Diabetes Unit, University Hospital at the Second University of Naples, Naples, Italy
Diabetes Unit, University Hospital at the Second University of Naples, Naples, Italy.
Diabetes Care. 2014 Jul;37(7):1824-30. doi: 10.2337/dc13-2899. Epub 2014 Apr 10.
To assess the long-term effects of dietary interventions on glycemic control, need for diabetes medications, and remission of type 2 diabetes.
Originally, in a two-arm trial design, overweight, middle-aged men and women with newly diagnosed type 2 diabetes were randomized to a low-carbohydrate Mediterranean diet (LCMD; n = 108) or a low-fat diet (n = 107). After 4 years, participants who were still free of diabetes medications were further followed up until the primary end point (need of a diabetic drug); remission of diabetes (partial or complete) and changes in weight, glycemic control, and cardiovascular risk factors were also evaluated.
The primary end point was reached in all participants after a total follow-up of 6.1 years in the low-fat group and 8.1 years in the LCMD group; median survival time was 2.8 years (95% CI 2.4-3.2) and 4.8 years (4.3-5.2), respectively. The unadjusted hazard ratio for the overall follow-up was 0.68 (0.50-0.89; P < 0.001). LCMD participants were more likely to experience any remission (partial or complete), with a prevalence of 14.7% (13.0-16.5%) during the first year and 5.0% (4.4-5.6%) during year 6 compared with 4.1% (3.1-5.0%) at year 1 and 0% at year 6 in the low-fat diet group.
In patients with newly diagnosed type 2 diabetes, an LCMD resulted in a greater reduction of HbA1c levels, higher rate of diabetes remission, and delayed need for diabetes medication compared with a low-fat diet.
评估饮食干预对血糖控制、糖尿病药物需求以及 2 型糖尿病缓解的长期影响。
最初，在一项双臂试验设计中，新诊断为 2 型糖尿病的超重中年男女被随机分配到低碳水化合物地中海饮食（LCMD；n=108）或低脂饮食（n=107）。4 年后，仍未使用糖尿病药物的参与者进一步随访至主要终点（需要使用糖尿病药物）；还评估了糖尿病的缓解（部分或完全）以及体重、血糖控制和心血管危险因素的变化。
在低脂组总随访 6.1 年和 LCMD 组 8.1 年后，所有参与者均达到了主要终点；中位生存时间分别为 2.8 年（95%CI 2.4-3.2）和 4.8 年（4.3-5.2）。整体随访的未调整风险比为 0.68（0.50-0.89；P<0.001）。LCMD 参与者更有可能经历任何缓解（部分或完全），第一年的患病率为 14.7%（13.0-16.5%），第六年的患病率为 5.0%（4.4-5.6%），而低脂饮食组第一年的患病率为 4.1%（3.1-5.0%），第六年为 0%。
在新诊断为 2 型糖尿病的患者中，与低脂饮食相比，LCMD 可降低 HbA1c 水平、提高糖尿病缓解率并延迟糖尿病药物的需求。
