Clinical benefit of a short term dietary oatmeal intervention in patients with type 2 diabetes and severe insulin resistance: a pilot study.
OBJECTIVE
To evaluate the potential effectiveness of 'carbohydrate days' as a dietary intervention to overcome insulin resistance in type 2 diabetes.


METHODS
Patients (n=14) with uncontrolled type 2 diabetes and insulin resistance as defined by a dosage of more than 1 IU/day (*)kg BW were consecutively enrolled in this prospective study. Primary outcomes were daily insulin requirement and mean blood glucose levels which were evaluated before, after, and 4 weeks after the intervention.


RESULTS
All patients had a metabolic syndrome, 75% had microvascular and 57.1% macrovascular complications. Hospital setting and diabetes adapted diet alone led to improved glycemic control with a mean blood glucose 158+/-47 mg/dl. Intervention with two days of oatmeal diet further decreased mean blood glucose to 118+/-37 mg/dl (p<0.05). This was associated with a significant reduction of insulin dosage by 42.5% (before: 145+/-68.9 U/d, after 83+/-34.2 U/d, p<0.001) as well as a significant reduction (-26.4%, p<0.01) of serum leptin levels. After the four weeks outpatient period, insulin dosage remained significantly decreased (83+/-20.2 U/kg (*)d, p<0.01). Glycemic control was comparable (mean blood glucose141+/-20.78 mg/dl) to glucose levels within the hospital setting. Adiponectin levels increased significantly by 53.8% (p<0.05).


CONCLUSIONS
In this uncontrolled pilot study, hospital admission and diabetes adapted diet followed by oatmeal intervention achieved a approximately 40% reduction of insulin dosage required to achieve controlled glucose levels. This effect was conserved after a 4 week outpatient phase with normal diet.
Lammert
A
A
V Medizinische Klinik, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany. alexander.lammert@med5.ma.uni-heidelberg.de
Kratzsch
J
J
Selhorst
J
J
Humpert
P M
PM
Bierhaus
A
A
Birck
R
R
Kusterer
K
K
Hammes
H-P
HP
D052242:Adiponectin / Q000097:blood; D018554:Avena; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000178:diet therapy* / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy; D010865:Pilot Projects; D013997:Time Factors; D016896:Treatment Outcome
D052242:Adiponectin; D006442:Glycated Hemoglobin; D007328:Insulin; D008055:Lipids; C499918:ADIPOQ protein, human; C517652:hemoglobin A1c protein, human