Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes.
BACKGROUND
It is not known how a low-carbohydrate, high-protein, high-fat diet causes weight loss or how it affects blood glucose levels in patients with type 2 diabetes.


OBJECTIVE
To determine effects of a strict low-carbohydrate diet on body weight, body water, energy intake and expenditure, glycemic control, insulin sensitivity, and lipid levels in obese patients with type 2 diabetes.


METHODS
Inpatient comparison of 2 diets.


METHODS
General clinical research center of a university hospital.


METHODS
10 obese patients with type 2 diabetes.


METHODS
Usual diets for 7 days followed by a low-carbohydrate diet for 14 days.


METHODS
Body weight, water, and composition; energy intake and expenditure; diet satisfaction; hemoglobin A1c; insulin sensitivity; 24-hour urinary ketone excretion; and plasma profiles of glucose, insulin, leptin, and ghrelin.


RESULTS
On the low-carbohydrate diet, mean energy intake decreased from 3111 kcal/d to 2164 kcal/d. The mean energy deficit of 1027 kcal/d (median, 737 kcal/d) completely accounted for the weight loss of 1.65 kg in 14 days (median, 1.34 kg in 14 days). Mean 24-hour plasma profiles of glucose levels normalized, mean hemoglobin A1c decreased from 7.3% to 6.8%, and insulin sensitivity improved by approximately 75%. Mean plasma triglyceride and cholesterol levels decreased (change, -35% and -10%, respectively).


CONCLUSIONS
The study was limited by the short duration, small number of participants, and lack of a strict control group.


CONCLUSIONS
In a small group of obese patients with type 2 diabetes, a low-carbohydrate diet followed for 2 weeks resulted in spontaneous reduction in energy intake to a level appropriate to their height; weight loss that was completely accounted for by reduced caloric intake; much improved 24-hour blood glucose profiles, insulin sensitivity, and hemoglobin A1c; and decreased plasma triglyceride and cholesterol levels. The long-term effects of this diet, however, remain uncertain.
Boden
Guenther
G
Temple University School of Medicine, Philadelphia, Pennsylvania, and University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine, Stratford, New Jersey.
Sargrad
Karin
K
Homko
Carol
C
Mozzoli
Maria
M
Stein
T Peter
TP
D001066:Appetite; D001786:Blood Glucose / Q000378:metabolism*; D001834:Body Water / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000378:metabolism; D004038:Diet, Reducing; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D002149:Energy Intake; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D007657:Ketone Bodies / Q000378:metabolism; D007677:Kidney Function Tests; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism; D015431:Weight Loss
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D006728:Hormones; D007328:Insulin; D007657:Ketone Bodies; D008055:Lipids