Very low carbohydrate diet beneficial for obese with T2DM

(HealthDay)—For obese adults with type 2 diabetes mellitus (T2DM), a very low carbohydrate diet is associated with greater improvements in glycemic control and cardiovascular risk markers than an energy-matched high unrefined carbohydrate diet, according to a study published online July 28 in Diabetes Care.

Jeannie Tay, from the Commonwealth Scientific and Industrial Research Organization in Adelaide, Australia, and colleagues compared the effects of a very low carbohydrate, high unsaturated/low saturated fat diet (LC) with a high-unrefined carbohydrate, low fat diet (HC) on glycemic control and cardiovascular disease risk factors. Participants included 115 obese adults with T2DM who were randomized to 24 weeks of a hypocaloric LC diet or an energy-matched HC diet, combined with structured exercise.

Ninety-three participants completed the 24-week program, with similar completion rates (LC, 79 percent; HC, 82 percent). The researchers found that weight loss was similar between the groups (LC: −12.0 ± 6.3 kg versus HC: −11.5 ± 5.5 kg; P ≥ 0.50), and blood pressure, fasting blood glucose, and low-density lipoprotein cholesterol all decreased, with no diet effect (P ≥ 0.10). Greater reductions were seen in triglycerides, antiglycemic medication effects score, and glycemic variability indices with LC (P ≤ 0.03). In participants with baseline values of hemoglobin A1c >7.8 percent and high-density lipoprotein cholesterol <1.29 mmol/L, LC induced greater reductions in hemoglobin A1c (P = 0.002) and greater increases in high-density lipoprotein cholesterol (P = 0.007).

"This suggests an LC diet with low saturated fat may be an effective dietary approach for T2DM management if effects are sustained beyond 24 weeks," the authors write.