The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus

Abstract

Objective: Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus.Research design and methods: Eighty-four community volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate, ketogenic diet (<20 g of carbohydrate daily; LCKD) or a low-glycemic, reduced-calorie diet (500 kcal/day deficit from weight maintenance diet; LGID). Both groups received group meetings, nutritional supplementation, and an exercise recommendation. The main outcome was glycemic control, measured by hemoglobin A 1c .Results: Forty-nine (58.3%) participants completed the study. Both interventions led to improvements in hemoglobin A 1c , fasting glucose, fasting insulin, and weight loss. The LCKD group had greater improvements in hemoglobin A 1c (-1.5% vs. -0.5%, p = 0.03), body weight (-11.1 kg vs. -6.9 kg, p = 0.008), and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p < 0.001) compared to the LGID group. Diabetes medications were reduced or eliminated in 95.2% of LCKD vs. 62% of LGID participants (p < 0.01). Conclusion:Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/ elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes.

Comparative Effects of Low-Carbohydrate High-Protein Versus Low-Fat Diets on the Kidney

“…Two recent modest-sized randomized trials found that lowcarbohydrate high-protein consumption over 6-12 months had no effect on serum creatinine compared with low-fat or low-glycemic diets, but no other markers of GFR, such as cystatin C and urinary creatinine clearance, were measured (13,53). In an observational study of 39 participants (54), a low-carbohydrate high-protein weight loss diet had no clinically significant effects on acid-base or electrolyte status, similar to our findings.…”

Optimal Control Analysis of a Mathematical Model for Breast Cancer

“…Until recently, a few studies, such as [6][7][8], investigated diet as a possible adjuvant to cancer treatment, which includes a ketogenic diet. A ketogenic diet consists of high edible fat with moderate or low protein content and very low carbohydrates, which forces the body to burn fat instead of glucose for adenosine triphosphate (ATP) synthesis [6,9].…”

“…Thus, strategies (1-3) use the objective functional (8). We assumed that there are practical limitations on the maximum rate at which the anti-cancer treatment may be applied in a given time period.…”

Asociación entre nutrientes y hemoglobina glicosilada en diabéticos tipo 2

“…El producto de glicación más común es la hemoglobina A1c (HbA1c) que es ampliamente utilizada como control metabólico y en algunos casos como diagnóstico (9). Es universalmente aceptado que la ingesta de CHO es la principal determinante de la glicemia (10) y que la restricción de CHO especialmente los de absorción rápida, muestra una mayor reducción en los niveles de glucosa postprandial y HbA1c (11)(12)(13).…”