Re: The effects of a long term Low Carb diet on T2D 134 patients , 2 years follow-up

On Sun, 11 Nov 2007 16:02:24 +0100, "GysdeJongh"
<jongh711@xxxxxxxxx> wrote:

"Alan S" <loralgtweightandcarbs@xxxxxxxxx> wrote in message
news:drucj354o1i1a6at5jojojnmebrp7lai26@xxxxxxxxxx
On Sun, 11 Nov 2007 01:07:32 GMT, Jim Chinnis
<jchinnis@xxxxxxxxxxxxxxxx> wrote:

"GysdeJongh" <jongh711@xxxxxxxxx> wrote in part:

Diabetes Res Clin Pract. 2007 Oct 31;
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.

PMID: 17980451

Gys

What an unexpected surprise! :-D

Sadly, for the traditionalists and those they treat, it is.
To me that is a dramatic difference in A1c; there were also
other benefits.

Hi Alan,

All were Type II diabetes

All were overweight and about my age

It was a large study over a long time and the "diet" was not forced upon the
patients



a few excerpts :


One reason for this failure is that a conventional diet (CD) with restricted
calories is troublesome, and diabetic patients, especially the elderly, are
unwilling to comply [2]. A new type of diet therapy is required,
specifically, one that is free of complicated calorie calculations and is
easier and more acceptable to patients. The CD for type 2 diabetes
emphasizes intake of carbohydrate-rich grains and limitation of saturated
fats and cholesterol [3]. However, we have fundamental questions about this
conventional high-carbohydrate, low-fat, energyrestricted diet. Furthermore,
it is well known that blood glucose concentrations are largely dependent on
the ingestion of food containing carbohydrates, but dietary protein and fat
have little effect on these concentrations [6-9].



Table 1 - Carbohydrate-rich foods instructed to remove in the
carbohydrate-reduced diet

Staple food: rice, bread, corn, spaghetti, noodle made of wheat or
buckwheat, potato, sweet potato, taro and yam



Fruits:pear, apple, persimmon, mikan, orange, grapefruit, peach, grape,
melon, water melon, banana, pine apple and Japanese chestnut, etc.



Vegetables:carrot, Indian lotus, pumpkin and autum squash Confectioneries



Drink:beverages containing sugar, glucose and fructose, and milk Alcohol:
brew: sake, beer and wine (distilled liquor was not restricted)



CARD = Carbohydrate-Reduced Diet

CD = Conventional Diet

CD CARD

Age 69 (11) 64(7)

Energy(kcal) 1734(410) 1773(441)

BMI(Start) 24.2(2.9) 25.1(3.4)



Carb(g) 229(50) 182(48)

Fat(g) 51(25) 64(23)

Prot(g) 68(14) 77(22)



Carb(%) 57(9) 45(12)

Fat(%) 26(8) 33(10)

Prot(%) 16(3) 18(4)



CD = Conventional Diet;after = 2 years

Before After

HbA1C(%) 7.1(1.0) 7.5(1.3)

BMI 24.2(2.9) 23.8(3.0)

Tot Chol 201(34) 210(38)



CARD = Carbohydrate-Reduced Diet

Before After

HbA1C(%) 7.4(1.1) 6.7(0.6)

BMI 25.1(3.4) 23.8(3.5)

Tot Chol 205(33) 200(29)



Withinthe above limitations, the number of patients who were on
sulfonylureas in the CARD group decreased in the 2- year study
period(glibenclamide: from18 to 1, glimepiride: from 7 to 4, tolbutamide:
from7 to 3), whereas those in the CD group increased or robustly did not
change (glibenclamide: from 11 to 9, glimepiride: from 6 to 16, tolbutamide:
from 3 to 3)



Don't worry mate it's going in the right direction :)

Have a nice weekend

Gys

Thank you for the extra detail; would it be possible to
email the full version?

Just some initial musings. You know I'm not a scientist so I
see these things from a slightly different slant.

One minor thing that puzzles me - I would not have
considered those starting BMI's overweight.

The CDC definitions are:
http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/about_adult_BMI.htm#Interpreted
BMI Weight Status
Below 18.5 Underweight
18.5 – 24.9 Normal
25.0 – 29.9 Overweight
30.0 and Above Obese

The starting BMI's of 24.2 and 25.1 average were not
representative of the majority of T2's I know from support
meetings. Most of them passed 30 going up a while ago. I'm
not including asd people in that generalisation.

The weight loss was only minor in that case, to 23.8 BMI in
both cases. To me that makes it more relevant, because the
reduction in A1c cannot be attributed to weight loss and
must therefore be significantly attributed to the dietary
change.

I think it is also significant that the A1c for the CD group
actually rose, albeit marginally.

The breakdown of the cholesterol numbers to see the
trigs/HDL ratio changes would also be interesting. Those who
argue against lower carb eating for diabetics tend to warn
against the resulting higher proportion of fat and protein
by claiming cholesterol must rise. This appears to show that
claim to be false. In fact it rose marginally in the CD
group and fell marginally in the CARD group. The raw figures
may show a rise in LDL but I'll be surprised if there isn't
a drop in trigs and a rise in HDL.

And a very minor quibble - squash is almost a free food for
me; it has negligible effect on my BG's.


Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Psyllium, Fibre, Muesli and Nuts
.

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