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Effects of low-carbohydrate diet on glycemic control in type 2 diabetes

Not Applicable
Conditions
Type 2 diabetes
Registration Number
JPRN-UMIN000000873
Lead Sponsor
Haimoto Clinic
Brief Summary

Background With respect to energy metabolism, acute metabolic responses to high-carbohydrate meals (HCMs) have not been determined in LCD patients with T2DM. Subjects and methods We enrolled 31 subjects with T2DM (mean age: 62 yrs, mean hemoglobin A1c level: 6.9%), of whom 13 were on a strict LCD (26% carbohydrate diet), and 18 a moderate one (44% carbohydrate diet). Two isocaloric meals were administered to all subjects in a randomized crossover design. The carbohydrate:protein:fat ratios of HCMs and low-carbohydrate meals (LCMs) were 59:20:21 and 7:20:73, respectively. Serum beta-hydroxybutyrate, acetoacetate, free fatty acids (FFAs), triglyceride and insulin, and plasma glucose concentrations were measured for 120 minutes after the intake of each meal. Results HCMs rapidly decreased postprandial beta-hydroxybutyrate, acetoacetate and FFA concentrations within 2 hours in all patients in combination with rapid increases in serum insulin and plasma glucose, while LCMs increased or did not change beta-hydroxybutyrate, acetoacetate and FFAs (P<0.001 for all). HCMs did not change postprandial triglyceride concentrations over 2 hours, while LCMs gradually increased them (P<0.001). HCMs sharply and rapidly decreased postprandial beta-hydroxybutyrate and acetoacetate concentrations in strict LCD subjects over 2 hours, but only slightly decreased them in moderate LCD subjects (P<0.001, difference between strict and moderate LCD subjects). The parameter deltaketone bodies (level at 120 minutes - level at baseline) was significantly correlated with the insulinogenic index (r=0.503 for Beta-hydroxybutyrate and 0.509 for acetoacetate), but not with total insulin secretory capacity. Moreover, HCMs slightly decreased postprandial triglyceride levels in strict LCD subjects but somewhat increased them in the moderate LCD subjects (P=0.002). The parameter deltatriglyceride was significantly correlated with background dietary %carbohydrate (r=0.484).

Detailed Description

Not available

Recruitment & Eligibility

Status
Complete: follow-up complete
Sex
All
Target Recruitment
35
Inclusion Criteria

Not provided

Exclusion Criteria

HbA1c>8.0, chronic renal failure, midication with sulfonylureas, malignancy

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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