This time in a somewhat heterogeneous (mixed) population of Type 2 diabetics. In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss
From the paper:
In the low-fat group, the mean age was 62.7±11 years, there were 13 men and 18 women and the mean duration of known diabetes was 8.8±6.2 years.Corresponding figures for the low-carbohydrate group were 61.2±9.5 years, 14 men and 16 women and a duration of known diabetes of 9.8±5.5 years. Age, sex distribution and known duration of diabetes did not differ between the groups (all p>0.5).
This was a two year study with assessments at 6, 12 and 24 months along with an additional assessment of intake at 3 months. These time frames match up with Shai. Unlike Shai, the dietary prescriptions for both LF and LC were calorie restricted -- 1600 cal/day women, 1800 cal/day men and for LC there was no induction/phasing in more carbs. Average intake was assessed with 3 days of journaling including 1 weekend day. The oral medication usage at baseline was quite a mixed bag but similar between groups. For LF/LC the numbers were: diet only - 2/2, oral hypoglycemics - 13/15, oral hypo + insulin - 11/10. The breakdown of statin use by number of patients wasn't reported, though average dosage was provided in the summary table.
For most of the participants, the intervention was comprised of some initial dietary instruction and monthly group meetings. Dietary instruction was provided at baseline, 2, 6, and 12 months by different physicians. A dietitian provided the first week's menu, recipes, and was available to ask questions at group meetings but individual counseling was not provided for all. For some reason, during the first year, the dietitian had individual consultations with 4 LC'ers and 3 LF'ers. Retention was good as only 3LF/4LC were lost for failure to attend meetings. However at 24 months, the dietary record submission was quite different between groups with only 4 LF'ers (out of 28 completers) not submitting records while 10 LC'ers (out of 26 completers!) did not submit.
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