Low-carb, High-protein Diet Benefits T2D Patients

Diet and lifestyle interventions can significantly impact outcomes for patients with type 2 diabetes (T2D). A recent study published in the November issue of Diabetologia evaluated the effect of a carbohydrate-reduced, high-protein (CRHP) diet compared to an iso-energetic conventional diabetes (CD) diet in T2D patients. Specifically, the researchers analyzed each diet’s effect on glycemic control and cardiovascular risk markers, with the primary outcome being change in hemoglobin A1c (HbA1c). Other outcomes included glycemic variables, ectopic fat content, and 24-hour blood pressure. T2D patients aged > 18 years with HbA1c 48–97 mmol/mol, hemoglobin >6/>7 mmol/l (women/men), and estimated glomerular filtration rate (eGFR) >30 ml min-1 (1.73 m)-2. Patients were randomized to the CRHP or CD diet. The CRHP diet consisted of carbohydrate 30/50 energy percent (E%), protein 30 E%, and fat 40 E%; the CD diet consisted of 50 E%, 17 E%, and 33 E%, respectively. Final analysis included 28 patients: 14 completed six weeks of the CRHP intervention followed by six weeks of the CD intervention, and the remaining 14 completed each intervention for six weeks in the opposite order. The CRHP diet, compared to the CD diet, reduced mean HbA1c by –6.2 mmol/mol versus –0.75 mmol/mol. The CRHP diet was associated with more significant reductions in secondary outcomes than the CD diet including fasting plasma glucose (–0.71 mmol/l versus 0.23 mmol/l), postprandial plasma glucose area under the curve (AUC) (9.58 mmol/l x 240 min versus 11.89 mmol/l x 240 min) and net AUC (1.25 mmol/l x 240 min versus 3.10 mmol/l x 240 min), hepatic fat content (–2.4% versus 0.2%), and pancreatic fat content (-1.7% versus 0.5%). Changes did not largely differ between the two diets regarding 24-hour blood pressure and muscle-, visceral-, or subcutaneous adipose tissue.