The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Low-carbohydrate, ketogenic diet in diabetes

     Does a low carbohydrate, keotgenic diet result in improved diabetes control in overweight people with type 2 diabetes mellitus?

    Researchers from Duke University Medical Center in Durham, North Carolina compared a low-carbohydrate, ketogenic diet to a low-glycemic, reduced-calorie diet.

    First, the details.

    • 84 obese people with type 2 diabetes were randomly assigned to a diet for 24 weeks.
      • A low-carbohydrate, ketogenic diet (less than 20 grams of carbs daily)
      • A low-glycemic, reduced-calorie diet (500 kcal/day less than needed for weight maintenance).
    • Both groups participated in group meetings and received nutritional supplementation and exercise recommendations.
    • The main outcome was blood sugar control, measured by hemoglobin A1c.
      • The A1c test shows the average amount of sugar in the blood over the last 3 months.
      • Ketogenic diets are high fat, adequate protein, and low in carbohydrates.

    And, the results.

    • Both treatments improvemed A1c, fasting blood sugar levels, fasting insulin, and weight loss.
    • The low-carb ketogenic diet group had significantly greater improvements in A1c, body weight, and HDL (good) cholesterol vs the low glycemic diet.
    • Diabetes medications were reduced or eliminated in 95% of low-carb group vs. 62% with the low glycemic diet.

    The bottom line?
    Both diets led to better diabetes control, less need for anti-diabetic drugs, and weight loss over 24 weeks. However, the low-carb, ketogenic diet was most effective.

    The greater effect of the low-carb ketogenic diet appeared to be due to the lower carbohydrate intake,” concluded the authors, “because statistical significance remained after adjustment for weight loss.

    Long-term compliance is a problem with any diet. This is particularly true with the ketogenic diet. In 1 study, only 50% of children receiving the ketogenic diet remained on the diet after 1 year.

    Similarly, in this study, 45% of those on the low-carb, ketogenic diet dropped out compared to 37% in the low-glycemic, reduced-calorie diet group.

    With so many lifestyle changes required of people with diabetes, are the added benefits of a low-carb ketogenic diet — which are considerable — worth the effort? And at what point in treatment should patients be introduced to it?

    1/7/09 20:42 JR

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