Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes.

Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. G Boden, K Sargrad, C Homko et al. Annals of Internal Medicine, March 15, 2005, 142:6, pages 403-411.
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To determine the effects of a strict low-carb diet on body weight, body water, E intake and expenditure, glycemic control, insulin sensitivity, and lipid levels in obese individuals with T2D.
22 days (usual diet 7 days followed by low-carb diet 14 days)
"All food was provided Targets: E: 2164kcal/d Carb: ~21g/d; 3.9%E Protein: none Fat: none Intake E: 2164kcal/d Carb: 21g/d; 3.9%E Protein: 151g/d Fat: 164g/d; 68.2%"
"Targets: none set; usual diet. Reported intake: E: 3111kcal Carb: 309g/d Protein: 137g/d Fat: 154g/d"
"Primary: weight, body, water E intake and expenditure, HbA1c, insulin sensitivity, FBG, insulin Secondary: and composition, diet satisfaction, BPHB, leptin, and ghrelin (hourly measures) "
Weight loss was due to deficit in E intake. 24-hr glucose profile normalized; HbA1c, insulin sensitivity, TG and total cholesterol levels improved.
"WG: NR BG: Y Glucose infusion to maintain euglycemia increased 30%"
Dosages for several medications decreased in several patients.
"Blood urea N SS increased 5.85→7.14mg/dL Serum and urinary creatinine, uric acid, urinary albumin excretion: NSS change "
"Diet satisfaction: questionnaire responses indicated low-carb and usual diet about equal in terms of hunger, E level, satisfaction, comfort. Renal function: blood urea nitrogen: SS increase. Serum and urinary creatinine, serum uric acid, urinary albumin: all NSS. Leptin: SS lower at end of low-carb diet. Ghrelin marginally lower."
"In a small group of obese patients with T2D, a low-carbohydrate diet followed for two weeks resulted in spontaneous reduction in E intake to a level appropriate to their height; weight loss was completely accounted for by reduced caloric intake; much improved 24hr blood glucose profiles, insulin sensitivity, and HbA1c, and decreased TG and C levels. The long-term effects of this diet, however, remain uncertain."


AHA - American Heart Association;
ALT - alanine aminotransferase;
AMDR - acceptable macronutrient distribution range;
AST - aspartate aminotransferase;
BG - between study groups;
BHOB - beta-hydroxybutyrate;
DBP - diastolic blood pressure;
E- energy, caloric intake;
eGFR - estimated glomerular filtration rate;
FBG - fasting blood glucose;
GGT - gamma-glutamyl transferase;
HDL-C - high-density lipoprotein cholesterol;
iGFR - isotope glomerurar filtration rate;
LDL-C - low-density lipoprotein cholesterol;
NAFLD - non-alcoholic fatty liver disease;
NR - not reported (or data needed for calculation not available);
N - no;
NA - not applicable;
NS - not specified;
NSS - not statistically significant;
SBP - systolic blood pressure;
SS - statistically significant;
TG - triglyceride;
total C - total cholesterol;
V - varied, mixed;
WG - within a study group;
WMD - weighted mean difference;
Y - yes

Number of People in Studies:

3,296 Enrolled in randomized controlled trials on 25% or less carbohydrates
2,626 Completed randomized controlled trials on 25% or less carbohydrates
79.67% 82% completion of studies

Duration of Trial

<6 Months
6-9 Months
1 -2 years
>2 years

# of Trials


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