A Low-Carbohydrate Diet Realizes Medication Withdrawal: A Possible Opportunity for Effective Glycemic Control.
Study Goal
The researchers aimed to compare the effects of a low-carbohydrate diet (LCD) versus a low-fat diet (LFD) on glycemic control, body weight, and medication use in Chinese patients with type 2 diabetes mellitus (T2DM).
Results Summary
The LCD group showed significant reductions in body weight, BMI, fasting blood glucose, postprandial blood glucose, and HbA1c levels compared to the LFD group. Additionally, the LCD group had a higher reduction in lipid-lowering agent use, though no significant differences were observed for other medications.
Population
121 Chinese patients with type 2 diabetes mellitus (T2DM).
Effective Dosage
Not specified (proportions of calories from major nutrients met LCD and LFD requirements).
Duration
6 months.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
low-carbohydrate diet (LCD) | decrease | body weight | Chinese patients with T2DM | - | decreased significantly | #1 |
low-carbohydrate diet (LCD) | decrease | body weight index (BMI) | Chinese patients with T2DM | - | decreased significantly | #2 |
low-carbohydrate diet (LCD) | decrease | fasting blood glucose (FBG) | Chinese patients with T2DM | - | decreased significantly | #3 |
low-carbohydrate diet (LCD) | decrease | postprandial 2-h blood glucose (PPG) | Chinese patients with T2DM | - | decreased significantly | #4 |
low-carbohydrate diet (LCD) | decrease | glycosylated hemoglobin (HbA1c) | Chinese patients with T2DM | - | decreased significantly | #5 |
low-carbohydrate diet (LCD) | decrease | MES | Chinese patients with T2DM | - | decreased | #6 |
low-carbohydrate diet (LCD) | decrease | lipid-lowering agents | Chinese patients with T2DM | - | decreased | #7 |
low-carbohydrate diet (LCD) | decrease | cost burden | Chinese patients with T2DM | - | decreased | #8 |
low-carbohydrate diet (LCD) | no change | antihypertensive agents | Chinese patients with T2DM | - | showed no significant difference | #9 |
low-carbohydrate diet (LCD) | no change | hormone-replacement agents | Chinese patients with T2DM | - | showed no significant difference | #10 |
low-carbohydrate diet (LCD) | no change | other agents | Chinese patients with T2DM | - | showed no significant difference | #11 |
low-fat diet (LFD) | no change | MES | Chinese patients with T2DM | - | showed no significant difference | #12 |
low-carbohydrate diet (LCD) | no change | dosages of insulin used | Chinese patients with T2DM | - | showed no significant difference | #13 |
OBJECTIVE: Multiple studies have confirmed that diet restrictions can effectively realize glycemic control and reduce metabolic risks in patients with type 2 diabetes mellitus (T2DM). In 2018, the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) stated that individuals can select a low-carbohydrate diet (LCD) according to their needs and preferences. Owing to the influence of Chinese traditional eating habits, only a small portion of patients in China have achieved their blood glucose goals. As a result, the Chinese government will incur huge expenditures. METHOD: This study recruited 134 T2DM participants and randomly assigned them to the LCD group (n = 67) or the low-fat diet (LFD) group (n = 67). All of the patients had a fixed amount of exercise and were guided by clinicians. After a period of dietary washout, all of the patients received corresponding dietary education according to group. The follow-up time was 6 months. The indicators for anthropometry, glycemic control, and medication application parameters were collected and compared between the two groups. RESULTS: There were 121 participants who finally entered the study. The proportions of calories from three major nutrients the participants consumed met the requirements of LCD and LFD. Compared with baseline, the pre-postdifferences of body weight, BMI, and several other indicators were significant except for dosages of insulin used in the LCD group and MES in the LFD group. After the intervention, body weight, body weight index (BMI), fasting blood glucose (FBG), postprandial 2-h blood glucose (PPG), and glycosylated hemoglobin (HbA1c) levels in the LCD group decreased significantly (p < 0.05) compared with the LFD group. The number of patients using lipid-lowering agents was significant higher in the LCD group and lower in the LFD group. However, there was no significant difference between the two groups for antihypertensive, hormone-replacement, and other agents. CONCLUSIONS: The LCD diet can decrease body weight, glycemic levels, MES, and lipid-lowering agents more than the LFD diet, thus decreasing cost burden in Chinese patients with T2DM. Strict diet control and monitoring are the keys to managing diabetes.