title: Remission of pre-diabetes to normal glucose tolerance in obese adults with high protein versus high carbohydrate diet: randomized control trial.
abstract: OBJECTIVE
  Remission of pre-diabetes to normal is an important health concern which has had little success in the past. This study objective was to determine the effect on remission of pre-diabetes with a high protein (HP) versus high carbohydrate (HC) diet and effects on metabolic parameters, lean and fat body mass in prediabetic, obese subjects after 6 months of dietary intervention.
  
  
  METHODS
  We recruited and randomized 24 pre-diabetes women and men to either a HP (30% protein, 30% fat, 40% carbohydrate; n=12) or HC (15% protein, 30% fat, 55% carbohydrate; n=12) diet feeding study for 6 months in this randomized controlled trial. All meals were provided to subjects for 6 months with daily food menus for HP or HC compliance with weekly food pick-up and weight measurements. At baseline and after 6 months on the respective diets oral glucose tolerance and meal tolerance tests were performed with glucose and insulin measurements and dual energy X-ray absorptiometry scans.
  
  
  RESULTS
  After 6 months on the HP diet, 100% of the subjects had remission of their pre-diabetes to normal glucose tolerance, whereas only 33.3% of subjects on the HC diet had remission of their pre-diabetes. The HP diet group exhibited significant improvement in (1) insulin sensitivity (p=0.001), (2) cardiovascular risk factors (p=0.04), (3) inflammatory cytokines (p=0.001), (4) oxidative stress (p=0.001), (5) increased percent lean body mass (p=0.001) compared with the HC diet at 6 months.
  
  
  CONCLUSIONS
  This is the first dietary intervention feeding study, to the best of our knowledge, to report 100% remission of pre-diabetes with a HP diet and significant improvement in metabolic parameters and anti-inflammatory effects compared with a HC diet at 6 months.
  
  
  BACKGROUND
  NCT0164284.
authors.affiliation: Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA.
authors.forename: Frankie B
authors.initials: FB
authors.lastname: Stentz
authors.affiliation: Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Brewer
authors.affiliation: Departments of Preventive Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA.
authors.forename: Jim
authors.initials: J
authors.lastname: Wan
authors.affiliation: Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA.
authors.forename: Channing
authors.initials: C
authors.lastname: Garber
authors.affiliation: Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA.
authors.forename: Blake
authors.initials: B
authors.lastname: Daniels
authors.affiliation: Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Sands
authors.affiliation: Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA.
authors.forename: Abbas E
authors.initials: AE
authors.lastname: Kitabchi
keywords: Cardiovascular Risk Factors; Dietary Intervention; Insulin Sensitivity; Pre-Diabetes