Effects of a low-carbohydrate diet on glycemic control in outpatients with severe type 2 diabetes
Effects of a low-carbohydrate diet on glycemic control in outpatients with severe type 2 diabetes
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DOI：
10.1186/1743-7075-6-21
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发表时间：
2009-05-06
影响因子：
4.5
通讯作者：
Umegaki, Hiroyuki
中科院分区：
文献类型：
--
作者：
Haimoto, Hajime;Sasakabe, Tae;Umegaki, Hiroyuki
我们之前的研究表明，与高碳水化合物饮食相比，轻度2型糖尿病门诊患者（平均HbA1c水平：7.4%）在2年内，松散限制的45%碳水化合物饮食导致血红蛋白A1c （HbA1c）的降低幅度更大。为了确定重度2型糖尿病患者是否可以通过30%碳水化合物饮食实现良好的血糖控制，33名HbA1c水平为9.0%或以上的门诊患者（15名男性，18名女性，平均年龄：59岁）在门诊遵循低碳水化合物饮食（1852 kcal； %CHO：脂肪：蛋白质= 30:44:20）6个月，并随访评估其HbA1c水平、体重指数和降糖药剂量。HbA1c水平从基线的10.9 +/- 1.6%急剧下降到3个月时的7.8 +/- 1.5%，6个月时的7.4 +/- 1.4%。身体质量指数从基线（23.8 +/- 3.3）到6个月（23.5 +/- 3.4）略有下降。只有两个病人退出了。除轻度便秘外，未见其他不良反应。服用磺脲类药物的患者人数从基线时的7人减少到6个月时的2人。没有病人需要住院治疗或胰岛素治疗。总之，超过6个月的30%碳水化合物饮食导致HbA1c水平显著降低，即使在没有任何胰岛素治疗、医院护理或增加磺脲类药物的严重2型糖尿病门诊患者中也是如此。这种饮食的效果可能与胰岛素疗法相当。
We previously demonstrated that a loosely restricted 45%-carbohydrate diet led to greater reduction in hemoglobin A1c (HbA1c) compared to high-carbohydrate diets in outpatients with mild type 2 diabetes (mean HbA1c level: 7.4%) over 2 years. To determine whether good glycemic control can be achieved with a 30%-carbohydrate diet in severe type 2 diabetes, 33 outpatients (15 males, 18 females, mean age: 59 yrs) with HbA1c levels of 9.0% or above were instructed to follow a low-carbohydrate diet (1852 kcal; %CHO: fat: protein = 30: 44: 20) for 6 months in an outpatient clinic and were followed to assess their HbA1c levels, body mass index and doses of antidiabetic drugs. HbA1c levels decreased sharply from a baseline of 10.9 +/- 1.6% to 7.8 +/- 1.5% at 3 months and to 7.4 +/- 1.4% at 6 months. Body mass index decreased slightly from baseline (23.8 +/- 3.3) to 6 months (23.5 +/- 3.4). Only two patients dropped out. No adverse effects were observed except for mild constipation. The number of patients on sulfonylureas decreased from 7 at baseline to 2 at 6 months. No patient required inpatient care or insulin therapy. In summary, the 30%-carbohydrate diet over 6 months led to a remarkable reduction in HbA1c levels, even among outpatients with severe type 2 diabetes, without any insulin therapy, hospital care or increase in sulfonylureas. The effectiveness of the diet may be comparable to that of insulin therapy.