A low-carbohydrate, ketogenic diet to treat type 2 diabetes

被引：165
作者：
Yancy Jr. W.S. [1 ,2 ]
Foy M. [1 ]
Chalecki A.M. [1 ]
Vernon M.C. [3 ]
Westman E.C. [2 ]
机构：
[1] Center for Health Services Research in Primary Care, Department of Veterans' Affairs Medical Center (152), Durham, NC 27705
[2] Department of Medicine, Duke University Medical Center, Durham, NC
[3] Private Bariatric and Family Practice, and Clinical Faculty, University of Kansas, School of Medicine, Lawrence, KS
来源：
Nutrition & Metabolism | / 2卷 / 1期
关键词：
Ketogenic Diet; Oral Hypoglycemic Agent; Diabetes Medication; Hypoglycemic Episode; Medication Adjustment;
D O I：
10.1186/1743-7075-2-34
中图分类号：
学科分类号：
摘要：
Background: The low-carbohydrate, ketogenic diet (LCKD) may be effective for improving glycemia and reducing medications in patients with type 2 diabetes. Methods: From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A 1c. Results: Twenty-one of the 28 participants who were enrolled completed the study. Twenty participants were men; 13 were White, 8 were African-American. The mean [± SD] age was 56.0 ± 7.9 years and BMI was 42.2 ± 5.8 kg/m2. Hemoglobin A1c decreased by 16% from 7.5 ± 1.4% to 6.3 ± 1.0% (p < 0.001) from baseline to week 16. Diabetes medications were discontinued in 7 participants, reduced in 10 participants, and unchanged in 4 participants. The mean body weight decreased by 6.6% from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg (p < 0.001). In linear regression analyses, weight change at 16 weeks did not predict change in hemoglobin A1c. Fasting serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001) while other serum lipid measurements did not change significantly. Conclusion: The LCKD improved glycemic control in patients with type 2 diabetes such that diabetes medications were discontinued or reduced in most participants. Because the LCKD can be very effective at lowering blood glucose, patients on diabetes medication who use this diet should be under close medical supervision or capable of adjusting their medication. © 2005 Yancy et al; licensee BioMed Central Ltd.
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