Nielsen Jørgen Vesti, Joensson Eva
Department of Medicine, Blekingesjukhuset, Karlshamn, 37480 Karlshamn, Sweden.
Nutr Metab (Lond). 2006 Jun 14;3:22. doi: 10.1186/1743-7075-3-22.
Low-carbohydrate diets in the management of obese patients with type 2 diabetes seem intuitively attractive due to their potent antihyperglycemic effect. We previously reported that a 20% carbohydrate diet was significantly superior to a 55-60% carbohydrate diet with regard to bodyweight and glycemic control in 2 non-randomised groups of obese diabetes patients observed closely over 6 months. The effect beyond 6 months of reduced carbohydrate has not been previously reported. The objective of the present study, therefore, was to determine to what degree the changes among the 16 patients in the low-carbohydrate diet group at 6-months were preserved or changed 22 months after start, even without close follow-up. In addition, we report that, after the 6 month observation period, two thirds of the patients in the high-carbohydrate changed their diet. This group also showed improvement in bodyweight and glycemic control.
Retrospective follow-up of previously studied subjects on a low carbohydrate diet.
The mean bodyweight at the start of the initial study was 100.6 +/- 14.7 kg. At six months it was 89.2 +/- 14.3 kg. From 6 to 22 months, mean bodyweight had increased by 2.7 +/- 4.2 kg to an average of 92.0 +/- 14.0 kg. Seven of the 16 patients (44%) retained the same bodyweight from 6 to 22 months or reduced it further; all but one had lower weight at 22 months than at the beginning. Initial mean HbA1c was 8.0 +/- 1.5%. After 6 and 12 months it was 6.6 +/- 1.0 % and 7.0 +/- 1.3%, respectively. At 22 months, it was still 6.9 +/- 1.1%.
Advice on a 20% carbohydrate diet with some caloric restriction to obese patients with type 2 diabetes has lasting effect on bodyweight and glycemic control.
低碳水化合物饮食对肥胖的2型糖尿病患者具有显著的降糖作用，从直观上看颇具吸引力。我们之前报道，在对两组肥胖糖尿病患者进行6个月的密切观察中，20%碳水化合物饮食组在体重和血糖控制方面显著优于55 - 60%碳水化合物饮食组。此前尚未报道碳水化合物摄入量减少超过6个月后的效果。因此，本研究的目的是确定低碳水化合物饮食组的16名患者在开始22个月后，即使没有密切随访，6个月时的变化在多大程度上得以保留或改变。此外，我们报告，在6个月观察期后，三分之二的高碳水化合物饮食组患者改变了饮食。该组患者的体重和血糖控制也有所改善。
对先前研究的低碳水化合物饮食受试者进行回顾性随访。
初始研究开始时的平均体重为100.6±14.7千克。6个月时为89.2±14.3千克。从6个月到22个月，平均体重增加了2.7±4.2千克，达到平均92.0±14.0千克。16名患者中有7名（44%）在6个月至22个月期间体重保持不变或进一步减轻；除1人外，其余所有人在22个月时的体重均低于开始时。初始平均糖化血红蛋白（HbA1c）为8.0±1.5%。6个月和12个月后分别为6.6±1.0%和7.0±1.3%。在22个月时，仍为6.9±1.1%。
对肥胖的2型糖尿病患者建议采用20%碳水化合物饮食并适当限制热量，对体重和血糖控制具有持久影响。
