high-carbohydrate diet containing 55% of the total energy as carbohydrates and 30% as fats was compared with a high-monounsaturated-fat diet containing 40% carbohydrates and 45% fats. The amounts of saturated fats, polyunsaturated fats, cholesterol, sucrose, and protein were similar. The study diets, prepared in metabolic kitchens, were provided as the sole nutrients to subjects for 6 weeks each. To assess longer-term effects, a subgroup of 21 patients continued the diet they received second for an additional 8 weeks.

MAIN OUTCOME MEASURES

Fasting plasma glucose, insulin, lipoproteins, and glycosylated hemoglobin concentrations. Twenty-four-hour profiles of glucose, insulin, and triglyceride levels.

RESULTS

The site of study as well as the diet order did not affect the results. Compared with the high-monounsaturated-fat diet, the high-carbohydrate diet increased fasting plasma triglyceride levels and very low-density lipoprotein cholesterol levels by 24% (P < .0001) and 23% (P = .0001), respectively, and increased daylong plasma triglyceride, glucose, and insulin values by 10% (P = .03), 12% (P < .0001), and 9% (P = .02), respectively. Plasma total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels remained unchanged. The effects of both diets on plasma glucose, insulin, and triglyceride levels persisted for 14 weeks.

CONCLUSIONS

In NIDDM patients, high-carbohydrate diets compared with high-monounsaturated-fat diets caused persistent deterioration of glycemic control and accentuation of hyperinsulinemia, as well as increased plasma triglyceride and very-low-density lipoprotein cholesterol levels, which may not be desirable.

Authors+Show Affiliations

Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas 75235-9052.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
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

7848401

Citation

Garg, A, et al. "Effects of Varying Carbohydrate Content of Diet in Patients With Non-insulin-dependent Diabetes Mellitus." JAMA, vol. 271, no. 18, 1994, pp. 1421-8.
Garg A, Bantle JP, Henry RR, et al. Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus. JAMA. 1994;271(18):1421-8.
Garg, A., Bantle, J. P., Henry, R. R., Coulston, A. M., Griver, K. A., Raatz, S. K., ... Huet, B. A. (1994). Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus. JAMA, 271(18), pp. 1421-8.
Garg A, et al. Effects of Varying Carbohydrate Content of Diet in Patients With Non-insulin-dependent Diabetes Mellitus. JAMA. 1994 May 11;271(18):1421-8. PubMed PMID: 7848401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus. A1 - Garg,A, AU - Bantle,J P, AU - Henry,R R, AU - Coulston,A M, AU - Griver,K A, AU - Raatz,S K, AU - Brinkley,L, AU - Chen,Y D, AU - Grundy,S M, AU - Huet,B A, PY - 1994/5/11/pubmed PY - 1994/5/11/medline PY - 1994/5/11/entrez SP - 1421 EP - 8 JF - JAMA JO - JAMA VL - 271 IS - 18 N2 - OBJECTIVE: To study effects of variation in carbohydrate content of diet on glycemia and plasma lipoproteins in patients with non-insulin-dependent diabetes mellitus (NIDDM). DESIGN: A four-center randomized crossover trial. SETTING: Outpatient and inpatient evaluation in metabolic units. PATIENTS: Forty-two NIDDM patients receiving glipizide therapy. INTERVENTIONS: A high-carbohydrate diet containing 55% of the total energy as carbohydrates and 30% as fats was compared with a high-monounsaturated-fat diet containing 40% carbohydrates and 45% fats. The amounts of saturated fats, polyunsaturated fats, cholesterol, sucrose, and protein were similar. The study diets, prepared in metabolic kitchens, were provided as the sole nutrients to subjects for 6 weeks each. To assess longer-term effects, a subgroup of 21 patients continued the diet they received second for an additional 8 weeks. MAIN OUTCOME MEASURES: Fasting plasma glucose, insulin, lipoproteins, and glycosylated hemoglobin concentrations. Twenty-four-hour profiles of glucose, insulin, and triglyceride levels. RESULTS: The site of study as well as the diet order did not affect the results. Compared with the high-monounsaturated-fat diet, the high-carbohydrate diet increased fasting plasma triglyceride levels and very low-density lipoprotein cholesterol levels by 24% (P < .0001) and 23% (P = .0001), respectively, and increased daylong plasma triglyceride, glucose, and insulin values by 10% (P = .03), 12% (P < .0001), and 9% (P = .02), respectively. Plasma total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels remained unchanged. The effects of both diets on plasma glucose, insulin, and triglyceride levels persisted for 14 weeks. CONCLUSIONS: In NIDDM patients, high-carbohydrate diets compared with high-monounsaturated-fat diets caused persistent deterioration of glycemic control and accentuation of hyperinsulinemia, as well as increased plasma triglyceride and very-low-density lipoprotein cholesterol levels, which may not be desirable. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/7848401/Effects_of_varying_carbohydrate_content_of_diet_in_patients_with_non_insulin_dependent_diabetes_mellitus_ L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/271/pg/1421 DB - PRIME DP - Unbound Medicine ER -