Low-carb diets show longer-term perks

In obese type 2 diabetic patients, a low-carbohydrate diet with some calorie restriction can have lasting benefits on body weight and glycemic control, a study has reported.

Swedish researchers previously reported that 16 obese patients with type 2 diabetes who followed a 20% carbohydrate diet demonstrated significantly better glycemic control and body weight over six months, compared to 15 patients following a 55-60% carbohydrate diet.

Follow-up data at 22 months for the low-carbohydrate group showed "stable improvement" of body weight and glycemic control, wrote Dr Jorgen Vesti Nielsen and Dr Eva A. Joensson in the journal Nutrition and Metabolism.

At six months, mean body weight among the low-carbohydrate group was 89.2 kg and at 22 months it was 92.0 kg, compared to 100.6 kg at the start of the trial.

"It is significant," the authors note, "that 44% of the patients have had a stable weight or have reduced it further and all but one had a lower weight at 22 months than at the beginning of the study."

Initial HbA1c was 8.0% in the low-carbohydrate group. After six and 12 months, HbA1c had improved to 6.6% and 7.0%, respectively. At 22 months it was still reduced among subjects, at 6.9%.

After six months on the low-carb diet, two of five patients using sulfonylurea had discontinued this medication and three were able to lower the dosage. Similarly, three of 11 insulin-treated patients discontinued insulin and the mean insulin requirement among the other eight had fallen significantly from 60 IU/day to 18 IU/day.

"Several recent reviews have made the case for reducing the carbohydrate load in type 2 diabetes...the diet presented here is clearly effective in many obese people with type 2 diabetes," the authors write. "Because of its effectiveness it should be used with close clinical supervision in patients on insulin or oral hypoglycemic agents."

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