[acb-diabetics] Question about carbohydrates

[Patricia LaFrance-Wolf]

Patients with type 2 diabetes are usually advised to keep a low-fat diet.
Now, a study shows that food with a lot of fat and few carbohydrates could
have a better effect on blood sugar levels and blood lipids.

Sixty-one patients were included in the study of type 2, or adult-onset
diabetes. They were randomized into two groups, where they followed either a
low-carbohydrate (high fat) diet or a low-fat diet.

In both groups, the participants lost approximately 4 kg on average. In
addition, a clear improvement in the glycemic control was seen in the
low-carbohydrate group after six months. Their average blood sugar level
dropped from 7.5 to 7.0A1c (58.5 to 53.7 mmol/mol). This means that the
intensity of the treatment for diabetes could also be reduced, and the
amounts of insulin were lowered by 30%.

Despite the increased fat intake with a larger portion of saturated fatty
acids, their lipoproteins did not get worse. Quite the contrary -- the HDL,
or 'good' cholesterol, content increased on the high fat diet.

No statistically certain improvements, either of the glycemic controls or
the lipoproteins, were seen in the low-fat group, despite the weight loss.

Dr. Fredrik Nyström, who was part of the study, said, "You could ask
yourself if it really is good to recommend a low-fat diet to patients with
diabetes, if despite their weight loss they get neither better lipoproteins
nor blood glucose levels."

In the low-carbohydrate diet, 50% of the energy came from fat, 20% from
carbohydrates, and 30% from protein. For the low-fat group the distribution
was 30% from fat, 55-60% from carbohydrates, and 10-15% from protein, which
corresponds to the diet recommended by the Swedish National Food Agency.

The participants were recruited from two primary health care centers and met
for four group meetings during the first year of the study. All 61
participants remained in the study for the follow-up.

Dr. Hans Guldbrand who was also part of the study says, "In contrast to most
other studies of this type, we lost no patients at all, which vouches for
the good quality of our data."

The results of a two-year dietary study led by Hans Guldbrand, general
practitioner, and Fredrik Nyström, professor of Internal Medicine,
Diabetologia, May 2012 


 

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