Authors (including presenting author) :
Wong TW(1)(4), Lee H(2)(4), Leung HT(1)(4), Chong YC(1)(4), Chan WS(3)(4), Kwok KP(3)(4), Ching KM(2)(4), Wong HY(2)(4), Chan SW(3)(4), Wong WM (3)(4), Leung JYY(1)(4)
Affiliation :
(1)Department of Medicine and Geriatrics, (2)Dietetic Department, (3)Nursing Services Division, (4)Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Low carbohydrate diet is a therapeutic option for people with diabetes and obesity as endorsed by the American Diabetes Association and European Association for the Study of Diabetes.
Objectives :
To investigate the effectiveness and safety of a low carbohydrate, non-ketogenic diet (LCNK) (<30% energy from carbohydrate) in overweight people with type 2 diabetes (T2D) with suboptimal diabetes control.
Methodology :
This prospective, open-label 26-week study, comparing a low carbohydrate, non-ketogenic diet (LCNK), to a calorie-reduced diet (CRD), included 45 T2D with BMI ≥25kg/m2 and HbA1c ≥7% from the outpatient clinic of Ruttonjee Hospital between September 2021 to June 2022. All participants selected their choice of diet and received one-to-one nutrition education with the dietitian. They were advised to restrict carbohydrate intake to <30% per day (LCNK) or to reduce 500 kcal from the baseline total daily energy intake (CRD). Both groups were advised to follow healthy eating principles. Diabetes medications were adjusted by endocrinologists and diabetes nurses during the study period.
Result & Outcome :
A total of 43 participants (LCNK n=25; CRD n=18) completed the study. At baseline, the median HbA1c, body weight (BW), and BMI were 7.9% (IQR 7.4-9.1%), 79.3kg (IQR 70.1-96.3kg), and 30.50 kg/m2 (IQR 27.50–33.45 kg/m2) respectively in LCNK, and 7.7% (IQR 7.15–8.23%), 77.6kg (IQR 65.0-92.7kg), and 28.45 kg/m2 (IQR 26.30-35.38 kg/m2) respectively in CRD. At 26 weeks, HbA1c decreased by 0.20% (0.05–0.65; p=0.029) and by 0.70% (IQR 0.03-0.93; p=0.006) in LCNK and CRD respectively. BW decreased by 1.9kg (IQR 0.25-3.05; p0.006) and 2.7 kg (IQR 0.48-3.03; p=0.001), in the LCNK and CRD, respectively. BMI decreased by 0.8kg/m2 (IQR 0.10-1.25; p0.006) and 1.0kg/m2 (IQR 0.25-1.13; p=0.001), in the LCNK and CRD, respectively. There were no significant differences in change in HbA1c (p=0.330), BW (p=0.409), and BMI (p=0.459) between the two groups. In both groups, there was no worsening of renal function, low-density cholesterol, and triglyceride levels.
This study demonstrated that a 6-month LCNK or a CRD reduced HbA1c and body weight. LCNK provides an alternative diet option for people with T2D.
