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In type 2 diabetes,...
In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss
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- Guldbrand, Hans (author)
- Linköpings universitet,Allmänmedicin,Hälsouniversitetet
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- Dizdar, B. (author)
- Linköpings universitet,Allmänmedicin,Hälsouniversitetet
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- Bunjaku, B. (author)
- Linköpings universitet,Allmänmedicin,Hälsouniversitetet
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- Lindström, Torbjörn (author)
- Linköpings universitet,Internmedicin,Endokrinologi,Hälsouniversitetet
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- Bachrach-Lindström, Margareta (author)
- Linköpings universitet,Omvårdnad,Hälsouniversitetet
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- Fredrikson, Mats (author)
- Linköpings universitet,Avdelningen för neuro- och inflammationsvetenskap,Hälsouniversitetet
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- Östgren, Carl Johan (author)
- Östergötlands Läns Landsting,Linköpings universitet,Allmänmedicin,Hälsouniversitetet,Primärvården i västra länsdelen
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- Nyström, Fredrik H. (author)
- Östergötlands Läns Landsting,Linköpings universitet,Internmedicin,Endokrinologi,Hälsouniversitetet,Endokrinmedicinska kliniken
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(creator_code:org_t)
- 2012-05-06
- 2012
- English.
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In: Diabetologia. - : Springer. - 0012-186X .- 1432-0428. ; 55:8, s. 2118-2127
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Abstract
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- AIMS/HYPOTHESIS: The study aimed to compare the effects of a 2 year intervention with a low-fat diet (LFD) or a low-carbohydrate diet (LCD), based on four group meetings to achieve compliance. METHODS: This was a prospective randomised parallel trial involving 61 adults with type 2 diabetes consecutively recruited in primary care and randomised by drawing ballots. Patients that did not speak Swedish could not be recruited. The primary outcomes in this non-blinded study were weight and HbA(1c). Patients on the LFD aimed for 55-60 energy per cent (E%) and those on LCD for 20 E% from carbohydrate. RESULTS: The mean BMI and HbA(1c) of the participants were 32.7 ± 5.4 kg/m(2) and 57.0 ± 9.2 mmol/mol, respectively. No patients were lost to follow-up. Weight loss did not differ between groups and was maximal at 6 months: LFD -3.99 ± 4.1 kg (n = 31); LCD -4.31 ± 3.6 kg (n = 30); p < 0.001 within groups. At 24 months, patients on the LFD had lost -2.97 ± 4.9 kg and those on LCD -2.34 ± 5.1 kg compared with baseline (p = 0.002 and p = 0.020 within groups, respectively). HbA(1c) fell in the LCD group only (LCD at 6 months -4.8 ± 8.3 mmol/mol, p = 0.004, at 12 months -2.2 ± 7.7 mmol/mol, p = 0.12; LFD at 6 months -0.9 ± 8.8 mmol/mol, p = 0.56). At 6 months, HDL-cholesterol had increased with the LCD (from 1.13 ± 0.33 mmol/l to 1.25 ± 0.47 mmol/l, p = 0.018) while LDL-cholesterol did not differ between groups. Insulin doses were reduced in the LCD group (0 months, LCD 42 ± 65 E, LFD 39 ± 51 E; 6 months, LCD 30 ± 47 E, LFD 38 ± 48 E; p = 0.046 for between-group change). CONCLUSIONS/INTERPRETATION: Weight changes did not differ between the diet groups, while insulin doses were reduced significantly more with the LCD at 6 months, when compliance was good. Thus, aiming for 20% of energy intake from carbohydrates is safe with respect to cardiovascular risk compared with the traditional LFD and this approach could constitute a treatment alternative. TRIAL REGISTRATION: ClinicalTrials.gov NCT01005498 FUNDING: University Hospital of Linköping Research Funds, Linköping University, the County Council of Östergötland, and the Diabetes Research Centre of Linköping University.
Keyword
- Blood glucose – Dietary intervention – HDL-cholesterol – LDL-cholesterol – Low-carbohydrate diet – Type 2 diabetes
Publication and Content Type
- ref (subject category)
- art (subject category)
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