Abstract

Abstract Introduction Obesity is strongly linked to the development of diabetic kidney disease. Very low carbohydrate diets (VLCBD) were associated with a reduction in weight but there is little evidence of its effects on diabetic kidney disease (DKD) patients. The aim of the randomized controlled trial study is to determine the metabolic effects of VLCBD in addition to low protein diet (LPD) in DKD patients. Materials and Methods 30 patients with type 2 diabetes aged 40-75 years and a HbA1c 7-10.5% were randomly allocated to receive VLCBD (<20g daily intake) versus standard low protein (0.8g/kg/day) diet. The patients received consultations every two weeks for 12 weeks. Metabolic profiles, glycemic control, inflammatory markers and visceral adipose tissue mass effects of the dietary interventions were compared. Result: The VLCBD group demonstrated significant reductions in weight (-4. 0 IQR 3.9 vs 0.2 IQR4.2 kg, p=<0. 001) and BMI (-1.5 IQR 1.18 vs 0. 074 IQR 1.54, p=<0. 001) in comparison to LPD group. There was reduction in waist circumference within both groups (- 4. 0 IQR 5.25, p= 0. 003 and -2. 0 IQR 3.6, p=0. 009) respectively. Estimated visceral adipose tissue mass and volume were significantly reduce in VLCBD group. There was significant reduction in ALT and GGT in both group. However, there is no significant changes in improvement in liver US in both groups. However, both group also showed significant reduction in HbA1c (-1.3 IQR 1.1% vs -0.7 IQR1.25%, respectively, p=NS). There is significant increment in LDL in VLCBD group which not present in LPD group. The VLCBD group showed a significant reduction in IL-6 levels with a contrasting rise within the LPD group (-1.53 IQR3.35 vs 0.46 IQR 1.95, p= 0. 028). Patients in VLCBD appeared to have improvement in physical activity score in comparison to LPD group. Conclusion After short term intensive VLCBD intervention in DKD patients, improvement were observed in metabolic markers, diabetes status and inflammatory markers with improvement of physical activity score. Presentation: No date and time listed

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