Replacing Carbohydrates with Protein and Fats Benefits Patients with T2DM

In a previous study, Dr Faidon Magkos and team reported beneficial glucoregulatory effects of a fully provided carbohydrate-reduced, high-protein (CRHP) diet in patients with type 2 diabetes mellitus (T2DM) in a crossover 2 × 6-week trial, in which patients maintained their body weight. In this present study, they investigated physiological changes during an additional 6-month period on a self-selected and self-prepared CRHP diet.

In this analysis, the researchers included twenty-eight patients with T2DM and instructed them to consume a CRHP diet (30% of energy from carbohydrate and 30% from protein) for 24 weeks, after an initial 2 × 6-week trial. They were provided with dietary advice every 2 weeks. At weeks 0, 6, 12 and 36, they underwent a 3-h intravenous glucose tolerance test, a 4-h mixed meal test, and a 48-h continuous glucose monitoring. The researchers used magnetic resonance imaging to evaluate liver, muscle, pancreas, and visceral fat contents.

Key findings of the study were:

• During the 24-week self-selected diet period (weeks 12–36), the researchers observed that body weight, visceral fat, liver fat, and glycated haemoglobin were maintained at the same levels achieved at the end of the fully provided diet period and were still lower than at baseline.
• They found significantly greater postprandial insulinaemia and insulin secretion.
• By week 36, they noted that the fasting insulin and C-peptide levels increased and, daily glycaemia decreased when compared with the end of the fully provided diet period.

The authors concluded, "Substituting dietary carbohydrate for protein and fat has metabolic benefits in patients with T2DM. These beneficial effects are maintained or augmented over the next 6 months when patients self-select and self-prepare this diet in a dietitian-supported setting."

For further information:

https://link.springer.com/article/10.1007%2Fs00394-021-02605-0