Katherine Esposito1, Maria Ida Maiorino2, Michela Petrizzo2, Giuseppe Bellastella3, Dario Giugliano3. 1. Diabetes Unit, University Hospital at the Second University of Naples, Naples, Italy katherine.esposito@unina2.it. 2. Diabetes Unit, University Hospital at the Second University of Naples, Naples, Italy. 3. Division of Endocrinology and Metabolic Diseases, University Hospital at the Second University of Naples, Naples, Italy.
Abstract
OBJECTIVE: To assess the long-term effects of dietary interventions on glycemic control, need for diabetes medications, and remission of type 2 diabetes. RESEARCH DESIGN AND METHODS: Originally, in a two-arm trial design, overweight, middle-aged men and women with newly diagnosed type 2 diabetes were randomized to a low-carbohydrate Mediterranean diet (LCMD; n = 108) or a low-fat diet (n = 107). After 4 years, participants who were still free of diabetes medications were further followed up until the primary end point (need of a diabetic drug); remission of diabetes (partial or complete) and changes in weight, glycemic control, and cardiovascular risk factors were also evaluated. RESULTS: The primary end point was reached in all participants after a total follow-up of 6.1 years in the low-fat group and 8.1 years in the LCMD group; median survival time was 2.8 years (95% CI 2.4-3.2) and 4.8 years (4.3-5.2), respectively. The unadjusted hazard ratio for the overall follow-up was 0.68 (0.50-0.89; P < 0.001). LCMD participants were more likely to experience any remission (partial or complete), with a prevalence of 14.7% (13.0-16.5%) during the first year and 5.0% (4.4-5.6%) during year 6 compared with 4.1% (3.1-5.0%) at year 1 and 0% at year 6 in the low-fat diet group. CONCLUSIONS: In patients with newly diagnosed type 2 diabetes, an LCMD resulted in a greater reduction of HbA1c levels, higher rate of diabetes remission, and delayed need for diabetes medication compared with a low-fat diet.
RCT Entities:
OBJECTIVE: To assess the long-term effects of dietary interventions on glycemic control, need for diabetes medications, and remission of type 2 diabetes. RESEARCH DESIGN AND METHODS: Originally, in a two-arm trial design, overweight, middle-aged men and women with newly diagnosed type 2 diabetes were randomized to a low-carbohydrate Mediterranean diet (LCMD; n = 108) or a low-fat diet (n = 107). After 4 years, participants who were still free of diabetes medications were further followed up until the primary end point (need of a diabetic drug); remission of diabetes (partial or complete) and changes in weight, glycemic control, and cardiovascular risk factors were also evaluated. RESULTS: The primary end point was reached in all participants after a total follow-up of 6.1 years in the low-fat group and 8.1 years in the LCMD group; median survival time was 2.8 years (95% CI 2.4-3.2) and 4.8 years (4.3-5.2), respectively. The unadjusted hazard ratio for the overall follow-up was 0.68 (0.50-0.89; P < 0.001). LCMD participants were more likely to experience any remission (partial or complete), with a prevalence of 14.7% (13.0-16.5%) during the first year and 5.0% (4.4-5.6%) during year 6 compared with 4.1% (3.1-5.0%) at year 1 and 0% at year 6 in the low-fat diet group. CONCLUSIONS: In patients with newly diagnosed type 2 diabetes, an LCMD resulted in a greater reduction of HbA1c levels, higher rate of diabetes remission, and delayed need for diabetes medication compared with a low-fat diet.
Authors: Katherine Esposito; Maria Ida Maiorino; Giuseppe Bellastella; Demosthenes B Panagiotakos; Dario Giugliano Journal: Endocrine Date: 2016-07-09 Impact factor: 3.633
Authors: Melanie J Davies; David A D'Alessio; Judith Fradkin; Walter N Kernan; Chantal Mathieu; Geltrude Mingrone; Peter Rossing; Apostolos Tsapas; Deborah J Wexler; John B Buse Journal: Diabetologia Date: 2018-12 Impact factor: 10.122