A Randomized Pilot Trial of a Moderate Carbohydrate Diet Compared to a Very Low Carbohydrate Diet in Overweight or Obese Individuals with Type 2 Diabetes Mellitus or Prediabetes

Study answer

What this study found

HbA1c decreased by 0.6 percentage points with LCK vs 0.0 in MCCR at 3 months (between-group difference -0.6%; 95% CI -1.1 to -0.03; p=0.04). 44% of LCK participants discontinued at least one diabetes medication vs 11% in MCCR (p=0.03); 31% vs 5% discontinued sulfonylureas (p=0.05). Weight loss tended to be greater with LCK (-5.5 kg) than MCCR (-2.6 kg; p=0.09). All LCK participants who completed 3 months had HbA1c reductions; results suggest that a very-low-carbohydrate diet with behavioral skills may improve glycemic control while reducing diabetes medications in overweight/obese adults…

Study & population

Single-site, parallel-group randomized pilot trial at UCSF, San Francisco, CA.

Intervention

MCCR: Moderate-carbohydrate, low-fat, calorie-restricted diet with carbohydrate counting: 45-50% of calories from carbohydrate; about 165 g/day; carbohydrate counting using 15 g units; 3 meals and 2 snacks per day; carbohydrate units per meal: 3 and per snack: 1; energy deficit ~500 kcal/day; protein kept constant;…

Key limitation

Small, single-site, unblinded pilot trial (n=34) over 3 months; includes adults with type 2 diabetes and prediabetes; some baseline differences (e.g., age and sex distribution) and data missing; not generalizable to insulin-treated individuals; short duration with limited follow-up.

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Original abstract