Meir Medical Center, Kfar Saba, Israel.
Diabetes Obes Metab. 2010 Mar;12(3):204-9. doi: 10.1111/j.1463-1326.2009.01151.x.
The appropriate dietary intervention for overweight persons with type 2 diabetes mellitus (DM2) is unclear. Trials comparing the effectiveness of diets are frequently limited by short follow-up times and high dropout rates.
The effects of a low carbohydrate Mediterranean (LCM), a traditional Mediterranean (TM), and the 2003 American Diabetic Association (ADA) diet were compared, on health parameters during a 12-month period.
In this 12-month trial, 259 overweight diabetic patients (mean age 55 years, mean body mass index 31.4 kg/m(2)) were randomly assigned to one of the three diets. The primary end-points were reduction of fasting plasma glucose, HbA1c and triglyceride (TG) levels.
194 patients out of 259 (74.9%) completed follow-up. After 12 months, the mean weight loss for all patients was 8.3 kg: 7.7 kg for ADA, 7.4 kg for TM and 10.1 kg for LCM diets. The reduction in HbA1c was significantly greater in the LCM diet than in the ADA diet (-2.0 and -1.6%, respectively, p < 0.022). HDL cholesterol increased (0.1 mmol/l +/- 0.02) only on the LCM (p < 0.002). The reduction in serum TG was greater in the LCM (-1.3 mmol/l) and TM (-1.5 mmol/l) than in the ADA (-0.7 mmol/l), p = 0.001.
An intensive 12-month dietary intervention in a community-based setting was effective in improving most modifiable cardiovascular risk factors in all the dietary groups. Only the LCM improved HDL levels and was superior to both the ADA and TM in improving glycaemic control.
对于 2 型糖尿病（DM2）患者超重人群，适宜的饮食干预措施尚不明确。比较饮食干预效果的试验常因随访时间短和高脱落率而受到限制。
比较低碳水化合物地中海（LCM）饮食、传统地中海（TM）饮食和 2003 年美国糖尿病协会（ADA）饮食在 12 个月期间对健康参数的影响。
在这项为期 12 个月的试验中，259 名超重糖尿病患者（平均年龄 55 岁，平均体重指数 31.4kg/m²）被随机分配到三种饮食中的一种。主要终点是空腹血糖、HbA1c 和三酰甘油（TG）水平的降低。
259 名患者中有 194 名（74.9%）完成了随访。12 个月后，所有患者的平均体重减轻了 8.3kg：ADA 组 7.7kg，TM 组 7.4kg，LCM 组 10.1kg。LCM 饮食组的 HbA1c 降低幅度明显大于 ADA 饮食组（分别为-2.0%和-1.6%，p<0.022）。仅 LCM 组（p<0.002）的 HDL 胆固醇升高（0.1mmol/l+/-0.02）。LCM（-1.3mmol/l）和 TM（-1.5mmol/l）组的血清 TG 降低幅度大于 ADA 组（-0.7mmol/l），p=0.001。
在社区环境中进行强化的 12 个月饮食干预在所有饮食组中均有效改善了大多数可改变的心血管危险因素。只有 LCM 改善了 HDL 水平，在改善血糖控制方面优于 ADA 和 TM。
