A 6-month low-carbohydrate fare whitethorn trim A1c levels successful radical with prediabetes oregon diabetes, caller probe suggests.
Results from a randomized trial involving 150 adults with untreated A1c of 6.0% to 6.9% were published online October 26 successful JAMA Network Open by Kirsten S. Dorans, ScD, adjunct prof of epidemiology astatine Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, and colleagues.
The dietary involution targeted a full nett carbohydrate intake of little than 40 g for the archetypal 3 months, past little than 60 g for the adjacent 3 months, emphasizing high-fiber carbohydrates. The examination radical followed a accustomed diet. "I deliberation the cardinal connection is that a debased carbohydrate diet, if it tin beryllium maintained, mightiness beryllium a utile attack for preventing and treating type 2 diabetes, but much probe is needed," Dorans told Medscape Medical News.
She besides noted, "Because of the plan we can't spot the effect autarkic of calorie simplification oregon value loss."
Indeed, successful a commentary via the Science Media Centre, Naveed Sattar, PhD, prof of metabolic medicine astatine the University of Glasgow, Scotland, UK, said: "We cognize value nonaccomplishment leads to improvements successful glucose, and truthful a low-carb diet, known to little weight, volition predictably little A1c. What this survey cannot amusement owed to plan is to what grade benefits are owed to value nonaccomplishment (likely astir successful my opinion) versus cutting carbs per se. That is the bigger question, though low-carb diets whitethorn not beryllium arsenic bully for radical successful presumption of cardiovascular risk and whitethorn not beryllium sustainable implicit longer periods."
However, Dorans explained, "We weren't doing a strictly controlled feeding study, but much of a behavioral manner intervention. We wanted to spot what types of changes radical would [undergo] by lowering their carbohydrate intake."
A1c Dropped, Other Parameters Improved
The survey participants, each adults aged 40-70 years, were recruited from the New Orleans, Louisiana, country via a wide mailing. Those identified to beryllium astatine elevated hazard for prediabetes oregon benignant 2 diabetes via pre-screening were invited for screening. Those with untreated A1c betwixt 6.0% (the World Health Organization lower cutoff for prediabetes) and 6.9% (the precocious bound of the American Diabetes Association's recommended A1c people for radical with diabetes) were selected.
Of the 150 enrolled, 72% were women and 59% were Black. Overall mean A1c was 6.2%, and astir (87%) had untreated A1c < 6.5% (ie, prediabetes).
The low-carbohydrate radical received behavioral counseling, a handbook with dietary guidelines and recipes, and supplemental foods. In the first phase, called "go low," idiosyncratic sessions were held play for the archetypal 4 weeks, followed by 4 tiny radical sessions each different week and 4 telephone follow-ups. A 2nd phase, "keep it low," progressive 3 monthly radical sessions and 3 telephone follow-ups.
In contrast, the accustomed fare radical received written accusation with modular dietary proposal and optional monthly acquisition sessions not related to diet.
This quality represents different limitation, noted Duane Mellor, registered dietitian and elder teaching fellow, Aston Medical School, Aston University, Birmingham, England, UK. "The groups were not fixed the aforesaid level of input, truthful the radical of the debased carbohydrate groups who were enrolled connected courses called 'go low' and 'keep it low' were fixed a batch much enactment than the power group...Ideally some groups should person been fixed the aforesaid level of support."
During follow-up, full calorie intake was little successful the involution than accustomed fare radical (net differences successful alteration astatine 3 and 6 months were –389 kcal and –456 kcal, respectively). Intakes of full and nett carbohydrates, added sugars, and sugar-sweetened beverages were each little successful the involution radical astatine follow-up, portion percentages of calories from proteins and fats were higher.
The superior outcome, alteration successful A1c from baseline to 6 months, was larger with the low-carbohydrate involution group, with a driblet of –0.26 percent points, compared with 0.04 percentage points successful the accustomed fare group, a important 0.23-point difference. The 0.16-point quality astatine 3 months was besides significant.
There were besides importantly greater 6-month decreases successful fasting plasma glucose (–8.4 mg/dL vs +1.9 mg/dL) and assemblage value (–6.4 kg vs –0.5 kg).
There were nary important differences betwixt groups successful changes successful total-to-high-density lipoprotein cholesterol.
Assessed utilizing continuous glucose monitoring, the involution radical spent 9.8% much clip successful scope of 70-120 mg/dL than the accustomed fare group. At 6 months, 39 participants (53%) successful the involution radical and 22 participants (32%) successful the accustomed fare radical had an A1c < 6.0%, a important difference.
Directions of effects were accordant crossed subgroups of contention and sex.
Rates of adverse events were akin betwixt groups, though importantly much participants successful the involution radical reported musculus cramps astatine 3 months (35% vs 19%; P = .03) and 6 months (34% vs 19%; P = .04).
The survey was supported by the National Institute of General Medical Sciences and the Tulane University Carol Lavin Bernick Faculty Grant Program. Dorans has reported receiving grants from the National Heart, Lung, and Blood Institute extracurricular the submitted work. The California Walnut Commission provided walnuts for the study. Shakes and bars were donated by The Simply Good Foods Company. Sugar replacement samples were provided by Swerve.
JAMA Netw Open. Published online October 26, 2022. Full text
Miriam E. Tucker is simply a freelance writer based successful the Washington, DC, area. She is simply a regular contributor to Medscape, with different enactment appearing successful The Washington Post, NPR's Shots blog, and Diabetes Forecast magazine. She is connected Twitter: @MiriamETucker.
For much diabetes and endocrinology news, travel america connected Twitter and Facebook.
English (US)