A photo of foods in a low-carbohydrate diet including, cheese, fish, corn, nuts, meats, vegetables, and fruit.

Low-carb diet helps lower HbA1c in prediabetes

A randomized clinical trial found that sticking to a low-carb diet helped people with prediabetes lower their HbA1c in just a few months.

Compared to those eating their typical diet, subjects with untreated high HbA1c who followed a low-carbohydrate diet experienced significantly greater improvement in fasting plasma glucose (-10.3 mg/dL, 95% CI -15.6 to -4.9 ) at month 6, according to Kristin S. Dorans, MD, of the School of Public Health and Tropical Medicine at Tulane University in New Orleans, and colleagues.

Those following a low-carb diet, which also included dietary advice, also experienced a 0.23% greater reduction in HbA1c at this time (95% CI -0.32 to -0.14), they wrote in JAMA Network is open.

Although the researchers acknowledged that this decrease in HbA1c was “modest”, they showed that it was still slightly greater than the 0.17% decrease observed in the lifestyle intervention arm in DPP . trialThis subsequently resulted in a 58% lower risk of type 2 diabetes over a 2.8-year period.

Participants on the low-carb diet also spent more time in the target glucose range (70-120 mg/dL) as measured by continuous glucose monitors. In addition, they had significantly lower average glucose levels over a 24-hour period than those who ate their usual diets.

The low-carb dieters also saw a greater decrease of 5.9 kg (95% CI -7.4 to -4.4) in body weight (about 13 lbs) after following the diet for half the year. This was likely due to the significant reduction in calorie intake among those on a low-carb diet.

The authors noted, “Few participants had detectable urinary ketones, indicating that ketosis is unlikely to be responsible for the results.”

The authors cautioned that “the study was not able to evaluate [low-carb diet] Effects apart from weight loss.”

However, Doran said in a statement that “the key message is that a low-carb diet, if maintained, may be a useful approach to preventing and treating type 2 diabetes, although more research is needed.”

Her group noted that study limitations included self-report of dietary intake, which is subject to potential recall bias. They also wrote that “participants in the low-carb group had frequent intrusive reactions, whereas the usual diet group did not.”

All benefits seen at the end of the trial had already reached their significance by the third month, with improvements only improving from 3 to 6 months. By month 3, HbA1c decreased 0.16% in the low-carb group, fasting plasma glucose decreased 8.0 mg/dL more, and body weight decreased 4.1 kg (about 9 lb) more.

Some other exploratory findings also showed significantly better results for 6 months with the low-carb diet:

  • Waist circumference: -4.7 cm (95% CI -6.7 to -2.6)
  • HOMA-IR: -2.4 (95% CI -3.7 to -1.1)
  • Fasting insulin: -6.2 µmol/L (95% CI -10.5 to -2.0)

Some other improvements were seen among dieters, but these benefits were much better than those who stick to a regular diet. These factors included systolic blood pressure, cholesterol, diastolic blood pressure, and 10-year risk of cardiovascular disease of atherosclerosis.

A total of 150 adults with prediabetes were randomized to a parallel group trial. At baseline, not all of them were treated with diabetes medication and their HbA1c level was between 6.0% to 6.9%. A total of 59% of the group were black and 41% white. Nearly three-quarters of the women were women and the average age was 59.

Those randomized to the ‘usual’ diet group were given only standard dietary advice but no continuing education or diet-specific recommendations. Low-carb dieters have been instructed to keep their net daily carbohydrate intake below 40g for the first two months. Then, participants were asked to choose the lowest possible goal (ie, less than 60 grams per day) for months 4 to 6. On top of these goals, participants participated in individual and group sessions during the diet period and were also provided with a guide to each. With nutritional instructions and recipes.

  • Christine Monaco She is a staff writer, focusing on endocrinology, psychiatry, and nephrology news. Operating out of a New York City office, she has been with the company since 2015.


The study was supported by the National Institute of General Medical Sciences, the Carol Lavigne Bernick College Scholarship Program at Tulane University, the California Nut Commission, Simply Good Foods Company, and Swerve.

Doran and co-authors disclose relationships with the National Institutes of Health.

#Lowcarb #diet #helps #HbA1c #prediabetes

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