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Two diets with different haemoglobin A1c and antiglycaemic medication effects despite similar weight loss in type 2 diabetes
Author(s) -
Mayer S. B.,
Jeffreys A. S.,
Olsen M. K.,
McDuffie J. R.,
Feinglos M. N.,
Yancy W. S.
Publication year - 2014
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12191
Subject(s) - weight loss , type 2 diabetes , medicine , body mass index , confidence interval , orlistat , diabetes mellitus , low carbohydrate , zoology , obesity , endocrinology , biology
We analysed participants with type 2 diabetes (n = 46) within a larger weight loss trial (n = 146) who were randomized to 48 weeks of a low‐carbohydrate diet ( LCD ; n = 22) or a low‐fat diet + orlistat ( LFD + O; n = 24). At baseline, mean body mass index ( BMI ) was 39.5 kg/m 2 (s.d. 6.5) and haemoglobin A1c ( HbA1c ) 7.6% (s.d. 1.3). Although the interventions reduced BMI similarly ( LCD −2.4 kg/m 2 ; LFD + O −2.7 kg/m 2 , p = 0.7), LCD led to a relative improvement in HbA1c: −0.7% in LCD versus +0.2% in LFD + O [difference −0.8%, 95% confidence interval ( CI ) = −1.6, −0.02; p = 0.045]. LCD also led to a greater reduction in antiglycaemic medications using a novel medication effect score ( MES ) based on medication potency and total daily dose; 70.6% of LCD versus 30.4% LFD + O decreased their MES by ≥50% (p = 0.01). Lowering dietary carbohydrate intake demonstrated benefits on glycaemic control beyond its weight loss effects, while at the same time lowering antiglycaemic medication requirements.