Low-carb diet promises to lower blood sugar in prediabetes

Low-carb diet promises to lower blood sugar in prediabetes

In a randomized trial, the decrease in HbA1c over 6 months was ‘modest’ but requires further study and longer follow-up.

A low-carb diet may help reduce it A small randomized study found hemoglobin A1c in patients with prediabetes or mild diabetes who are not already taking medication.

There is good evidence that a low-carb diet can reduce blood sugar levels in people with type 2 diabetes. But there is much less knowledge and understanding about people about it. [lower] Durance, and how low carbs affect your blood sugar,” said Christine S. JAMA network is open.

Among 150 participants randomized to less than 60 grams of carbohydrates per day, or their usual diet, a greater reduction in baseline HbA1c levels was achieved in the low-carb group at 6 months. Doran and colleagues say the average decrease is 0.23%, which is a significant reduction (s <0.001), was also 'modest' and accompanied by lower calorie intake and greater weight loss.

“The main message to take here is that a low-carb diet, if maintained, may be a useful approach to preventing and treating type 2 diabetes, but more research is needed,” she added.

Pay attention to low-carb diets for weight loss and cardiovascular disease Its history goes back decadesbut trials so far produced mixed results. modern diabetes Screening Recommendations The US Preventive Services Team advises clinicians to refer patients with prediabetes to preventative interventions, including changes in lifestyle, diet, and exercise that lead to weight loss, noting that about a third of people with prediabetes are unaware of this.

The differences behind only HbA1c

The randomized patients in the study (median age 59 years; 72% female; 59% black) had no HbA1c treatment between 6.0% and 6.9% (42 to 52 mmol/mol). The low-carb group (n = 75) received behavioral counseling and major complementary foods, including nuts and olive oil, to improve odds of compliance. During the first 3 months, the low carbohydrate group was asked to limit their daily carbohydrate intake to less than 40 g/day, then from months 4 to 6, their daily carbohydrate intake goal was less than 60 g. In the first four weeks, participants received weekly one-to-one behavioral counseling sessions, which moved to small group sessions with other participants every two weeks over the next four weeks, and then to mainly telephone follow-up in the last four weeks. The usual diet group (n = 75) received standardized written nutritional advice and provided monthly information sessions unrelated to weight loss, but no other nutritional support.

At baseline, 3 months, and 6 months, all participants were assessed by a 24-h dietary recall questionnaire, height, weight, and waist circumference were measured, and they underwent three blood pressure measurements. HbA1c was also measured at this time, as were other biomarkers. A urine test was performed to measure ketones, and in a subgroup of 59 participants, 24-hour glucose levels were measured by a 14-day continuous glucose monitor.

Total calorie intake in the low-carb group decreased by an average of 389 calories per day compared to the usual diet group at 3 months, and the average was 456 calories per day lower by 6 months (s <0.001 for both). Participants in the low-carb group ate fewer total and net carbs, added sugars, and sugar-sweetened beverages. Conversely, the low-carb group had higher percentages of calories from protein, monounsaturated fat, and polyunsaturated fat.

In addition to the decrease in HbA1c, the low-carb group had a greater decrease in fasting plasma glucose at 6 months (s <0.001). While the regular diet group lost only 0.5 kg in 6 months, the average loss in the low-carb group was 6.4 kg (s <0.001). Other differences in favor of the low-carb group included a decrease in fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and waist circumference at 6 months. The low-carb group also had lower average 24-hour glucose and nighttime glucose, and spent 9.8% more time in the glycemic range of 70 mg/dL to 120 mg/dL than the usual diet group. By 6 months, 53% of those in the low-carb group had an HbA1c <6.0% compared to only 32% of those in the usual diet group (s = 0.01).

In subgroup analyses, the change in HbA1c at 6 months was greater in black than in white participants and in men than in women. However, given the small numbers, Doran said that these results, while generating hypotheses, are difficult to interpret in the context of the experiment.

What is really the best diet?

For TCTMD, Dorans said that longer follow-up is needed to clarify the effect of a low-carb diet on HbA1c and see if calories and weight start to creep back in after 6 months, something she said often appears in weight loss trials.

“While it is true that reducing carbohydrates can control blood glucose in diabetics, it is not the whole story,” said Andrew Freeman, MD (National Jewish Health, Denver, CO), who commented on the TCTMD findings. “It’s a subset of the bigger truth, which is why people who eat carbohydrates have higher sugars when they have diabetes? It’s usually because of fatty liver and fatty muscle infiltration.”

Freeman said studies dating back to the 1940s showed that diet can improve diabetes and that it doesn’t necessarily have to include drastic carbohydrate reduction. One of the reasons many people lose a lot of weight on a low-carb diet is to reduce what he calls “carbohydrates,” or foods rich in processed carbohydrates that are known to raise blood glucose.

“That’s why it’s really hard in this study and in other studies to tell whether a low-carb diet is the cause of the improvement in diabetes or if it helps people lose weight and get rid of the bad stuff,” he added.

Freeman said while low-carb diets may be a contributor to some people trying to control blood glucose, what people are replacing with carbohydrates is important, since low-carb, high-carb diets rich in meat, cheese, and processed foods can increase the risk of cholesterol and cancer, and are environmentally irresponsible in the long term.

I think there is a lot of potential in this area to try to figure out the best diet to help people fight their diabetes.” But the effect observed in this study was relatively small. What would have happened with a more plant-based diet than with processed white carbohydrates? I suspect the results It would have been bigger.”

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