PT  - JOURNAL ARTICLE
AU  - Shabina Roohi Ahmed
AU  - Sridevi Bellamkonda
AU  - Mihail Zilbermint
AU  - Jiangxia Wang
AU  - Rita Rastogi Kalyani
TI  - Effects of the low carbohydrate, high fat diet on glycemic control and body weight in patients with type 2 diabetes: experience from a community-based cohort
AID  - 10.1136/bmjdrc-2019-000980
DP  - 2020 Mar 01
TA  - BMJ Open Diabetes Research & Care
PG  - e000980
VI  - 8
IP  - 1
4099  - http://drc.bmj.com/content/8/1/e000980.short
4100  - http://drc.bmj.com/content/8/1/e000980.full
SO  - BMJ Open Diab Res Care2020 Mar 01; 8
AB  - Objective The optimal diet to improve glycemia in patients with type 2 diabetes remains unclear. Low carbohydrate, high fat (LCHF) diets can improve glycemic control, but have not been investigated in real-world settings.Research design and methods We investigated effects of the LCHF diet compared with usual care in a community-based cohort of patients with type 2 diabetes by performing a retrospective study of 49 patients who followed the LCHF diet for ≥3 months, and compared glycemic outcomes with age-matched and body mass index (BMI)-matched controls who received usual care (n=75). The primary outcome was change in A1C from baseline to the end of follow-up.Results Compared with the usual care group, the LCHF group showed a significantly greater reduction in A1C (−1.29% (95% CI −1.75 to −0.82; p<0.001)) and body weight (−12.8 kg (95% CI −14.7 to −10.8; p<0.001) at the end of follow-up after adjusting for age, sex, baseline A1C, BMI, baseline insulin dose. Of the patients initially taking insulin therapy in the LCHF group, 100% discontinued it or had a reduction in dose, compared with 23.1% in the usual care group (p<0.001). The LCHF group also had significantly greater reduction in fasting plasma glucose (−43.5 vs −8.5 mg/mL; p=0.03) compared with usual care.Conclusions In a community-based cohort of type 2 diabetes, the LCHF diet was associated with superior A1C reduction, greater weight loss and significantly more patients discontinuing or reducing antihyperglycemic therapies suggesting that the LCHF diet may be a metabolically favorable option in the dietary management of type 2 diabetes.