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Low-carb diet better than low-GI diet for type 2
diabetics
Abstract
Objective
Dietary carbohydrate is the major determinant of
postprandial glucose levels, and several clinical
studies have shown that low-carbohydrate diets improve
glycemic control. In this study, we tested the
hypothesis that a diet lower in carbohydrate would lead
to greater improvement in glycemic control over a
24-week period in patients with obesity and type 2
diabetes mellitus. Research design and methods:
Eighty-four community volunteers with obesity and type
2 diabetes were randomized to either a
low-carbohydrate, ketogenic diet (<20 g of
carbohydrate daily; LCKD) or a low-glycemic,
reduced-calorie diet (500 kcal/day deficit from weight
maintenance diet; LGID). Both groups received group
meetings, nutritional supplementation, and an exercise
recommendation. The main outcome was glycemic control,
measured by hemoglobin A1c.
Results
Forty-nine (58.3%) participants completed the study.
Both interventions led to improvements in hemoglobin
A1c, fasting glucose, fasting insulin, and weight loss.
The LCKD group had greater improvements in hemoglobin
A1c (-1.5% vs. -0.5%, p=0.03), body weight (-11.1 kg
vs. -6.9 kg, p=0.008), and high density lipoprotein
cholesterol (+5.6 mg/dL vs. 0 mg/dL, p<0.001)
compared to the LGID group. Diabetes medications were
reduced or eliminated in 95.2% of LCKD vs. 62% of LGID
participants (p<0.01).
Conclusions
Dietary modification led to improvements in glycemic
control and medication reduction/elimination in
motivated volunteers with type 2 diabetes. The diet
lower in carbohydrate led to greater improvements in
glycemic control, and more frequent medication
reduction/elimination than the low glycemic index diet.
Lifestyle modification using low carbohydrate
interventions is effective for improving and reversing
type 2 diabetes.
Westman EC, et al. The effect of
a low-carbohydrate, ketogenic diet versus a
low-glycemic index diet on glycemic control in type 2
diabetes mellitus. Nutrition
& Metabolism 2008, 5:36
doi:10.1186/1743-7075-5-36
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