Three-graded stratification of carbohydrate restriction by level of baseline hemoglobin A1c for type 2 diabetes patients with a moderate low-carbohydrate diet

摘要

Background A moderate low-carbohydrate diet has been receiving attention in the dietary management of type 2 diabetes (T2DM). A fundamental issue has still to be addressed; how much carbohydrate delta-reduction (Δcarbohydrate) from baseline would be necessary to achieve a certain decrease in hemoglobin A1c (HbA1c) levels. Objective We investigated the effects of three-graded stratification of carbohydrate restriction by patient baseline HbA1c levels on glycemic control and effects of Δcarbohydrate on decreases in HbA1c levels (ΔHbA1c) in each group. Research design and methods We treated 122 outpatients with T2DM by three-graded carbohydrate restriction according to baseline HbA1c levels (≤?7.4% for Group 1, 7.5%-8.9% for Group 2 and?≥?9.0% for Group 3) and assessed their HbA1c levels, doses of anti-diabetic drugs and macronutrient intakes over 6 months. Results At baseline, the mean HbA1c level and carbohydrate intake were 6.9?±?0.4% and 252?±?59 g/day for Group 1 (n?=?55), 8.1?±?0.4% and 282?±?85 g/day for Group 2 (n?=?41) and 10.6?±?1.4% and 309?±?88 g/day for Group 3 (n?=?26). Following three-graded carbohydrate restriction for 6 months significantly decreased mean carbohydrate intake (g/day) and HbA1c levels for all patients, from 274?±?78 to 168?±?52 g and from 8.1?±?1.6 to 7.1?±?0.9% (n?=?122, P?