Long-term effects of a diet loosely restricting carbohydrates on HbA1c levels, BMI and tapering of sulfonylureas in type 2 diabetes: a 2-year follow-up study
Abstract
The aim was to assess the long-term effect of a loose restriction of carbohydrate intake (carbohydrate-reduced diet: CARD) compared to a conventional diet (CD) in type 2 diabetes. One hundred and thirty-three type 2 diabetic outpatients followed the CD (n=57, 1734+/-410 kcal, carbohydrate:protein:fat ratio=57:16:26) or CARD (n=76, 1773+/-441 kcal, carbohydrate:protein:fat ratio=45:18:33) according to their own will, and were followed up for 2 years. Glycemic control, body mass index (BMI), serum cholesterols and dose of antidiabetic drugs were assessed at baseline and after 1 and 2 years. At baseline, hemoglobin A1c (HbA1c) and BMI levels were 7.1+/-1.0% and 24.2+/-2.9, respectively, in the CD group, and 7.4+/-1.1% and 25.1+/-3.4 in the CARD group, showing no significant differences. During the 2-year follow-up period, HbA1c levels were significantly improved in the CARD group (CD: 7.5+/-1.3%, CARD: 6.7+/-0.6%, P<0.001), and BMI decreased more significantly in the CARD group (CD: 23.8+/-3.0, CARD: 23.8+/-3.5, P<0.001). The doses of sulfonylureas clearly tapered, and serum cholesterol profiles improved significantly with the CARD. Our results warrant a long-term and large-scale randomized study of the diet for type 2 diabetes.
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Current evidence for carbohydrate restricted nutrition therapy is limited to two-years of follow-up.
“It is well recognized among professional society guidelines that carbohydrate restricted nutrition therapy results in improved glycemia, most cardiovascular risk markers and reduced need for medication [11][12][13][14], yet current evidence is limited to two-years of follow-up [8,15,16,17,18].”
The 0.9% absolute (12% relative) HbA1c reduction observed at 2 years is consistent with low carbohydrate studies reporting HbA1c reductions of 8-15% at 2 to 3.5 years with medication reduction.
“The 0.9% absolute (12% relative) HbA1c reduction observed at 2 years is consistent with low carbohydrate studies reporting HbA1c reductions of 8–15% at 2 to 3.5 years (52, 55–57) with medication reduction.”
Other interventions using carbohydrate restriction reported variable long-term glycemic improvement outcomes.
“Other interventions using carbohydrate restriction reported variable long-term glycemic improvement outcomes (52–57).”
Other low-carbohydrate interventions report visceral fat reduction as a component of weight loss.
“This is consistent with other low-carbohydrate interventions reporting visceral fat reduction as a component of weight loss (30, 56, 66–68).”
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- Authors
- Haimoto, H., Iwata, M., Wakai, K., & Umegaki, H.
- Affiliations
- Nagoya University (JP)
- Aichi Cancer Center Research Institute (JP)
- Corresponding author
- Haimoto, Hajime
- Venue
- Diabetes Research and Clinical Practice
- Publisher
- Elsevier BV
- Published
- 2008-02
- Volume
- 79
- Issue
- 2
- Pages
- 350-356
- ISSN
- 0168-8227 (ISSN-L)
- OpenAlex
- W2126437067
- Cited by
- 60
- References
- 27
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 7 · 2018: 7 · 2017: 2 · 2016: 4 · 2015: 4 · 2014: 1 · 2013: 7 · 2012: 2
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Research and Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, low-carbohydrate diet, carbohydrate restriction, glycemic control, HbA1c, body mass index, weight loss, serum cholesterol, long-term dietary intervention
- MeSH terms
- Aged, Aged, 80 and over, Energy Intake, Diabetes Mellitus, Type 2, Diet, Diabetic, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Male, Middle Aged, Sulfonylurea Compounds, Body Mass Index, Diet, Carbohydrate-Restricted
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