Improvements in Glucose Metabolism and Insulin Sensitivity with a Low-Carbohydrate Diet in Obese Patients with Type 2 Diabetes

Krebs, Jeremy; Bell, Damon A.; Hall, Rosemary M; Parry‐Strong, Amber; Docherty, Paul; Clarke, K; Chase, J.G.

doi:10.1080/07315724.2013.767630

Cited by 51 publications

(72 citation statements)

References 36 publications

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“…Similarly, the evidence consistently showed significant improvements in HDL cholesterol with a low‐carbohydrate diet, with 10 studies finding a significant increase over control diet . It is also worth again noting that two studies showed a significant increase in LDL cholesterol in the low‐carbohydrate arm; the rest of the studies found no change or a decrease of LDL cholesterol. Adding a clause in future guidelines on monitoring LDL cholesterol or apolipoprotein B would further guide physicians in recommending this diet for their patients to ensure no additional CVD risk factor worsening, as individual results may vary.…”

Section: Resultsmentioning

confidence: 79%

“…In another study, the diet improved LDL cholesterol significantly in women but not in men . Two studies found that the diet resulted in significant worsening from baseline . However, the study by Hallberg et al reported no change between the test and control diets for measured apolipoprotein B, probably more pertinent to CVD risk than the calculated LDL cholesterol value, which is impacted proportionately by the significant rise in HDL cholesterol and decrease in triglycerides in the Friedewald equation used to calculate LDL cholesterol …”

Section: Resultsmentioning

confidence: 97%

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Improving the scientific rigour of nutritional recommendations for adults with type 2 diabetes: A comprehensive review of the American Diabetes Association guideline‐recommended eating patterns

Hallberg

Dockter²,

Kushner³

et al. 2019

Diabetes Obesity Metabolism

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Aims The global rate of type 2 diabetes (T2D) continues to rise. Guidelines that influence the worldwide treatment of this disease are central to changing this trajectory. We sought in this review to evaluate the appropriateness of sources cited in the American Diabetes Association's (ADA) guidelines on eating patterns for T2D management, identify additional relevant sources, and evaluate the evidence. Materials and Methods We reviewed the evidence behind the ADA's recommendations on eating patterns in the 2018 and 2019 ADA Standards of Care and the 2014 ADA Nutrition Therapy Recommendations for Adults with Diabetes. Additionally, we conducted a comprehensive search to identify any additional studies not included in the cited evidence. To determine appropriateness of inclusion in the guidelines, the following criteria were applied: 1) it was a clinical trial or systematic review/meta‐analysis of clinical trials; 2) it involved persons with T2D; 3) one of the study arms followed one of the eating patterns currently recommended; 4) its reported outcomes included glycaemic control; 5) outcomes were reported separately for persons with T2D. Results We found a wide variation in the evidence for each eating pattern. Issues that have hampered the guideline process include: lack of a rigorous literature review, resulting in the omission of pertinent studies; an overreliance on prospective cohort studies; inconsistent standards for evidence; inclusion of studies not on persons with T2D; and bias. Conclusions The ADA Guidelines recommended eating patterns fall short of rigorous standards of scientific review according to state‐of‐the‐art systematic review and guideline creation practices.

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Section: Resultsmentioning

confidence: 79%

Section: Resultsmentioning

confidence: 97%

Improving the scientific rigour of nutritional recommendations for adults with type 2 diabetes: A comprehensive review of the American Diabetes Association guideline‐recommended eating patterns

Hallberg

Dockter²,

Kushner³

et al. 2019

Diabetes Obesity Metabolism

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show abstract

“…35 In short-term studies, people with T2DM require less antidiabetic agents to control glucose levels and achieve improvements in glycated hemoglobin (HbA1c). 33,34,37 In some studies, these improvements are greater with a very low carbohydrate diet compared with other approaches, 41 but data are not consistent and there are no long-term studies convincingly demonstrating any greater benefit on HbA1c from VLCD's. Davis et al demonstrated similar modest weight loss but no significant improvement in glycemic control in those with T2DM on a low fat or low carbohydrate diet after 1 year.…”

Section: Glycemic Controlmentioning

confidence: 99%

“…33 The primary reduction in carbohydrate produces only a small reciprocal increase in protein and fat and therefore a reduction in total energy intake. 34,35 A systematic review demonstrated that low carbohydrate, Atkins-type diets were more effective at reducing weight than low fat, low energy diets over 6 months. Additionally, low carbohydrate, high protein diets were at least as effective as low fat diets up to 1 year.…”

mentioning

confidence: 99%

Importance of low carbohydrate diets in diabetes management

Hall¹,

Parry‐Strong²,

Krebs³

2016

NDS

Self Cite

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Dietary strategies are fundamental in the management of diabetes. Historically, strict dietary control with a low carbohydrate diet was the only treatment option. With increasingly effective medications, the importance of dietary change decreased. Recommendations focused on reducing dietary fat to prevent atherosclerotic disease, with decreasing emphasis on the amount and quality of carbohydrate. As the prevalence of obesity and diabetes escalates, attention has returned to the macronutrient composition of the diet. Very low carbohydrate diets (VLCD's) have demonstrated effective initial weight loss and improvement in glycemic control, but difficult long-term acceptability and worsening lipid profile. Modifications to the very low carbohydrate (VLC) have included limiting saturated fat and increasing carbohydrate (CHO) and protein.Reducing saturated fat appears pivotal in reducing low-density lipoprotein (LDL) cholesterol and may mitigate adverse effects of traditional VLCD's. Increased dietary protein enhances satiety, reduces energy intake, and improves glycemic homeostasis, but without sustained improvements in glycemic control or cardiovascular risk over and above the effect of weight loss. Additionally, recent studies in type 1 diabetes mellitus suggest promising benefits to diabetes control with low carbohydrate diets, without concerning effects on ketosis or hypoglycemia. Dietary patterns may highlight pertinent associations. For example, Mediterranean-style and paleolithic-type diets, low in fat and carbohydrate, are associated with reduced body weight and improved glycemic and cardiovascular outcomes in type 2 diabetes mellitus (T2DM). A feature of these dietary patterns is low refined CHO and sugar and higher fiber, and it is possible that increasing sugar consumption is having a substantial effect on global escalations in obesity and T2DM. Dietary recommendations in type 1 diabetes and T2DM are changing. Dietary CHO is unquestionably important, but long-term acceptability of any diet is critical to sustain improvements in health benefits. Personalized dietary management, using a variety of dietary approaches, may be the key to optimal diabetes outcomes.

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“…Several studies have shown that consuming a diet with a low glycemic index (GI) can reduce insulin resistance (König et al, 2014), blood lipid concentrations (Levitan et al, 2008), body weight (Krebs et al, 2013), and the levels of glycated hemoglobin (Wang et al, 2015a) and pro-inflammatory markers (Feliciano, das Graças, Alfenas, 2014) in blood. Other studies have shown low GI diets to be associated with increased satiety (Pardo-Beutimea et al, 2012) and the incidence of cancer (Truong, Yuet, Hall, 2014).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the impact of orally administered carbohydrates on postprandial blood glucose levels in different pre-clinical models

Marques

Schiavon

Travassos

et al. 2016

Braz. J. Pharm. Sci.

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We developed a pre-clinical model in which to evaluate the impact of orally administered carbohydrates on postprandial blood glucose levels. For this purpose, we compared the effects of different carbohydrates with well-established glycemic indexes. We orally administered (gavage) increasing amounts (0.2, 0.4, 0.6, 0.8, and 1.0 g/kg) of sucrose and lactose to rats which had been fasted for 6 h or 15 h, respectively. In part of the experiments we administered frutose (gavagem). Three different models were compared for measuring postprandial blood glucose levels: a) evaluation of interstitial glucose concentrations by using a real time continuous glucose monitoring system; b) evaluation of glucose levels in blood obtained from the rat tail; c) evaluation of serum glucose levels in blood collected after decapitation. Our results showed that blood obtained from the tails of 15-h fasted rats was the best model in which to evaluate the effect of carbohydrates on postprandial blood glucose levels.

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Improvements in Glucose Metabolism and Insulin Sensitivity with a Low-Carbohydrate Diet in Obese Patients with Type 2 Diabetes

Abstract: A low-carbohydrate diet was well tolerated and achieved weight loss over 24 weeks in subjects with diabetes. Glycemic control improved with a reduction in requirements for hypoglycemic agents.

Cited by 51 publications

References 36 publications

Improving the scientific rigour of nutritional recommendations for adults with type 2 diabetes: A comprehensive review of the American Diabetes Association guideline‐recommended eating patterns

Improving the scientific rigour of nutritional recommendations for adults with type 2 diabetes: A comprehensive review of the American Diabetes Association guideline‐recommended eating patterns

Importance of low carbohydrate diets in diabetes management

Evaluation of the impact of orally administered carbohydrates on postprandial blood glucose levels in different pre-clinical models

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