CHICAGO — Compared with a low-fat, calorie-restricted diet, a low-carbohydrate diet reduced HbA1c and resulted in twice as much weight loss in patients with diabetes, study results presented at the ADA Scientific Sessions suggest.
Participants were randomly assigned a low-fat, calorie-restricted diet in which caloric intake was 500 calories below the estimated need for weight maintenance (n=18) or a low-carbohydrate diet that restricted intake of carbohydrates to 50 gm per day excluding fiber (n=16). Carbohydrates comprised 45% to 50% and fat comprised 25% to 35% of the low-fat, low-calorie diet. Both groups were taught psychological skills to assist in behavior change and maintenance during 13 sessions over 3 months. Patients receiving insulin were excluded from the trial, and 74% were receiving oral medication.
Overall, mean HbA1c decreased –0.02% in the low-fat, low-calorie group and –0.59% in the low-carbohydrate group (P=.04 comparing groups). Thirteen percent of participants in the low-carbohydrate diet group reached an HbA1c of less than 5.7% vs. none in the low-fat, low-calorie group, according to the study abstract. The use of oral diabetes medication was reduced or discontinued by 11% of participants in the low-fat, low-calorie diet group vs. 47% in the low-carbohydrate group. Although calories were not restricted, those on the low-carbohydrate diet lost twice as much weight compared with those on the low-fat, low-calorie diet. Researchers said that blood lipid levels did not worsen in the low-carbohydrate group, despite the high fat content of carbohydrates.
“Our results propose that a lower carbohydrate diet coupled with skills that promote behavior change may improve glucose control in type 2 diabetes,” researchers wrote.
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