Abstract
Although intensive interventions with low carbohydrate diets compared with higher carbohydrate diets can reduce HbA1c in people with type 2 diabetes, it is not clear if simple advice to make modest reductions in carbohydrate is effective in clinical practice. Forty-three people with type 2 diabetes and poor control (HbA1c > 7.5%) were randomized to receive 2 short education sessions over 6 months with a non-dietitian researcher on how to reduce carbohydrate intake by about 25% or to 2 control sessions in which the Australian Guide to Healthy Eating was provided. Hba1c and fasting glucose and lipids were measured at baseline and 3 months and 6 months. 33 volunteers attended a baseline visit; 27 completed 3 months and 24 6 months. HbA1c was reduced by 0.6% - 0.7% in the low carbohydrate diet group compared with the control group (P = 0.1). Fasting glucose was reduced by 2.3 mmol/L compared with the control group at 3 months (P < 0.03) only. Changes in HbA1c at 6 months were related to baseline HbA1c in the intervention group only. Although we have obtained suggestive evidence that a low carbohydrate diet can be successfully implemented in normal practice without professional help, our results are limited by low participant numbers and further studies are required.
Highlights
Intensive intervention with very low carbohydrate diets combined with weight loss could lead to lower HbA1c
Low carbohydrate interventions without weight loss can lower HbA1c and glucose in untreated type 2 diabetes but trial numbers are small, and the interventions have been very intensive, and the volunteers were on no medication for diabetes [5]
Low carbohydrate diets are recommended as the first line therapy for both type 1 and type 2 diabetes by some authors [6] diabetes associations currently do not recommend this and there is very little evidence of efficacy of the diet in patients on a variety of medications including insulin and in which contact is limited to usual clinical practice rather than the more intensive research contact
Summary
Intensive intervention with very low carbohydrate diets combined with weight loss could lead to lower HbA1cHow to cite this paper: Clifton, P.M., Coles, L.T. and Galbraith, C.E. (2016) Low Carbohydrate Diets in Type 2 Diabetes—A Translational Study. Intensive intervention with very low carbohydrate diets combined with weight loss could lead to lower HbA1c. Low carbohydrate interventions without weight loss can lower HbA1c and glucose in untreated type 2 diabetes but trial numbers are small, and the interventions have been very intensive, and the volunteers were on no medication for diabetes [5]. A 3 month very low carbohydrate intervention [7] with 4education sessions in patients with very poor glycemic control (Hba1c 9%) led to 2.6 kg more weight loss than a low fat diet in 79 completers (P < 0.001), but HBA1c was reduced by only 0.3% more than the control diet (P = 0.1). There were no differences in weight or glycemic control between the groups at 6, 12 or 24 months despite weekly visits for a month and monthly visits thereafter [8]
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