Weight loss improves β-cell function independently of dietary carbohydrate restriction in people with type 2 diabetes:A 6-week randomized controlled trial

Autor:	Mads N. Thomsen, Mads J. Skytte, Amirsalar Samkani, Arne Astrup, Mogens Fenger, Jan Frystyk, Bolette Hartmann, Jens J. Holst, Thomas M. Larsen, Sten Madsbad, Faidon Magkos, Jens F. Rehfeld, Steen B. Haugaard, Thure Krarup
Jazyk:	angličtina
Rok vydání:	2022
Předmět:	Nutrition and Dietetics β-cell function Endocrinology Diabetes and Metabolism Faculty of Science low-grade inflammation insulin sensitivity type 2 diabetes weight loss Food Science carbohydrate restriction
Zdroj:	Thomsen, M N, Skytte, M J, Samkani, A, Astrup, A, Fenger, M, Frystyk, J, Hartmann, B, Holst, J J, Larsen, T M, Madsbad, S, Magkos, F, Rehfeld, J F, Haugaard, S B & Krarup, T 2022, ' Weight loss improves β-cell function independently of dietary carbohydrate restriction in people with type 2 diabetes : A 6-week randomized controlled trial ', Frontiers in nutrition, vol. 9, 933118 . https://doi.org/10.3389/fnut.2022.933118 Thomsen, M N, Skytte, M J, Samkani, A, Astrup, A, Fenger, M, Frystyk, J, Hartmann, B, Holst, J J, Larsen, T M, Madsbad, S, Magkos, F, Rehfeld, J F, Haugaard, S B & Krarup, T 2022, ' Weight loss improves β-cell function independently of dietary carbohydrate restriction in people with type 2 diabetes: A 6-week randomized controlled trial ', Frontiers in Nutrition, vol. 9, 933118 . https://doi.org/10.3389/fnut.2022.933118
Popis:	BackgroundCarbohydrate restriction may benefit β-cell function and glucose metabolism in type 2 diabetes (T2D) but also leads to weight loss which in itself is beneficial.MethodsIn order to determine the additional effect of carbohydrate restriction in addition to a fixed body weight loss, we randomly assigned 72 adults with T2D and obesity (mean ± SD HbA1c 7.4 ± 0.7%, BMI 33 ± 5 kg/m2) to a carbohydrate-reduced high-protein diet (CRHP; energy percent from carbohydrate/protein/fat: 30/30/40) or an isocaloric conventional diabetes diet (CD; 50/17/33) for 6 weeks. All foods were provided free of charge and total energy intake was tailored individually, so both groups lost 6% of baseline body weight.ResultsDespite significantly greater reductions in HbA1c (mean [95% CI] −1.9 [−3.5, −0.3] mmol/mol) after 6 weeks, the CRHP diet neither improved glucose tolerance, β-cell response to glucose, insulin sensitivity, during a 4-h oral glucose tolerance test, nor basal proinsulin secretion when compared to the CD diet, but increased C-peptide concentration and insulin secretion rate (area under the curve [AUC] and peak) significantly more (~10%, P ≤ 0.03 for all). Furthermore, compared with the CD diet, the CRHP diet borderline increased basal glucagon concentration (16 [−0.1, 34]%, P = 0.05), but decreased glucagon net AUC (−2.0 [−3.4, −0.6] mmol/L ×240 min, P < 0.01), decreased basal triglyceride and total AUC (~20%, P < 0.01 for both), and increased gastric inhibitory polypeptide total AUC (14%, P = 0.01).ConclusionA moderately carbohydrate-restricted diet for 6 weeks decreased HbA1c but did not improve β-cell function or glucose tolerance beyond the effects of weight loss when compared with a conventional diabetes diet in people with T2D.Clinical trials registrationwww.Clinicaltrials.gov, Identifier: NCT02472951.
Databáze:	OpenAIRE
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