title: A protein-enriched low glycemic index diet with omega-3 polyunsaturated fatty acid supplementation exerts beneficial effects on metabolic control in type 2 diabetes.
abstract: OBJECTIVE
  The current study aims to investigate practicability and effects of a combined dietary intervention with increased relative protein content supplemented with omega-3 polyunsaturated fatty acids (PUFA) on metabolic control and inflammatory parameters in a real life situation in type 2 diabetes patients.
  
  
  METHODS
  In this observational study we advised thirty mostly obese patients with type 2 diabetes to follow a protein-enriched diet with carbohydrates of low glycemic index (low GI) and moderate fat reduction supplemented with omega-3 PUFA for 24 weeks. Primary efficacy parameter was the change in HbA1c; secondary parameters included changes in systemic inflammation (measured by ultrasensitive C-reactive protein, usCRP), body weight, waist circumference, fat mass. The study is registered at clinicaltrials.gov (NCT01474603).
  
  
  RESULTS
  The dietary intervention significantly reduced the primary efficacy variable HbA1c from a baseline value of 63±11mmol/mol to 59±14mmol/mol (P=0.033) and 56±12mmol/mol (P=0.001) after 12 and 24 weeks, respectively. In addition, usCRP decreased significantly at 24 weeks (P=0.039). Waist circumference, an important indicator for cardiometabolic-risk and silent inflammation, decreased from baseline 116.0±14.1cm to 114.9±13.5cm (P=0.019), 114.0±14.4cm (P=0.001), and 112.7±13.4cm (P=0.049), after 3, 12 and 24 weeks, respectively.
  
  
  CONCLUSIONS
  Counseling a protein enriched and low glycemic index diet supplemented with long-chain omega-3 PUFA in a real-life clinical setting improves glycemic control and also reduces waist circumference and silent inflammation in overweight or obese patients with type 2 diabetes.
authors.affiliation: Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Austria.
authors.forename: Simone M
authors.initials: SM
authors.lastname: Moosheer
authors.affiliation: Diabetes Outpatient Clinic, Health Center South, Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Waldschütz
authors.affiliation: Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Austria.
authors.forename: Bianca K
authors.initials: BK
authors.lastname: Itariu
authors.affiliation: Diabetes Outpatient Clinic, Health Center South, Vienna, Austria.
authors.forename: Helmut
authors.initials: H
authors.lastname: Brath
authors.affiliation: Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Austria. Electronic address: thomas.stulnig@meduniwien.ac.at.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Stulnig
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D001317:Austria; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy* / Q000209:etiology; D018752:Diet, Fat-Restricted; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004044:Dietary Proteins / Q000008:administration & dosage*; D019587:Dietary Supplements; D004734:Energy Metabolism; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D038321:Glycemic Index; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D010865:Pilot Projects; D013997:Time Factors; D016896:Treatment Outcome; D055105:Waist Circumference; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D004040:Dietary Carbohydrates; D004044:Dietary Proteins; D015525:Fatty Acids, Omega-3; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators; C517652:hemoglobin A1c protein, human
keywords: Diabetes mellitus type 2; Dietary protein; Inflammation; Low GI diet; Metabolic control; Omega-3 polyunsaturated fatty acids