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Effect of a Low-Carbohydrate Diet on Appetite, Blood Glucose Levels, and Insulin Resistance in Obese Patients with Type 2 Diabetes

Boden, G., Sargrad, K., Homko, C., et. al., “Effect of a Low-Carbohydrate Diet on Appetite, Blood Glucose Levels, and Insulin Resistance in Obese Patients with Type 2 Diabetes,” Annals of Internal Medicine, 142(6), 2005, pages 403-411.

The following information is available at Pub Med and was not written by Atkins professionals.

BACKGROUND: It is not known how a low-carbohydrate, high-protein, high-fat diet causes weight loss or how it affects blood glucose levels in patients with type 2 diabetes.

OBJECTIVE: To determine effects of a strict low-carbohydrate diet on body weight, body water, energy intake and expenditure, glycemic control, insulin sensitivity, and lipid levels in obese patients with type 2 diabetes.

DESIGN: Inpatient comparison of 2 diets.

SETTING: General clinical research center of a university hospital.

PATIENTS: 10 obese patients with type 2 diabetes.

INTERVENTION: Usual diets for 7 days followed by a low-carbohydrate diet for 14 days.

MEASUREMENTS: Body weight, water, and composition; energy intake and expenditure; diet satisfaction; hemoglobin A1c; insulin sensitivity; 24-hour urinary ketone excretion; and plasma profiles of glucose, insulin, leptin, and ghrelin.

RESULTS: On the low-carbohydrate diet, mean energy intake decreased from 3111 kcal/d to 2164 kcal/d. The mean energy deficit of 1027 kcal/d (median, 737 kcal/d) completely accounted for the weight loss of 1.65 kg in 14 days (median, 1.34 kg in 14 days). Mean 24-hour plasma profiles of glucose levels normalized, mean hemoglobin A1c decreased from 7.3% to 6.8%, and insulin sensitivity improved by approximately 75%. Mean plasma triglyceride and cholesterol levels decreased (change, -35% and -10%, respectively).

LIMITATIONS: The study was limited by the short duration, small number of participants, and lack of a strict control group.

CONCLUSION: In a small group of obese patients with type 2 diabetes, a low-carbohydrate diet followed for 2 weeks resulted in spontaneous reduction in energy intake to a level appropriate to their height; weight loss that was completely accounted for by reduced caloric intake; much improved 24-hour blood glucose profiles, insulin sensitivity, and hemoglobin A1c; and decreased plasma triglyceride and cholesterol levels. The long-term effects of this diet, however, remain uncertain.

The following information was written by Atkins professionals.

Ten obese Type 2 diabetics lived in a clinical research center for 3 weeks and had their food intake measured. During the first week, they ate their meals as they usually would but for the next two weeks, they followed a low carbohydrate diet. They were instructed to eat 21 grams of carbohydrates per day but protein and fat were not restricted. They were also allowed Atkins brand products. Although there was no change in weight after the first week on their usual diet, individuals lost up to 19 pounds after 2 weeks on the low carb diet. Additionally, improvements were seen in risk factors associated with heart disease and blood sugar control. Researchers concluded that controlling carbohydrates is effective in producing weight loss because individuals reduce total caloric intake.