Krebs, J.D.Bell, D.Hall, R.Parry-Strong, A.Docherty, P.D.Clarke, K.Chase, Geoff2014-03-312014-03-312013Krebs, J.D., Bell, D., Hall, R., Parry-Strong, A., Docherty, P.D., Clarke, K., Chase, J.G. (2013) Improvements in glucose metabolism and insulin sensitivity with a low-carbohydrate diet in obese patients with type 2 diabetes. Journal of the American College of Nutrition, 32(1), pp. 11-17.http://hdl.handle.net/10092/9024Objective: The optimal diet for weight loss in type 2 diabetes remains controversial. This study examined a low-carbohydrate, high-fat diet with detailed physiological assessments of insulin sensitivity, glycemic control, and risk factors for cardiovascular disease. Methods: Fourteen obese patients (body mass index [BMI] 40.6 ± 4.9 kg/m2) with type 2 diabetes were recruited for an “Atkins”-type low-carbohydrate diet. Measurements were made at 0, 12, and 24 weeks of weight, insulin sensitivity, HbA1c, lipids, and blood pressure. Results: Twelve completers lost a mean of 9.7 ± 1.8 kg over 24 weeks attributable to a major reduction in carbohydrates and resultant reduction in total energy intake. Glycemic control significantly improved (HbA1c -1.1 ± 0.25%) with reductions in hypoglycemic medication. Fasting glucose, homeostasis model assessment (HOMA), and area under the curve (AUC) glucose (intravenous glucose tolerance test [IVGTT]) were significantly reduced by week 12 ( p < 0.05). There were nonsignificant improvements in insulin sensitivity (SI) at week 12 ( p = 0.19) and week 24 ( p = 0.31). Systolic blood pressure was reduced (mean -10.0 mmHg between weeks 0 and 24, p = 0.13). Mean high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol all increased. The ratio of total: HDL cholesterol and triglycerides was reduced. Conclusion: A low-carbohydrate diet was well tolerated and achieved weight loss over 24 weeks in subjects with diabetes. Glycemic control improved with a reduction in requirements for hypoglycemic agents.enLow-Carbohydrate dietType 2 diabetesWeight lossGlycaemic controlInsulin sensitivityJournal ArticleField of Research::09 - Engineering::0903 - Biomedical EngineeringFields of Research::32 - Biomedical and clinical sciences::3205 - Medical biochemistry and metabolomics::320502 - Medical biochemistry - carbohydrateshttps://doi.org/10.1080/07315724.2013.767630