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Two diets with different haemoglobin A1c and antiglycaemic medication effects despite similar weight loss in type 2 diabetes.

Abstract
We analysed participants with type 2 diabetes (n = 46) within a larger weight loss trial (n = 146) who were randomized to 48 weeks of a low-carbohydrate diet (LCD; n = 22) or a low-fat diet + orlistat (LFD + O; n = 24). At baseline, mean body mass index (BMI) was 39.5 kg/m(2) (s.d. 6.5) and haemoglobin A1c (HbA1c) 7.6% (s.d. 1.3). Although the interventions reduced BMI similarly (LCD -2.4 kg/m(2) ; LFD + O -2.7 kg/m(2) , p = 0.7), LCD led to a relative improvement in HbA1c: -0.7% in LCD versus +0.2% in LFD + O [difference -0.8%, 95% confidence interval (CI) = -1.6, -0.02; p = 0.045]. LCD also led to a greater reduction in antiglycaemic medications using a novel medication effect score (MES) based on medication potency and total daily dose; 70.6% of LCD versus 30.4% LFD + O decreased their MES by ≥50% (p = 0.01). Lowering dietary carbohydrate intake demonstrated benefits on glycaemic control beyond its weight loss effects, while at the same time lowering antiglycaemic medication requirements.
AuthorsS B Mayer, A S Jeffreys, M K Olsen, J R McDuffie, M N Feinglos, W S Yancy Jr
JournalDiabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 16 Issue 1 Pg. 90-3 (Jan 2014) ISSN: 1463-1326 [Electronic] England
PMID23911112 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S.)
Copyright© 2013 John Wiley & Sons Ltd.
Chemical References
  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • hemoglobin A1c protein, human
Topics
  • Blood Glucose (metabolism)
  • Body Mass Index
  • Diabetes Mellitus, Type 2 (diet therapy, drug therapy, metabolism)
  • Diet, Carbohydrate-Restricted
  • Diet, Fat-Restricted
  • Diet, Reducing
  • Female
  • Glycated Hemoglobin (metabolism)
  • Humans
  • Hypoglycemic Agents (pharmacology)
  • Male
  • Middle Aged
  • Patient Compliance
  • Treatment Outcome
  • Weight Loss

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