Effects of the low carbohydrate, high fat diet on glycemic control and body weight in patients with type 2 diabetes: experience from a community-based cohort.


Journal

BMJ open diabetes research & care
ISSN: 2052-4897
Titre abrégé: BMJ Open Diabetes Res Care
Pays: England
ID NLM: 101641391

Informations de publication

Date de publication:
03 2020
Historique:
received: 12 10 2019
revised: 11 12 2019
accepted: 28 01 2020
entrez: 21 3 2020
pubmed: 21 3 2020
medline: 22 6 2021
Statut: ppublish

Résumé

The optimal diet to improve glycemia in patients with type 2 diabetes remains unclear. Low carbohydrate, high fat (LCHF) diets can improve glycemic control, but have not been investigated in real-world settings. We investigated effects of the LCHF diet compared with usual care in a community-based cohort of patients with type 2 diabetes by performing a retrospective study of 49 patients who followed the LCHF diet for ≥3 months, and compared glycemic outcomes with age-matched and body mass index (BMI)-matched controls who received usual care (n=75). The primary outcome was change in A1C from baseline to the end of follow-up. Compared with the usual care group, the LCHF group showed a significantly greater reduction in A1C (-1.29% (95% CI -1.75 to -0.82; p<0.001)) and body weight (-12.8 kg (95% CI -14.7 to -10.8; p<0.001) at the end of follow-up after adjusting for age, sex, baseline A1C, BMI, baseline insulin dose. Of the patients initially taking insulin therapy in the LCHF group, 100% discontinued it or had a reduction in dose, compared with 23.1% in the usual care group (p<0.001). The LCHF group also had significantly greater reduction in fasting plasma glucose (-43.5 vs -8.5 mg/mL; p=0.03) compared with usual care. In a community-based cohort of type 2 diabetes, the LCHF diet was associated with superior A1C reduction, greater weight loss and significantly more patients discontinuing or reducing antihyperglycemic therapies suggesting that the LCHF diet may be a metabolically favorable option in the dietary management of type 2 diabetes.

Identifiants

pubmed: 32193200
pii: 8/1/e000980
doi: 10.1136/bmjdrc-2019-000980
pmc: PMC7103851
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NIDDK NIH HHS
ID : R03 DK109163
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001079
Pays : United States

Informations de copyright

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

Diabetes Care. 2009 Jul;32(7):1147-52
pubmed: 19366978
Diabetes Obes Metab. 2015 Apr;17(4):371-8
pubmed: 25523815
Diabetes Obes Metab. 2010 Jan;12(1):47-53
pubmed: 19788429
Diabet Med. 1996 Jul;13(7):656-62
pubmed: 8840101
Nutr Diabetes. 2016 Sep 19;6(9):e230
pubmed: 27643725
JAMA Netw Open. 2018 Dec 7;1(8):e186125
pubmed: 30646315
Diabetes Ther. 2018 Apr;9(2):583-612
pubmed: 29417495
Nutr Metab (Lond). 2008 Dec 19;5:36
pubmed: 19099589
Am J Clin Nutr. 2018 Aug 1;108(2):300-331
pubmed: 30007275
Nutr Metab (Lond). 2005 Dec 01;2:34
pubmed: 16318637
Am J Clin Nutr. 2015 Oct;102(4):780-90
pubmed: 26224300
Eur J Epidemiol. 2018 Feb;33(2):157-170
pubmed: 29302846
J Am Coll Nutr. 2013;32(1):11-7
pubmed: 24015695
J Lab Clin Med. 1963 Oct;62:646-56
pubmed: 14080865
Diabetes Care. 2006 Sep;29(9):2102-7
pubmed: 16936160
Am J Epidemiol. 2012 Oct 1;176 Suppl 7:S44-54
pubmed: 23035144
Prog Lipid Res. 2008 Sep;47(5):307-18
pubmed: 18396172
Diabetes Obes Metab. 2015 Apr;17(4):350-62
pubmed: 25399739
Nutrients. 2013 Dec 18;5(12):5205-17
pubmed: 24352095
Lancet. 2014 Jun 7;383(9933):1999-2007
pubmed: 24910231
N Engl J Med. 2008 Jul 17;359(3):229-41
pubmed: 18635428
J Clin Invest. 1988 Feb;81(2):442-8
pubmed: 3276730
Diabetes Care. 2019 Jan;42(Suppl 1):S46-S60
pubmed: 30559231
Popul Health Metr. 2010 Oct 22;8:29
pubmed: 20969750
Ann Intern Med. 2005 Mar 15;142(6):403-11
pubmed: 15767618
Diabetes Obes Metab. 2018 Apr;20(4):858-871
pubmed: 29178536
Metabolism. 2012 Jan;61(1):76-83
pubmed: 21816443
Pharmacoepidemiol Drug Saf. 2008 Aug;17(8):753-9
pubmed: 18613215
Nutrition. 2012 Oct;28(10):1016-21
pubmed: 22673594
Obes Res Clin Pract. 2008 Mar;2(1):I-II
pubmed: 24351673
N Engl J Med. 2002 Feb 7;346(6):393-403
pubmed: 11832527
Obes Surg. 2010 Sep;20(9):1245-50
pubmed: 20524158
Int J Obes Relat Metab Disord. 1992 Jun;16(6):397-415
pubmed: 1322866
Nutr Diabetes. 2017 Dec 21;7(12):304
pubmed: 29269731
Diabetes Care. 2018 May;41(5):917-928
pubmed: 29567642

Auteurs

Shabina Roohi Ahmed (SR)

Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Shabina.r.ahmed@gmail.com.
Endocrinology, Johns Hopkins Community Physicians, Bethesda, Maryland, USA.

Sridevi Bellamkonda (S)

Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Internal Medicine, Johns Hopkins Community Physicians, Germantown, Maryland, USA.

Mihail Zilbermint (M)

Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Endocrinology, Diabetes and Metabolism, Johns Hopkins Community Physicians Suburban Hospital, Suburban Hospital, Bethesda, Maryland, USA.

Jiangxia Wang (J)

Biostatistics Consulting Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.

Rita Rastogi Kalyani (RR)

Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

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