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Low-carbohydrate diet reduces A1c in diabetes and prediabetes

 


6 months of low carb diet may decrease A1c levels in pre-diabetes or diabetic patients, new research suggests.

results from randomized trial 150 adults with untreated A1c between 6.0% and 6.9% were included publish online October 26th JAMA network open By Kirsten S. Dorans, ScD, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, and a colleague Assistant Professor of Epidemiology.

The dietary intervention targeted a total net carbohydrate intake of <40 g for the first 3 months and <60 g for the next 3 months, emphasizing high-fiber carbohydrates. A comparison group followed a normal diet. "I think the key message is that a low-carbohydrate diet, if maintained, could be a useful approach to prevention and treatment. type 2 diabetesbut more research is needed,” Dorans said. Medscape Medical News.

She also added, “Due to the design, we cannot see any effects independent of calorie reduction or weight loss.

In fact, Dr. Naveed Sattar, Professor of Metabolic Medicine at the University of Glasgow, Scotland, UK, said in a commentary for the Science Media Centre: Known to reduce weight.- Carbohydrate diets cardiovascular risk May not be sustainable over the long term. ”

However, Dorans explains: [undergo] By reducing carbohydrate intake. ”

Removed A1c and improved other parameters

All study participants were adults between the ages of 40 and 70 and were recruited by mass mail from the New Orleans, Louisiana area. Individuals identified by prescreening as being at high risk for prediabetes or type 2 diabetes were invited for screening. Patients with untreated her A1c between 6.0% (the lower World Health Organization cutoff for prediabetes) and 6.9% (the upper limit of his A1c target for diabetics recommended by the American Diabetes Association) were selected. rice field.

Of the 150 people enrolled, 72% were female and 59% were black. The overall mean A1c was 6.2% and most (87%) had untreated her A1c <6.5% (i.e. prediabetes).

The low-carb group received behavioral counseling, a handbook containing dietary guidelines and recipes, and supplements. Four small group sessions and four telephone follow-ups were conducted biweekly. The second phase, ‘Discreet’, consisted of 3 monthly group sessions and 3 phone follow-ups.

In contrast, the normal diet group received written information including standard dietary advice and monthly educational sessions for non-diet-related options.

This difference represents another limitation, says Duane Mellor, registered dietitian and senior teaching fellow at Aston College of Medicine, Aston University, Birmingham, UK. “Since the groups were not given the same level of input, the low-carbohydrate groups enrolled in courses called ‘low-carbohydrate’ and ‘low-carbohydrate’ were given significantly more support than the control group.” …ideally.both groups should have been given the same level of support. ”

During follow-up, total caloric intake was lower in the intervention than in the normal diet group (net differences in change at 3 and 6 months were -389 and -456 kcal, respectively). ). Total and net carbohydrate intake, added sugars, and sweetened beverage intake were all lower in the intervention group at follow-up, whereas the percentage of calories from protein and fat was higher.

The primary outcome, the change in A1c from baseline to 6 months, was greater in the low-carbohydrate intervention group compared to 0.04 percentage points in the normal diet group, a decrease of -0.26 percentage points, with a significance of 0.23 percentage points. There was a difference. A difference of 0.16 points at 3 months was also significant.

There was also a significant 6-month reduction in fasting blood glucose (-8.4 mg/dL vs +1.9 mg/dL) and body weight (-6.4 kg vs -0.5 kg).

Changes in cholesterol from total cholesterol to high-density lipoprotein did not differ significantly between groups.

As assessed using continuous glucose monitoring, the intervention group spent 9.8% more time in the 70–120 mg/dL range than the normal diet group. At 6 months, 39 participants (53%) in the intervention group and 22 participants (32%) in the normal diet group had his A1c <6.0%, a significant difference.

The direction of effect was consistent across race and gender subgroups.

Although the incidence of adverse events was similar between groups, more participants in the intervention group reported muscle cramps after 3 months (35% vs. 19%; P. = .03) and 6 months (34% vs 19%; P. = .04).

This research was supported by the National Institute of General Medical Sciences and the Tulane University Carol Rabin Vernick Undergraduate Grant Program. Dorans reports receiving grants from the National Heart, Lung, and Blood Institute outside of her submitted work. The California Walnut Commission provided walnuts for this study. Shakes and bars were donated by The Simply Good Foods Company. Sugar replacement samples were provided by Swerve.

JAMA net opened. Published online on October 26, 2022. full text

Miriam E. Tucker is a freelance journalist based in Washington, DC. She is a regular contributor to her Medscape, and her other work appears in her The Washington Post, her Shots blog on NPR, and Diabetes Forecast magazine. She uses @MiriamETucker on her Twitter.

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