FP-2. Clinical experience of a carbohydrate-restricted diet: effect on diabetes mellitus.

The objective of this study was to assess the effect of a carbohydrate-restricted dietary approach on diabetes mellitus in a clinical practice setting. The rationale for using a carbohydrate-restricted diet for diabetes mellitus derives from the effect of dietary carbohydrate on increasing insulin secretion. A chart review was performed of an outpatient weight and metabolism management program utilizing a carbohydrate-restricted diet (<20 grams/day). Patients were self-referred or referred by other physicians for weight loss or risk factor management (abnormal lipids or diabetes). Patients were included if they were diagnosed with diabetes mellitus, and had at least baseline and 2-month follow-up weight measurements and laboratory values. Medical monitoring was necessary to adjust diabetic and anti-hypertensive medications. Follow-up clinic visits occurred at 1-week intervals, or more frequently if needed. Fourteen individuals (57% female) were identified. The median age was 49 years, all were Caucasian; 13 patients had type II diabetes. The median duration of follow-up was 8 months. From baseline to follow-up there was a statistically significant reduction in hemoglobin A1c, from 10.0% to 5.95 (P < 0.001). At follow-up, 7 of the 14 hemoglobin A1c readings were normalized to non-diabetic levels (<5.5%). There was a non-significant reduction of weight of 9.7% (P = 0.15); four individual patients had reductions in hemoglobin A1c despite minimal or weight loss. Among the patients with type II diabetes, there were statistically significant reductions in total cholesterol and serum triglycerides of 14.3% and 50.3%, respectively (P < 0.01). The triglyceride/HDL-C and total cholesterol/HDL-C ratios ratios also were reduced by 55.0% and 21.2%, respectively (P < 0.01). In this subgroup of compliant diabetic patients, a carbohydrate-restricted diet led to improvements in hemoglobin A1C and serum lipid parameters. These findings are consistent with those from other recent publications. We conclude that a carbohydrate-restricted diet may be useful for the treatment of diabetes mellitus.