A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes. – Saslow (2014)

SASLOW LR, KIM S, DAUBENMIER JJ, MOSKOWITZ JT, PHINNEY SD, GOLDMAN V, MURPHY EJ, COX RM, MORAN P, HECHT FM.

A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes.

PLoS One. 2014 Apr 9;9(4):e91027.
DOI: 10.1371/journal.pone.0091027

pubmed

Summary: Randomized Controlled (Pilot) study of a Low carb ketogenic diet (LCKD) for overweight or Obese adults with non insulin dependant type 2 diabetes or prediabetes.  Control arm was given a medium carbohydrate, low fat, calorie restricted, carbohydrate counting diet (MCCR) consistent with guidelines from the American Diabetes Association.

Results: At 3 months, mean glucose control as measured by HbA1c for the control arm (MCCR, n=18) was unchanged, for the intervention arm (LCKD, n=16) there was a significant drop in HbA1c  (-0.6%, 95% CI, -1.1% to -0.03%, p = 0.04).  44% of the intervention (LCKD) group discontinued one or more medications. compared to 11% in the control (MCCR) group (p=0.03).  The intervention (LCKD) group lost 5.5 kgs, while the control (MCCR) group lost 1.6 kgs (p=0.09).  0% of the control arm achieved a normal (<5.7%) HbA1c, 13% of the intervention arm achieved a normal (<5.7%) HbA1c at the end of the 3 month study.


We reckon:This showed that a low carb ketogenic diet is better for type 2 diabetics than the standard of care recommended by the American Diabetes Association.  2 participants in the control group during the study progressed from prediabetes to clinical type 2 diabetes, 1 participant in the control arm saw a jump in HbA1c % from 6.7% to 9.8%.

The control was a calorie controlled diet, the intervention was ad libitum.  Both arms saw a similar reduction in total daily energy intake.  Interestingly the fat consumed per day (in grams) by the intervention arm remained the same after the intervention as before the study despite that amount being ad-libitum.  The amount of fat as a percentage of total calories increased only as the total amount of carbohydrates decreased.

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