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A low-carbohydrate, ketogenic diet to treat type 2 diabetes

机译：低碳水化合物生酮饮食可治疗2型糖尿病

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Background The low-carbohydrate, ketogenic diet (LCKD) may be effective for improving glycemia and reducing medications in patients with type 2 diabetes. Methods From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A1c. Results Twenty-one of the 28 participants who were enrolled completed the study. Twenty participants were men; 13 were White, 8 were African-American. The mean [± SD] age was 56.0 ± 7.9 years and BMI was 42.2 ± 5.8 kg/m2. Hemoglobin A1c decreased by 16% from 7.5 ± 1.4% to 6.3 ± 1.0% (p < 0.001) from baseline to week 16. Diabetes medications were discontinued in 7 participants, reduced in 10 participants, and unchanged in 4 participants. The mean body weight decreased by 6.6% from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg (p < 0.001). In linear regression analyses, weight change at 16 weeks did not predict change in hemoglobin A1c. Fasting serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001) while other serum lipid measurements did not change significantly. Conclusion The LCKD improved glycemic control in patients with type 2 diabetes such that diabetes medications were discontinued or reduced in most participants. Because the LCKD can be very effective at lowering blood glucose, patients on diabetes medication who use this diet should be under close medical supervision or capable of adjusting their medication.
机译：背景低碳水化合物生酮饮食（LCKD）可能有效改善2型糖尿病患者的血糖水平并减少用药。方法我们从门诊诊所招募了28名2型糖尿病超重参与者，进行了为期16周的单臂试验饮食干预试验。我们提供了LCKD咨询，最初的目标是每天摄入少于20 g碳水化合物，同时在饮食开始时减少了糖尿病药物的剂量。参与者每两周返回一次，进行测量，咨询和进一步的用药调整。主要结果是血红蛋白A1c。结果28名参与者中有21名完成了研究。二十名参与者是男性;白人13人，非裔美国人8人。平均[±SD]年龄为56.0±7.9岁，BMI为42.2±5.8 kg / m2。从基线到第16周，血红蛋白A1c从7.5±1.4％下降了6.3％至6.3±1.0％（p <0.001），下降了16％（7名受试者中止了糖尿病药物治疗，10名受试者中止了糖尿病药物治疗，4名受试者中止了糖尿病药物治疗）。平均体重从131.4±18.3公斤下降了6.6％至122.7±18.9公斤（p <0.001）。在线性回归分析中，第16周的体重变化并未预测血红蛋白A1c的变化。空腹血清甘油三酸酯从2.69±2.87 mmol / L降低至1.57±1.38 mmol / L（p = 0.001），降低了42％，而其他血清脂质的测定没有明显变化。结论LCKD改善了2型糖尿病患者的血糖控制，因此大多数受试者中止或减少了糖尿病药物的使用。由于LCKD可以非常有效地降低血糖，因此使用这种饮食的接受糖尿病药物治疗的患者应接受密切的医学监督或能够调整其药物治疗。

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