Kimura Masayo, Kondo Yoshinobu, Aoki Kazutaka, Shirakawa Jun, Kamiyama Hiroshi, Kamiko Kazunari, Nakajima Shigeru, Terauchi Yasuo
Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan.
Nakajima Naika Clinic, Yokosuka 238-0011, Japan.
J Clin Med Res. 2018 Mar;10(3):182-188. doi: 10.14740/jocmr3281w. Epub 2018 Jan 26.
Low-carbohydrate diets have been shown to effectively improve the metabolic status of patients with type 2 diabetes mellitus. However, patients may find it challenging to maintain a strict low-carbohydrate diet. The objective of this study was to determine if a one-meal, low-carbohydrate diet is as effective in improving metabolic status as a conventional, energy-restricted diet among patients with type 2 diabetes mellitus.
In this 12-week randomized controlled study, the primary endpoint was differences in the changes of plasma glycosylated hemoglobin (HbA1c) levels between the two experimental groups. Since the two groups had differences in body weight, body mass index, and waist circumference, propensity score matching was used to assess HbA1c outcomes via cohort pairs according to age, sex, body weight, HbA1c level, and waist circumference.
There were no differences in the changes in HbA1c between the two groups (P = 0.95). In addition, there were no differences in the changes in glycated albumin, 1,5-anhydroglucitol, lipid profile, body weight, waist circumference, and fat mass between the two groups. The mini low-carbohydrate diet group had an increased protein intake (P = 0.0085), as compared with the control group. However, neither group showed changes in their Diabetes Treatment Satisfaction Questionnaire score.
Either diet would be effective for improving the metabolic status of this study population.
低碳水化合物饮食已被证明能有效改善2型糖尿病患者的代谢状况。然而，患者可能会发现维持严格的低碳水化合物饮食具有挑战性。本研究的目的是确定在2型糖尿病患者中，一日低碳水化合物饮食在改善代谢状况方面是否与传统的能量限制饮食同样有效。
在这项为期12周的随机对照研究中，主要终点是两个实验组之间血浆糖化血红蛋白（HbA1c）水平变化的差异。由于两组在体重、体重指数和腰围方面存在差异，因此采用倾向得分匹配法，根据年龄、性别、体重、HbA1c水平和腰围，通过队列配对来评估HbA1c结果。
两组之间HbA1c的变化没有差异（P = 0.95）。此外，两组之间糖化白蛋白、1,5-脱水葡萄糖醇、血脂谱、体重、腰围和脂肪量的变化也没有差异。与对照组相比，低碳水化合物饮食组的蛋白质摄入量有所增加（P = 0.0085）。然而，两组的糖尿病治疗满意度问卷得分均未显示出变化。
两种饮食方式对改善本研究人群的代谢状况均有效。
