January 05, 2009
Type 2 Diabetes Reduced By Very Low Carbo Diet

For people with type 2 (insulin resistant) diabetes a diet with very little carbs lowers blood sugar more than a diet with low glycemic index carbs.

DURHAM, NC -- In a six-month comparison of low-carb diets, one that encourages eating carbohydrates with the lowest-possible rating on the glycemic index leads to greater improvement in blood sugar control, according to Duke University Medical Center researchers.

Patients who followed the no-glycemic diet experienced more frequent reductions, and in some cases elimination, of their need for medication to control type 2 diabetes, according to lead author Eric Westman, MD, director of Duke's Lifestyle Medicine Program. The findings are published online in Nutrition and Metabolism.

"Low glycemic diets are good, but our work shows a no-glycemic diet is even better at improving blood sugar control," he says. "We found you can get a three-fold improvement in type 2 diabetes as evidenced by a standard test of the amount of sugar in the blood. That's an important distinction because as a physician who is faced with the choice of drugs or diet, I want a strong diet that's shown to improve type 2 diabetes and minimize medication use."

Eight-four volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate ketogenic diet (less than 20 grams of carbs/day) or a low-glycemic, reduced calorie diet (500 calories/day). Both groups attended group meetings, had nutritional supplementation and an exercise regimen.

After 24 weeks, their glycemic control was determined by a blood test that measured hemoglobin A1C, a standard test used to determine blood sugar control in patients with diabetes. Of those who completed the study, the volunteers in the low-carbohydrate diet group had greater improvements in hemoglobin A1C. Diabetes medications were reduced or eliminated in 95 percent of the low-carbohydrate volunteers, compared to 62 percent in the low-glycemic group. The low-carbohydrate diet also resulted in a greater reduction in weight.

Eating low glycemic index carbohydrates is a good bet if you are going to eat carbohydrates. Probably for someone who does not have obesity or type 2 diabetes a ketogenic very low carb diet is too extreme. There are risks with putting your body into ketosis.

Type 2 diabetes is worth controlling for a number of reasons. For example type 2 diabetes impairs a couple of types of cognitive function.

WASHINGTON Adults with diabetes experience a slowdown in several types of mental processing, which appears early in the disease and persists into old age, according to new research. Given the sharp rise in new cases of diabetes, this finding means that more adults may soon be living with mild but lasting deficits in their thought processes.

A full analysis appears in the January issue of Neuropsychology, which is published by the American Psychological Association.

Researchers at Canada's University of Alberta analyzed a cross-section of adults with and without adult-onset Type 2 diabetes, all followed in the Victoria Longitudinal Study. At three-year intervals, this study tracks three independent samples of initially healthy older adults to assess biomedical, health, cognitive and neurocognitive aspects of aging. The Neuropsychology study involved 41 adults with diabetes and 424 adults in good health, between ages 53 and 90.

The research confirmed previous reports that diabetes impairs cognition and added two important findings. First, it teased out the specific domains hurt by diabetes. Second, it revealed that the performance gap was not worse in the older group. Thus, the reductions in executive function and processing speed seem to begin earlier in the disease.

Healthy adults performed significantly better than adults with diabetes on two of the five domains tested: executive functioning, with significant differences across four different tests, and speed, with significant differences or trends across five different tests. There were no significant differences on tests of episodic and semantic memory, verbal fluency, reaction time and perceptual speed.

Another example of the high stakes for controlling type 2 diabetes: Type 2 diabetes at least triples risk of heart attack.

Men with type 2 diabetes and men with previous heart attack or stroke had a 3 to 4 fold risk of cardiovascular death compared to men without either disease in the years following the first acute event, according to a study in CMAJ http://www.cmaj.ca/press/pg40.pdf.

The study underscores the high risk of diabetes, as "men with type 2 diabetes and no previous cardiovascular disease had a 3-fold cardiovascular mortality risk compared with men with neither cardiovascular disease nor diabetes at the beginning of the follow-up," write Dr. Gilles Dagenais and colleagues from Laval University and the University of Montreal. However, the study was limited to white men and diabetes was self-reported in two-thirds of cases.

Stay skinny, get a lot of exercise, and eat healthy food so that you do not develop type 2 diabetes. It'll age you more rapidly. Worth avoiding.

Share |      Randall Parker, 2009 January 05 11:17 PM  Aging Diet Heart Studies

Tom Bri said at January 6, 2009 6:24 AM:

Be interested to hear what you think the risks of being in ketosis are. I have spent months in keyosis on very low carb and didn't notice any ill effects. In general I like it.

Mirco said at January 7, 2009 6:15 AM:

Me too.
The problem is not ketosis, that is a physiological condition, but keto-acidosis, that is a pathological condition happening with type I diabetes. Keto-acidosis is mainly about lack of insulin, not about glycemic levels.

Ketoacidosis should not be confused with ketosis, which is one of the body's normal processes for the metabolism of body fat. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased.

Without glucose inside the cells the body start produce ketone, but without insulin to move the ketone inside the cell, the cell continue to be lacking energy and signaling to produce other ketone.

Randall Parker said at January 7, 2009 11:05 PM:

Patri Friedman wrote a pretty good web page on ketosis and high protein diets.

Ketosis can cause a dangerous loss of potassium. So people under medical supervision on a high protein, low carb diet often take potassium supplements.

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