BREAKING!
Johns Hopkinsin tutkijat tutkivat tiukan hiilarirajoituksen (max 20 g/d kolmen kuukauden ajan) vaikutuksia tyypin 2 diabeetikoilla. Tutkimuksen LCHF oli siis ketodieetti.
Tulokset olivat loistavia. HbA1C putosi tutkimusryhmässä keskimäärin 1,29 prosenttiyksikköä ja paino 12,8 kiloa. Kaikki alkutilanteessa insuliinia käyttäneet saattoivat pienentää annosta tai vapautuivat insuliinista kokonaan.
Effects of the Low Carbohydrate, High Fat Diet on Glycemic Control and Body Weight in Patients With Type 2 Diabetes: Experience From a Community-Based CohortLainaa:
Results:
Compared with the usual care group, the LCHF group showed a significantly greater reduction in A1C (-1.29% (95% CI -1.75 to -0.82; p<0.001)) and body weight (-12.8 kg (95% CI -14.7 to -10.8; p<0.001) at the end of follow-up after adjusting for age, sex, baseline A1C, BMI, baseline insulin dose. Of the patients initially taking insulin therapy in the LCHF group, 100% discontinued it or had a reduction in dose, compared with 23.1% in the usual care group (p<0.001). The LCHF group also had significantly greater reduction in fasting plasma glucose (-43.5 vs -8.5 mg/mL; p=0.03) compared with usual care.
Conclusions:
In a community-based cohort of type 2 diabetes, the LCHF diet was associated with superior A1C reduction, greater weight loss and significantly more patients discontinuing or reducing antihyperglycemic therapies suggesting that the LCHF diet may be a metabolically favorable option in the dietary management of type 2 diabetes.
KOKO TEKSTIHyvin siis toimi LCHF/keto tässäkin tutkimuksessa. Ei ollut valittamista tuloksissa niiden sydäntaudin riskitekijöidenkään osalta.
Lainaa:
Although studies of the long- term cardiovascular
outcomes of the LCHF diet are lacking, there is evidence
that key biomarkers of cardiovascular disease are
improved, including serum triglycerides and HDL- C,
which often correlate with improved hyperglycemia. We
saw a non- significant reduction in triglycerides. Values for
HDL- C either increased or remained stable in previous
heterogeneous studies of the LCHF diet. We
found no significant changes in HDL in either group,
but note that both groups had initial HDL values in the
normal range. We also found no significant changes
in LDL levels in either group, consistent with previous
studies. Two previous studies associated
LCHF diets with the more favorable distribution of
LDL particles (more non- atherogenic, large LDL parti-
cles25 27), although we did not measure this parameter.
While controversial, some studies suggest patients who
take insulin may have a dose- dependent increased risk
of cardiovascular events.36–39 The possible increased
cardiovascular morbidity may be related to weight gain
and hypoglycemic events, which can accompany the use
of sulfonylurea drugs and insulin particularly at higher
doses. Highlighting the potential beneficial impact of the
LCHF diet, in which sulfonylureas were routinely discon-
tinued and insulin doses were initially reduced, and many
of our patients in the LCHF group were able to further
reduce or eliminate insulin.
Tutkimuksen arvoa nostaa se, että se toteutettiin "oikeassa elämässä", diabetesvastaanotolla.
Lainaa:
What are the new findings?
► To our knowledge, this is the first study to date that investigates the implementation of the low carbohydrate, high fat (LCHF) diet in a community- based setting, making the results generalizable and applicable to the clinical practitioner.
► Our study shows that it is feasible and safe to implement the LCHF diet in a ‘real- world’ community practice setting among patients with type 2 diabetes, and that this diet may offer superior glycemic reduction, along with greater weight loss, compared with usual care over 3 months.
► All patients following the LCHF diet who initially took insulin had either a reduction or discontinuation of this therapy by their healthcare provider when clinically indicated, compared with less than a quarter of those receiving usual care.
Loistavien hoitotulosten saavuttamiseksi ei siis tarvita sellaisia hienoja systeemejä kuin mitä Virralla on.
Lainaa:
Our study adds to growing evidence that supports the LCHF diet in the treatment of type 2 diabetes and further demonstrates its effectiveness in real-world settings. Our results are consistent with prior studies of LCHF diets (defined as 5%–10% carbohydrates), reporting a significant reduction in A1C of >1% over a period of 12 weeks to 1 year. In particular, our results are most comparable to the Virta Health study,23 a remotely monitored intervention that implements the LCHF diet in patients with type 2 diabetes. At 1 year, the LCHF group showed a significant difference in A1C (−1.5%±0.2% (p<0.05)), comparable to similar results in our study over ≥3 months. LCHF patients in the Virta Health study also reduced or discontinued insulin and most other glucose-lowering medications, and consequently reduced the mean annual cost of medications per person by 46% over the first year on the LCHF diet. We found a similar reduction in glucose-lowering medications, supporting the hypothesis that the LCHF diet has the potential to improving patient outcomes and reduce costs. Americans spend about US$106 billion per year on diabetes prescription medications and supplies alone; this and other factors including the rising cost of insulin and its accessibility can directly impact daily care for patients with diabetes.28 Patients in our study had clinic visits covered by insurance. By contrast, virtual or remote LCHF programme cost each patient thousands of dollars, if not covered by their insurance29 and may be financially unfeasible for many patients. Thus, our study demonstrates the feasibility of implementing the LCHF diet in a community-based practice as part of an ongoing dietary treatment plan for the management of type 2 diabetes.
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