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

被引:26
作者
Ahmed, Shabina Roohi [1 ,2 ]
Bellamkonda, Sridevi [3 ,4 ]
Zilbermint, Mihail [1 ,5 ]
Wang, Jiangxia [6 ]
Kalyani, Rita Rastogi [1 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Med, Div Endocrinol Diabet & Metab, Baltimore, MD 21205 USA
[2] Johns Hopkins Community Phys, Endocrinol, Bethesda, MD 21202 USA
[3] Johns Hopkins Univ, Sch Med, Dept Med, Div Gen Internal Med, Baltimore, MD 21205 USA
[4] Johns Hopkins Community Phys, Internal Med, Germantown, MD USA
[5] Suburban Hosp, Johns Hopkins Community Phys, Endocrinol Diabet & Metab, Bethesda, MD USA
[6] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Biostat Consulting Ctr, Baltimore, MD USA
基金
美国国家卫生研究院;
关键词
type; 2; diabetes; nutritional management; dietary intervention; LIFE-STYLE INTERVENTION; INSULIN; RISK; ASSOCIATION; MANAGEMENT; MORTALITY;
D O I
10.1136/bmjdrc-2019-000980
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ObjectiveThe 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.Research design and methodsWe 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.ResultsCompared 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 (-12.8kg (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 -8.5mg/mL; p=0.03) compared with usual care.ConclusionsIn 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.
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页数:8
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