Saturday, September 11, 2010

Shai and Diabetes

I thought I would post the following graphic from the Shai Study that compared Low Fat, Low Carb and Mediterranean diets over 2 years.  Just to refresh regarding weight loss, when one compares LC to MDTN, at around 1 year the average weight loss was comparable and essentially the same at the 2 year mark.  Therefore the changes in diabetic markers are (at least on average) independent of weight loss.  As a limitation, although there were roughly 100 participants in each group, only 11-13 of them were T2 diabetics, so the sample size here is quite small.  Also, to refresh, the LC group reduced carb intake by around 125g and caloric intake by ~550 cal on average while the MDTN group's intakes were reduced by around 45-50g and 350 cal respectively.


The legend doesn't give stats for the non-diabetics, but there was no difference between the three diets for FBG, there does not appear to be much difference for HOMA-IR (measure of insulin resistance), but a fasting insulin does appear to have been significantly reduced by LC.  I'll leave that result for another post.

Many people believe carbohydrate restriction is superior for treatment of T2 diabetes.  Remember, the purple triangles are LC and the orange squares are MDTN.  At the 2 year mark the MDTN diet beats LC for all three markers.  What MAY be going on is that with improved insulin sensitivity, the MDTN's produced less basal insulin, and the insulin they do produce is "seen" by the liver suppressing gluconeogenesis resulting in lower fasting blood glucose levels.  I wish they assessed NEFA's!

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