The effect of intensive dietary therapy on serum high density lipoprotein cholesterol in patients with Type 2 (non-insulin-dependent) diabetes mellitus: a prospective study.

Intensive dietary therapy in 57 newly diagnosed Type 2 (non-insulin-dependent) diabetic patients led to an increase, compared with pre-treatment levels, in serum high density lipoprotein (HDL) cholesterol and the HDL/total cholesterol ratio after 3 and 6 months (0.05 less than p less than 0.1). The increase in HDL cholesterol was related to the degree of weight loss achieved. In 28 patients whose weight decreased by greater than or equal to 10% average body weight during the 6 months, HDL cholesterol rose from 1.22 +/- 0.06 to 1.36 +/- 0.06 mmol/l (p less than 0.001), whereas patients who lost less weight showed no significant increase in HDL cholesterol. The increase in mean serum HDL-cholesterol levels in female patients was associated with a mean weight reduction of 12.1% average body weight. Patients who were obese at diagnosis lost more weight during the study than non-obese patients (mean 13.2 versus 5.6% average body weight), and showed a significant increase in serum HDL-cholesterol levels. We conclude that intensive dietary therapy may lead to a less atherogenic lipid profile in Type 2 diabetes, particularly in patients who achieve a major weight reduction.