Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes

Laura R. Saslow, Jennifer J. Daubenmier, Judith Tedlie Moskowitz, Sarah Kim, Elizabeth J. Murphy, Stephen D. Phinney, Robert Ploutz-Snyder, Veronica Goldman, Rachel M. Cox, Ashley E. Mason, Patricia Moran, Frederick M. Hecht

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Dietary treatment is important in management of type 2 diabetes or prediabetes, but uncertainty exists about the optimal diet. We randomized adults (n = 34) with glycated hemoglobin (HbA1c) > 6.0% and elevated body weight (BMI > 25) to a very low-carbohydrate ketogenic (LCK) diet (n = 16) or a moderate-carbohydrate, calorie-restricted, low-fat (MCCR) diet (n = 18). All participants were encouraged to be physically active, get sufficient sleep, and practice behavioral adherence strategies based on positive affect and mindful eating. At 12 months, participants in the LCK group had greater reductions in HbA1c levels (estimated marginal mean (EMM) at baseline = 6.6%, at 12 mos = 6.1%) than participants in MCCR group (EMM at baseline = 6.9%, at 12 mos = 6.7%), p =.007. Participants in the LCK group lost more weight (EMM at baseline = 99.9 kg, at 12 mos = 92.0 kg) than participants in the MCCR group (EMM at baseline = 97.5 kg, at 12 mos = 95.8 kg), p <.001. The LCK participants experienced larger reductions in diabetes-related medication use; of participants who took sulfonylureas or dipeptidyl peptidase-4 inhibitors at baseline, 6/10 in the LCK group discontinued these medications compared with 0/6 in the MCCR group (p =.005). In a 12-month trial, adults with elevated HbA1c and body weight assigned to an LCK diet had greater reductions in HbA1c, lost more weight, and reduced more medications than those instructed to follow an MCCR diet.

Original languageEnglish (US)
Article number304
JournalNutrition and Diabetes
Volume7
Issue number12
DOIs
StatePublished - Dec 1 2017

Fingerprint

Carbohydrate-Restricted Diet
Prediabetic State
Type 2 Diabetes Mellitus
Carbohydrates
Ketogenic Diet
Fat-Restricted Diet
Fats
Body Weight
Dipeptidyl-Peptidase IV Inhibitors
Weights and Measures
Glycosylated Hemoglobin A
Uncertainty
Sleep
Eating
Diet

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Saslow, Laura R. ; Daubenmier, Jennifer J. ; Moskowitz, Judith Tedlie ; Kim, Sarah ; Murphy, Elizabeth J. ; Phinney, Stephen D. ; Ploutz-Snyder, Robert ; Goldman, Veronica ; Cox, Rachel M. ; Mason, Ashley E. ; Moran, Patricia ; Hecht, Frederick M. / Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. In: Nutrition and Diabetes. 2017 ; Vol. 7, No. 12.
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title = "Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes",
abstract = "Dietary treatment is important in management of type 2 diabetes or prediabetes, but uncertainty exists about the optimal diet. We randomized adults (n = 34) with glycated hemoglobin (HbA1c) > 6.0{\%} and elevated body weight (BMI > 25) to a very low-carbohydrate ketogenic (LCK) diet (n = 16) or a moderate-carbohydrate, calorie-restricted, low-fat (MCCR) diet (n = 18). All participants were encouraged to be physically active, get sufficient sleep, and practice behavioral adherence strategies based on positive affect and mindful eating. At 12 months, participants in the LCK group had greater reductions in HbA1c levels (estimated marginal mean (EMM) at baseline = 6.6{\%}, at 12 mos = 6.1{\%}) than participants in MCCR group (EMM at baseline = 6.9{\%}, at 12 mos = 6.7{\%}), p =.007. Participants in the LCK group lost more weight (EMM at baseline = 99.9 kg, at 12 mos = 92.0 kg) than participants in the MCCR group (EMM at baseline = 97.5 kg, at 12 mos = 95.8 kg), p <.001. The LCK participants experienced larger reductions in diabetes-related medication use; of participants who took sulfonylureas or dipeptidyl peptidase-4 inhibitors at baseline, 6/10 in the LCK group discontinued these medications compared with 0/6 in the MCCR group (p =.005). In a 12-month trial, adults with elevated HbA1c and body weight assigned to an LCK diet had greater reductions in HbA1c, lost more weight, and reduced more medications than those instructed to follow an MCCR diet.",
author = "Saslow, {Laura R.} and Daubenmier, {Jennifer J.} and Moskowitz, {Judith Tedlie} and Sarah Kim and Murphy, {Elizabeth J.} and Phinney, {Stephen D.} and Robert Ploutz-Snyder and Veronica Goldman and Cox, {Rachel M.} and Mason, {Ashley E.} and Patricia Moran and Hecht, {Frederick M.}",
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Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. / Saslow, Laura R.; Daubenmier, Jennifer J.; Moskowitz, Judith Tedlie; Kim, Sarah; Murphy, Elizabeth J.; Phinney, Stephen D.; Ploutz-Snyder, Robert; Goldman, Veronica; Cox, Rachel M.; Mason, Ashley E.; Moran, Patricia; Hecht, Frederick M.

In: Nutrition and Diabetes, Vol. 7, No. 12, 304, 01.12.2017.

Research output: Contribution to journalArticle

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T1 - Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes

AU - Saslow, Laura R.

AU - Daubenmier, Jennifer J.

AU - Moskowitz, Judith Tedlie

AU - Kim, Sarah

AU - Murphy, Elizabeth J.

AU - Phinney, Stephen D.

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AU - Moran, Patricia

AU - Hecht, Frederick M.

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